What’s the Difference Between Medi-Cal and Medicare?
Medicare is a health insurance for people over 65. If you worked for over 10 years, you get part A for free (hospitals). You have to buy part B (doctors), and part D (drugs). It doesn’t pay for nursing home or long-term care facility.
Medi-Cal is a California state health insurance for low income individuals. It covers for all medical needs, including hospitals, doctors, drugs, and nursing home.
Should I plan for Medi-Cal if I already have Medicare?
Medicare does not cover extended long-term care facility or nursing home.
Medi-Cal, however, will pay for all long-term care costs if you qualify for benefits. By planning for Medi-Cal in advance, you will raise your chances of qualifying for Medi-Cal when needed.
Though most people think they are relatively healthy, the probability that you will end up in a nursing home at some point is very high. For people over age 65, the odds are about 40%, and by age 80 the odds increases to 75% that you will need long-term care. The average stay in a long-term care facility is about 2.5 years, and the average costs for long-term care is about $10,000 a month. This means you may use up all of your savings to pay for long-term care.
Medi-Cal Planning involves developing a plan to reallocate your assets in such a way that Medi-Cal will not take them into consideration when determining your eligibility. If nursing home care is needed in the future, you can have Medi-Cal pay for the cost of care, instead of using up your own resources.
How can I qualify for Medi-Cal?
To qualify for California’s Medi-Cal program, you need to keep your countable assets below a certain limit — $2,000 for a single person and $3,000 for married couples. Excess assets will need to be spent before you can qualify for Medi-Cal benefits.
Medi-Cal has a five year “look-back” period to prevent people from trying to transfer assets prior to applying. This means that if you give away your assets, Medi-Cal has a formula to calculate the waiting period before they will start paying for your medical costs.
The right solution is Medi-Cal planning. By using legal strategies and techniques, you can protect your assets and ensure Medi-Cal eligibility for much needed benefits in the future.
