Many adult children experience a role reversal with their parents as their parents age. If you are going through this phenomenon with your parents, you are likely starting to worry about the rising cost of healthcare for seniors. As your parents get older, their healthcare costs will undoubtedly increase. If one (or both) of them needs long-term care at some point, the cost of that care could easily exceed $100,000 per year. To ensure that your parents can afford that care if it is needed, the Los Angeles Medi-Cal planning attorneys at Collins Law Firm encourage you to determine if your parents will qualify for Medi-Cal.
Medi-Cal Eligibility for Seniors
A senior may qualify for Medi-Cal for the aged, blind, or disabled several different ways. First, the applicant must be over 65, blind or disabled as well as meet the residency requirements. There is also an income and asset test that applies. In California, a senior might qualify for Medi-Cal under any of the following categories of eligibility:
- SSI eligibility: If you qualify for Supplemental Security Income (SSI), then you automatically qualify for full Medi-Cal coverage. SSI (Supplemental Security Income) is a program funded by the state and federal governments which provides cash assistance on a monthly basis. Eligibility criteria include being elderly, blind, disabled, or a person whose income is low and assets are limited. For 2018, the income limit for an individual is just $910.72 per month and for a couple, it is $1,532.14. In addition, an individual may not have more than $2,000 worth of non-exempt assets and a married couple not more than $3,000.
- Aged and Disabled Federal Poverty Level Program (A&DFPLP): A&DFPLP program was reinstated in 2001 by the State of California in order to provide Medi-Cal coverage to elderly and disabled persons who meet SSI’s resource limits, but have a higher income than SSI limits. For 2018, the income limits are $1,242 per month for a single person and $1,682 per month for a married couple. The same asset limits for SSI apply for this program.
- Medi-Cal Share of Cost (SOC): If you meet the asset requirements for the SSI or A&DFPLP Medi-Cal programs, but your income is too high, you might qualify for the Share of Cost Medi-Cal program. SOC functions like a deductible. You must pay this amount in any month you incur medical costs. After your SOC is paid, Medi-Cal will pay the remaining amount of your medical bills for that month. For 2018, your SOC amount is determined by subtracting $600 (for an individual) or $934 (for a couple) from your monthly income, and any other health-insurance premiums you may be paying. What is left is your SOC for the month. For example, if you are single and your income for the month is $1,600, your SOC would be $1,000. Medi-Cal would start helping pay for medical bills for the month in excess of $1,000.
Medi-Cal Long-Term Care Eligibility
In addition to basic Medi-Cal that covers general healthcare expenses, Medi-Cal also has a long-term care program for individuals who require the type of care only available in a nursing home type facility. To qualify for the Medi-Cal long-term care program the following requirements apply:
- Care test – you must qualify to live longer than thirty days at the skilled nursing level of care as determined by your ability to perform daily tasks of living.
- Income — patients pay a share of cost based on an income after deduction for health insurance premiums and other expenses. You also receive a $35 personal needs allowance each month that is not factored into the share of cost formula.
- Assets — countable assets must be no higher than $2,000 for an individual applicant. If you are married with a spouse remaining at home, referred to as a “community spouse,” countable assets can reach $123,600. The rules for income and assets are complex when a community spouse is part of the equation so be sure you discuss your specific circumstances with an experienced Medi-Cal planning attorney.
Contact a Los Angeles Estate Planning Attorney
For more information, please join us for an upcoming FREE seminar. If you have additional questions about qualifying for Medi-Cal, contact an experienced Los Angeles Estate Planning attorney. Contact the Collins Law Group by calling (310) 677-9787 to register for one of our FREE estate planning workshops.