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NEW MEDI-CAL RULES YOU NEED TO READ

California recently changed the asset limits (not the same as Medi-Cal income limits) to qualify for Medi-Cal – California’s Medicaid program. In the past, a single person who had more than $2,000 of property could not receive Medi-Cal; that asset limit has been raised to $130,000 for senior citizens, people with disabilities, and a few other special groups.

What is Medi-Cal?

Medi-Cal is a combined federal and California State program designed to help pay for medical care for public assistance recipients and other low-income persons. Although Medi-Cal recipients may receive Medicare, the Medi-Cal program is not related to the Medicare program. Medi-Cal is a need- based program and is funded jointly with state and federal Medicaid funds.

SSI and other categorically-related recipients are automatically eligible. Others, whose income would make them ineligible for public benefits, may also qualify as “medically needy” if their income and resources are within the Medi-Cal limits (current resource limit is $130,000 for a single individual). This includes:

  • Low-income persons who are 65 or over, blind or disabled may qualify for the Aged and Disabled Federal Poverty Level Program
  • Low-income persons with dependent children
  • Children under 21
  • Pregnant women
  • Medically indigent adults in skilled nursing or intermediate care or those who qualify for Medi-Cal funded home and community-based waiver programs.

The following property is generally exempt and therefore not counted in determining Long Term Care Medi-Cal eligibility:

  • The home: totally excluded, if it is the principal residence. The applicant must state an “intent to return to the home.” Includes mobile home, houseboat, or an entire multi-unit dwelling as long as any portion serves as the principal residence of the applicant.
  • Other real property: may be excluded if it is used in whole or in part as a business or means of self-support (you should see an attorney if you have other real property).
  • Household goods and personal effects: totally exempt.
  • Jewelry: for a single person, wedding, engagement rings and heirlooms, and items of jewelry with a net market value of $100 or less are totally exempt; for spouses, there is no limit on exempt jewelry for determining the institutionalized spouse’s eligibility.
  • One car is generally exempt if used for the benefit of the applicant or if needed for medical reasons.
  • Whole life insurance policies with a total face value (also called “combined death benefit”) of $1,500 or less.
  • Term life insurance: Totally excluded.
  • Burial plots: totally excluded, includes headstone, crypts, etc.
  • Prepaid irrevocable burial plan of any amount and $1,500 in designated burial funds. These designated funds must be kept separate from all other accounts.
  • IRAs and work-related pensions: if in applicant’s name, the balance of the IRA or the pension is considered unavailable if the applicant is receiving periodic payments of interest and principal. If in the spouse’s name, the balance of the IRA or pension is totally exempt.
  • Non-work related annuities: the balance of certain types of annuities may be exempt (see CANHR’s fact sheet, “Medi-Cal for Long Term Care” for more information.) You should see an attorney if you are considering buying an annuity – call CANHR for a referral.
  • As of 7/1/2022, the state raised the Medi-Cal asset limit for an individual to $130,000, and $65,000 for each additional family member.
  • Community Spouse Resource Allowance (CSRA) for 2022: the spouse at home can keep the first $137,400 in assets, and may be able to keep more if his/her income is below the Minimum Monthly Maintenance Needs Allowance (MMMNA).

If you have any questions about MEDI-CAL or planning for incapacity, please reach out to our office. We’re here to help you! Call us: 714-451-5766

Information came from: http://www.canhr.org/factsheets/medi-cal_fs/html/fs_medcal_overview.htm

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