As the cost of nursing homes continues to rise, it becomes increasingly difficult for many families to provide their loved ones with the nursing home care they need. In many cases, paying out of pocket can exceed $7,000 per month, which makes it nearly impossible for most families to keep up with expenses for an extended time. One effective solution to fully or partially cover these costs is the California Medical Assistance Program or Medi-Cal.
What is Medi-Cal?
According to the California Department of Health Services (DHCS), Medi-Cal is “a public health insurance program which provides needed health care services for low-income individuals including families with children, seniors, persons with disabilities, foster care, pregnant women, and low income individuals with specific diseases such as tuberculosis, breast cancer or HIV/AIDS.”
How it Works
While it covers many demographics and a variety of medical needs, it can work perfectly for elderly individuals and their families who simply cannot afford to pay for nursing home care out of pocket. Unlike Medicare, which will only pay for a maximum of 100 days (and only an average of 20 days), Medi-Cal covers care for an extended period of time. This program is meant for the long haul for senior citizens needing ongoing care.
Covering Expenses
In some cases, Medi-Cal will pay 100% of nursing home expenses. This can obviously make a world of difference and ensures that the elderly receive the care they need without putting financial stress on their loved ones. Other times, families will be required to make partial “share of cost” payments. However, even with a high share of cost, the money paid out of pocket pales in comparison to what it would cost for private care.
Eligibility Requirements
It can be complicated to determine who is or isn’t eligible for Medi-Cal. Some people who think they are exempt end up not applying, while in reality they may actually qualify. In terms of annual earnings, the DHCS states that families’ incomes up to 138% of the federal poverty level may qualify. This breaks down as follows:
| Family Size | 138% of Federal Poverty Level |
| 1 | $16,105 |
| 2 | $21,708 |
| 3 | $27,311 |
| 4 | $32,913 |
| 5 | $38,516 |
| 6 | $44,119 |
| 7 | $49,722 |
| 8 | $55,325 |
Individuals who are 65 or older, disabled, blind, or in a skilled nursing or intermediate care home may also qualify.
Learning if You’re Eligible
If you think there’s a possibility that you or your loved ones qualify, it’s important to do further research and fully educate yourself. You may also want to contact an attorney or legal expert for further guidance. They can take your unique situation into consideration and fill you in on the details concerning eligibility. Otherwise, you may be missing out on a golden opportunity.
Medi-Cal is an excellent way to provide nursing care for the elderly and eliminate or at least reduce the financial burden on family Members. While it won’t necessarily cover all expenses, it can still be a huge help and ensure that seniors get the professional care they need.
Sanford M. Fisch
CEO & Co-Founder
American Academy of Estate Planning Attorneys, Inc.
9444 Balboa Avenue, Suite 300
San Diego, California 92123
Phone: (800) 846-1555
www.aaepa.com
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