For those who need around-the-clock skilled nursing care, residence in a nursing home may become the only option. And as one would expect, long-term skilled nursing care is expensive. Any coverage by Medicare or private insurance is only temporary – generally a maximum of 100 days. However, Medi-Cal (Medicaid in other states) may help alleviate this financial burden and allow you to preserve assets for spouses, children and future generations.
Our attorneys’ specialized understanding of federal, state and local implementation of the Medi-Cal program can help you avoid depleting your net worth. We pursue all available strategies to achieve your asset preservation goals, including gift planning, conversion between exempt and countable assets, prioritization of expenses, increasing spousal resource allowances, and other estate planning instruments and techniques.
Exempt vs. Countable Resources
Becoming eligible for Medi-Cal benefits may be a part of your asset preservation plan. Our customized step-by-step plan will ensure that you become eligible and approved for Medi-Cal benefits, in a way that is entirely transparent with the Medi-Cal office. We work closely with the assigned Medi-Cal eligibility worker to provide Medi-Cal with all of the information needed to properly and efficiently process your application.
Our entire staff is specially trained in every step of the Medi-Cal application process. We are dedicated to providing a cost-effective and accelerated approval of benefits for you and your family.
Asset & Income Changes
Medi-Cal eligibility is an ongoing requirement as long as a person wishes to receive benefits. Medi-Cal requires annual redetermination applications and have strict reporting requirements for any changes in income or assets.
We assist with all aspects of the annual redetermination to ensure maintenance of coverage. We monitor any notices or payments from Medi-Cal to confirm that correct share-of-cost amounts are being assessed to the Medi-Cal recipient, and we pursue to remedy any reduction in benefits. We work to preserve existing income streams and fine-tune estate plans as needed to ensure the maximum protection of your desired assets.
Appeals & Fair Hearings
Eligibility workers do make mistakes and newer workers often lack knowledge of how Medi-Cal regulations are actually implemented. Usually, these issues are resolved through communication with the appropriate staff. Sometimes, although rarely, the only recourse is to file a formal appeal or request for fair hearing with the Department of Healthcare Services.
In those situations, we will act as your advocate through the entire appeal process, either with appeals officers or in front of administrative law judges during fair hearings.
Medi-Cal Estate Recovery
Successfully becoming a Medi-Cal recipient is only one part of a comprehensive asset preservation plan. Once the recipient passes away, Medi-Cal will then attempt to recover its contributions from the person’s estate. Planning to avoid such recovery is as important as obtaining eligibility. A sophisticated plan at the outset may become entirely worthless if the “preserved” assets have to be ultimately surrendered to the State.
Our plans always consider the possibility or extent of Medi-Cal recovery or other potential claims against your estate. Proactive planning can limit or avoid Medi-Cal recovery altogether – to preserve your estate for your intended beneficiaries, not the State or creditors.
Elder Law Litigation
Increased CSRAs and Support
As a Medi-Cal applicant or recipient, nursing homes may be less willing to accommodate for your care. We work with local Ombudsmen and oversight authorities to ensure that our clients are treated fairly by their facilities, and in extreme cases we may need to defend your rights in court.
Court proceedings may also be necessary when one spouse becomes incapacitated suddenly and unexpectedly. In these situations, families are often left with exorbitant medical bills without any prior planning to preserve the family’s assets. Our attorneys have successfully petitioned the court for relief in these situations, including orders allowing for accelerated Medi-Cal eligibility, allocating income to the healthy spouse to eliminate any share of cost owed, and transferring exempt assets to prevent future Medi-Cal recovery. Our firm’s expertise in family law and interspousal transfers provide added value of services to our clients.