Many families first come to us when they are faced with a Medi-Cal crisis. Their loved one has just been discharged from the hospital and is in a nursing home when they learn that Medicare only pays for up to 100 days of skilled nursing. On top of that, they are told that they have too many resources making them ineligible for Medi-Cal. They are told to reapply after they have spent down – exhausted – their life savings. Sadly, the $6,000 per month cost of nursing home care will rapidly deplete their savings. They aren’t always told about their options.
The first question our clients ask is how can they afford to pay for the quality care that they or their loved one needs and still protect assets for a husband, wife, or other family member without all of their hard earned savings being consumed by extremely expensive long-term care costs?
In other words, how can they get quality care for themselves without going broke or losing the house?
At Moynihan Lyons we help seniors and their families find the right answer to this vital question. As discussed in the Life Care Planning section of this website, we help our senior clients and their families find, get and pay for quality long-term care. Knowledge of how to qualify for Medi-Cal benefits often plays a central role in answering the question about how to pay for quality long-term care.
“Medicare will cover the cost of a nursing home stay.”
The truth is that Medicare only pays for up to 100 days of skilled nursing care. Once the level of care drops from skilled nursing to custodial care, Medicare stops paying. So does most private insurance. Beyond that, the patient must use other resources to pay.
If Medi-Cal pays for long-term care, the quality of care will be diminished. Federal law prohibits facilities from discriminating against residents based on the source of their payment.
Many of our clients believe that they must “spend down” their life savings to almost nothing in order to become eligible for Medi-Cal.
Additionally, they think that an automatic penalty applies to any transfers they might make during a 5 year “look back” period.
They are often shocked and relieved to find out they are wrong. It’s not their fault. The rules that apply to getting Medi-Cal to pay for long term care coverage are complicated and can be difficult to understand – particularly since California still operates under rules that have been replaced by much more stringent regulations elsewhere. However, Medi-Cal planning still requires expertise in dealing with the complicated rules regarding countable and exempt assets, asset transfers, and understanding the meaning of such terms as “spend-down and “look back.”
The good news is that right now is actually easier to qualify for Medi-Cal – called Medicaid in the rest of the country – in California than in other states.
In addition to helping our clients obtain Medi-Cal benefit to pay for long-term care, our planning helps our clients protect their house from Estate Recovery.
It is equally important to know that good planning can also protect your loved ones from losing your house or other assets to Medi-Cal estate recovery.
If you or someone you love needs help because of their age or health situation, the team at Moynihan Lyons can help you navigate the long-term care maze, qualify for Medi-Cal benefits to stop the drain on your finances that expensive long-term care causes, and protect everything you are legally entitled to protect.
While disability and retirement planning, and special needs planning can be ‘top of mind’ issues for boomers or older seniors, there are two additional essential estate planning needs that are not directly tied to the economy. These two concerns, if not addressed adequately, are responsible for a lot of family discord and discontent, not to [...]
Here’s another great tip that Jeff Lanza shared at his identity theft presentation last week.
Don’t believe caller id.
Just because the name or number on a display looks like it from a legitimate source, you could be the victim of a spoofer.
Bad guys can use “spoof cards” to make the caller id readout display any name/number they want.
Are you prepared? Have you given someone the legal authority to make medical decisions on your behalf if you are unable to do so through an Advance Directive or Healthcare Power of Attorney? Does that person know what you want AND what you don’t want? Do you have a Living Will which addresses your end-of-life [...]
Maureen just returned from the joint meeting of Northern & Southern California chapters of the National Academy of Elder Law Attorneys in San Jose. A great group of colleagues shared a wealth of valuable information. Thanks to all. In particular, thanks to Julie Fiedler of San Ramon for spearheading the efforts.