Friday, July 6, 2018

The Truth Behind the Medi-Cal “Spend-Down”

Will I need to spend down my savings before I can qualify for Medicaid?

Medicaid is a joint federal and state program which offers long term care for seniors. In the state of California, Medicaid is referred to as Medi-Cal. With rising healthcare and nursing home costs, more and more Americans rely on Medicaid to cover their long term care needs. In fact, it is estimated that over 70 percent of the 1.3 million Americans who live in nursing homes use Medicaid to cover the approximately $83,000 in costs per year, according to the U.

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Thursday, December 21, 2017

Your Role as a Health Care Agent

How can I make the best medical decisions possible for someone else?

Health care agents or surrogates hold a critically important role.  A health care agent is someone vested with the power to make medical decisions either through a power of attorney or state law.  If you have been designated as a loved one’s health care agent, it will be important for you to research the role so that you are prepared if and when your loved one becomes incapacitated.  Our Orange County
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Thursday, March 16, 2017

California Law Now Limits Medi-Cal Estate Recovery

What steps can I take to protect myself from a Medi-Cal lien?

Governor Jerry Brown approved legislation last year that limits California’s estate recovery from low income recipients of Medi-Cal.  The new law took effect on January1st of this year, and it considerably limits the power of the state of California to recover from individuals who receive state medical assistance during their lifetime.  As of this year, claims filed by the California Medi-Cal Estate Recovery Program will not exceed the minimum requirements set under federal law.  

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Sunday, July 31, 2016

California Budget Limits Medi-Cal’s Ability to Seize Estates

When you die, you probably hope to pass on whatever assets you have left to your family and friends. But did you know that the State of California might end up seizing your estate depending on what sort of healthcare benefits you received from the government before you died?

Many people enrolled in the state’s Medi-Cal program do not realize that without a proper estate plan in place, they may end up leaving nothing to their family and friends because the state will take and sell off all their possessions to pay itself back for money it spent on healthcare costs.

Fortunately, starting January 1, a new provision included in the recent state budget will limit the ability of the state to seize estates.

Read more . . .

Monday, June 1, 2015

5 Common Estate Planning Myths in California

I hear a lot of different information about the consequences of making a mistake in an estate plan. How can I separate fact from fiction? 

Estate planning is, of course, an important consideration for every family, regardless of size or financial situation. However, there are a number of myths out there, many of which are designed to coax folks into purchasing costly plans or unnecessary trusts on the promise of tax avoidance and the like. The following explores five common myths circulating the estate planning industry, followed by helpful suggestions to avoid being duped or misguided. 

Myth #5: Everyone needs a revocable trust: A revocable trust is an estate planning tool that requires testators (known as “grantors” or “settlors”) to retitle their property into the name of the trust, which will then be distributed according to the terms of the trust agreement. This tool is handy for probate avoidance, but will not necessarily save on estate taxes or other assessments if not properly drafted. Likewise, a revocable trust may not be necessary for everyone, as it can be costly to set up and maintain. 

Myth #4: A trust avoids estate tax: Only a very small fraction of estates in the U.S. are subject to the estate tax. To avoid paying estate tax, an elaborate and complex network of trusts, gifting, asset transfers, and charitable bequests is necessary – and begins long before the testators reach their final years. In sum, a simple trust will generally not avoid estate tax, and most individuals need not worry about this issue in the first place.

Myth #3: Probate is to be avoided at all costs: Many will have you believe that enduring the probate process will be an intolerable experience fraught with delay, expense and unnecessary court procedures. While true that probate proceedings can be inconvenient, executing an elaborate and expensive estate plan to avoid the process may be unnecessary for some, particularly those with a small estate. 

Myth #2: Transferring assets to my children will qualify me for Medicaid: This myth may be partially true, provided the transfers occurred long ago and fall outside the five-year look-back period. By contrast, transferring property to children immediately prior to applying for Medicaid will trigger a lengthy penalty period, and you may be better off selling the assets for value in order to pay for medical expenses prior to reaching eligibility.

Myth #1: I can download my will from the Internet: At first blush, downloading a will template from the Internet may seem like a cost-effective exercise, particularly if your estate is relatively straightforward. However, this can also invite disaster, particularly if the will form is not drafted with California formalities in mind.

Contact a reputable Orange County estate planning attorney today


OC Wills & Trust Attorneys have more than 20 years of experience guiding clients in their estate planning journey. Contact our Orange County, California office today by calling (949)347-5256.

Friday, May 8, 2015

Using Annuities in Planning for Long-Term Care

I am approaching retirement and still in great health. What are some long-term care planning options aside from a long-term care insurance policy? 

For those who are considering their options in long-term care planning, one of most pivotal issues to consider is eventual eligibility for Medicaid. Unlike Medicare, Medicaid is the only government health insurance program that provides full coverage for the staggering costs of residing in a nursing home.  But, only those meeting certain income and asset requirements will qualify. What’s more, for married couples – with only one spouse needing care – using one’s savings to pay for long-term care can render the community spouse nearly destitute.
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Thursday, April 30, 2015

Medicaid/Medi-Cal Eligibility and Asset Protection

Can an Estate Planning Attorney Help You Protect Your Family’s Assets via Medi-Cal planning?

The federal Medicaid program, along with several California state programs, comprise Medi-Cal, which provides funds for medical and nursing home care for almost one-third of Californians annually. Just several years ago, Medi-Cal served over 9 million state residents. Now, following the state’s adoption of the federal healthcare overhaul, Medi-Cal covers 12 million Californians and costs approximately $95 billion annually.
Read more . . .

Friday, January 16, 2015

Concerns When Applying for Medi-Cal

Can I Apply for Medi-Cal?

Open enrollment for Medi-Cal (California’s version of Medicaid) is open through the spring.  During the first month of enrollment 216,423 state residents signed up for Medi-Cal. The program is designed to help those with low income (having less than $2,000 in liquid assets), elderly and disabled individuals pay for health care, including long term care.
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Wednesday, October 8, 2014

Asset Protection for Medi-Cal Enrollees Staying the Same For Now

Many Americans rely on the government to pay for their very expensive long term care costs.  The Federal and state governments usually work together to assist those in need through their respective Medicaid programs.  In California, these benefits are managed by Medi-Cal, which is a means tested program.  Only those that fall below a certain financial level qualify for these benefits in the state.

Even for those who are eligible, chances are that when the money becomes available they will be pursued.  If a Medi-Cal enrollee passes away, the state can take steps to collect the money they spent on that persons care from their estate or surviving spouse.  Right now, the only protection for the surviving spouse of a Medi-Cal enrollee is an exception that exists if collecting the money would cause the spouse substantial hardship. 

There has been a push in the California legislature to reform the Medi-Cal recovery rules.  Senate Bill 1124, proposed by Senator Ed Hernandez, was introduced but eventually rejected.  This bill would have revised the Medi-Cal recovery rules to allow only Federally required actions to collect expenditures.  It would have limited recovery to cases where the recipient used the benefits to cover nursing home care and disallowed recovery in cases of expenditures for necessary medical treatment.  The bill would have also barred recovery from surviving spouses’ estates.  In essence, the legislation would have made it much more difficult for the state to collect the money they laid out to Medi-Cal recipients.  Recently, the bill was vetoed by Governor Jerry Brown.  While he expressed that reform might be necessary in this area a better solution is needed.  As the state does not collect anywhere near what it expends on Medi-Cal benefits, the Governor reiterated that reform must be made with this is mind.  

If you or a loved one are having trouble paying for long term care or are interested in planning to avoid this hardship, speaking with an experienced Medi-Cal planning attorney is in your best interest.  Eligibility for Medi-Cal benefits can be difficult to understand and you should rely on a trusted advisor to explain all of the options to you.  Call Orange County, CA attorney Brian Chew at (949)347-5256 for a consultation today.

Thursday, February 28, 2013

Government Lookback Periods Are Changing - Don't Wait to Act

Despite the fact that you planned ahead, you find yourself in need of help paying for long term care.  The options are limited, but may include Medicaid or Veterans Benefits of Aid & Attendance Pension.  For eligibility purposes, the government will determine whether you qualify for the benefit based on the amount of assets and income in your estate.  Also, they may look at whether you have transferred assets out of your estate in order to qualify.


General Info - In California our version of Medicaid is called Medi-Cal, which is a government health program for certain people and families with low incomes and limited resources.  It is a means tested program and is jointly funded by state and federal governments and managed by the state.  As each state moves towards the federal norm, changes will come to Medi-Cal.

Assets and Transfers - If a Medi-Cal applicant’s property and assets are over the Medi-Cal property limit, the applicant will not be eligible for Medi-Cal unless they lower their property and asset levels.  But Medi-Cal will also consider the nature and amount of assets transferred out of a person’s estate.  The term transfer means an outright gift or a sale made at less than fair market value.  If such a transfer of property is made, Medi-Cal may calculate the period of ineligibility for nursing facility level of care.  

Look Back Period - The current look back period for asset transfers for Medi-Cal is 30 months.  However, the Deficit Reduction Act of 2005 changed the look back period to 5 years, which will soon be implemented in California.

Penalty – The length of the ineligibility period is based on the net fair market value of transferred property which would have resulted in excess property, had an application for Medi-Cal been submitted at the time of the transfer and the property retained by the Medi-Cal applicant.  The amount of excess property is divided by the monthly average of private nursing facility cost by County.


General Info – The Aid and Attendance pension is a benefit paid by Veterans Affairs to qualified veterans, veteran spouses and surviving spouses to help pay for long term care.  It is a non-service connected disability benefit, to aid a qualified person who requires assistance with 2 or more Activities of Daily Living.    

Assets and Transfers – The VA looks at the amount of assets and income of a veteran and their spouses to determine eligibility.  In order to receive the maximum amount of the benefit the claimant’s unreimbursed medical expenses must exceed their income.  And the assets held by the Veteran or Spouse must be of an exempt status, such as the primary residence, car, etc.    

Look Back Period – Currently there is no look back period for the Aid and Attendance Benefit.  However this is soon going to change. Senators and the Veteran's Administration are introducing legislation intended to require a three year lookback period for applicants applying for the Aid and Attendance program.



There are a number of effective planning techniques that can be put in place to protect assets from being counted against an applicant and reducing the liability of those assets.  It is important to note that actions that are taken on behalf of someone for Veterans Benefits may impact Medi-Cal eligibility.  You will want to work with a qualified attorney who can explain the consequences of your choices and help you weigh the alternatives. 

Since Medi-Cal and the Aid and Attendance Pension are both primary sources of paying for long term care it is important to note that the look back periods are about to change and will extend the period of time for penalties.  Don’t wait to act.   

Wednesday, November 14, 2012

Medi-Cal / Medicaid Eligibility

Although Medicaid eligibility rules vary from state to state, federal minimum standards and guidelines must be observed.


Medi-Cal will pay your long term care expenses if you have less than $2,000 in liquid assets (cash & securities).  However, for most seniors, qualifying for Medi-Cal is quite complicated and we can help show you how to qualify to as quickly as possibe for this benefit.


While Medicaid eligibility with respect to long-term care was not difficult in the past, there has been a steady drift towards more complex and restrictive rules, the latest being the Deficit Reduction Act of 2005 which went into effect in 2006.  These changes have resulted in complex eligibility requirements for those in need of Medicaid benefits.  It’s no longer as easy as reviewing one’s bank statements.  There are a myriad of regulations involving look-back periods, income caps, transfer penalties and waiting periods to plan around. 
Our law firm has the experience and the expertise to help avoid the financial ruin associated with the high cost of long-term care.  Contact us today to start the process of understanding the issues surrounding Medicaid eligibility and to implement the planning and application process. 


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