724 Oak Grove Avenue, Suite 110
Menlo Park, CA 94025

Elder Law

Elder Law

The high cost of long-term care has made planning a critically important issue for most middle class seniors and their families.  In fact, most seniors will likely require some form of long-term care. Sadly, many of them are unprepared for the significant financial burdens it places on their family’s hard-earned savings.  Financial devastation looms large for a family facing ongoing care at a rate of $10,000 or more per month.

Long-Term Care Options

While some seniors are able to afford private pay care, the cost of long-term care will wipe out savings of all but the wealthiest families in a matter of years.  Those who have planned ahead by purchasing long-term care insurance have a degree of certainty and peace of mind, knowing that they have a lesser need to rely on other sources in the future.  Unfortunately, many can’t afford the high cost of long-term care insurance or, because of age or medical condition, cannot qualify for long-term care insurance altogether.  If you do have long-term care insurance, you should be aware of what your policy covers.  Many policies have high deductibles or provide for only a short period of care in a facility.  In actuality, many who have long-term care insurance still have to resort to Medi-Cal to pay for their care.

Medi-Cal Eligibility

If long-term care cannot be paid from savings or insurance, the remaining option is Medi-Cal.  A joint federal-state program, Medi-Cal provides medical assistance to low-income individuals, including those who are 65 or older, disabled or blind. Medi-Cal is the single largest payer of nursing home bills in California and serves as the option of last resort for people who have no other way to finance their long-term care. Although eligibility rules vary from state to state, federal minimum standards and guidelines must be observed.

While Medi-Cal eligibility with respect to long-term care was less difficult in the past, there has been a steady drift towards more complex and restrictive rules, the latest being the Deficit Reduction Act of 2005 which will soon be implemented by the State of California. These changes have resulted in complex eligibility requirements for those in need of Medi-Cal benefits.  It’s no longer as easy as reviewing one’s bank statements. There are myriad regulations involving look-back periods, income caps, transfer penalties and waiting periods to plan around. Once California adopts permanent regulations implementing the DRA, the ability to transfer assets will be greatly restricted.

Our law firm has the experience and the expertise to help avoid the financial ruin associated with the high cost of long-term care.  Contact us today to start the process of understanding the issues surrounding Medi-Cal eligibility and to implement the planning and application process.

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