Medicaid is a government-sponsored health insurance program providing free or low-cost health care to low-income people. Some states have privately managed health plans that may supplement your coverage with Medi-Cal in San Bernardino. Although the eligibility rules vary slightly from state to state, some people with a low income can generally qualify. These include their taxable income and assets. Additionally, there is a spend-down period.
To qualify for Medi-Cal, an individual must have a countable income. This income is “an individual receives, legally available to them.” This income can include interest from a savings account. It can also include income from home care allowances (HCAs), which a person receives when they provide home care services. In addition, wages received from participation in WIA programs are countable income. To determine eligibility for Medi-Cal, a person must meet the income requirements of MassHealth. A person must meet the income limit based on family size and current or prior-monthly household income.
When determining your eligibility, Medicaid does not count your primary residence as an asset. However, you can gift your primary residence to your children to avoid the asset recovery rule. This way, the California Department of Health Services cannot take your primary residence if you lose it. If your spouse has the right to return, the state will not pursue you for your assets.
If approved for Medicaid, you may be required to spend down your assets. This is necessary to prevent a penalty period when non-exempt assets are transferred for less than their fair market value during the spend-down period. During this time, you can pay off debts, buy assistive devices and medical equipment, or make home modifications to age in place.
This spend-down period is meant to help you reduce your income, but it can be a complex process. You must meet a certain income level before you can receive Medicaid benefits. This spending limit applies to you and each member of your household, and it’s calculated in months. If you miss the spend-down period for five months, you could end up paying for nursing home care.
The spending period for Medi-Cal can last up to 30 months. However, some actions may be forbidden under Medi-Cal rules. For example, you may not be able to sell your house or put it up for sale during this time. Fortunately, there are ways to avoid Medi-Cal spend-down rules by planning. The Northern California Center for Estate Planning and Elder Law can help you with your Medi-Cal planning.