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....... MEDI-CAL FAQs
For Long Term Care: Advanced


life saver cartoonAdvanced
21. What are main reasons that eligibility is denied?
When applicant is over Property Resource Limits, or has performed asset transfers that incur significant time penalties, or is living at a non Medi-Cal long term care residence level, or when applicant does not meet a county worker's request and therefore has failed to verify information on the application with supplemental documentation.

22. What is In Kind Income and how is counted?
When the family helps out financially to support a Medi-Cal beneficiary for food, rent and/or utilities, this help is called in-kind income. Any in-kind income over the allowable annual published government budget would be counted as extra income and could possibly increase the monthly share cost for an individual living independently.

23. Does a Trust protect the family home?
Yes and no! Property in a revocable living trust is not protected from the State Recovery Unit. However, property In an irrevocable trust is usually safe from recovery. Trusts are complex In regard to Medi-Cal law and must be carefully devised. Talk to Senior Medi-Benefits first before seeking an attorney who may not know Medi-Cal law as a specialty. It is our responsibility to guide you in the right direction to avoid future estate claims.

24. Can the State put a claim on a Life Insurance Policy or a Retirement Account?
It depends. If you have named a beneficiary on the policy or on the retirement account, the State cannot file a claim. However, if the opposite is true and there is no beneficiary named, then your assets become recoverable allowing the State to file a claim on your policy or retirement accounts.

25. Can you qualify for Medi-Cal if you are under 65 years old?
Perhaps. The key to under 65 eligibility is to meet one of the disability requirements listed on the Presumptive Disability Form, which is a somewhat draconian set of questions concerning an individual s disability. If the individual is totally blind, totally deaf, an amputee, confined to a bed or comatose, suffered a severe stroke and lost the ability to do 3 of the 6 ADLs, or has Down's Syndrome, then the presumptive disability will be granted; you will still need to also qualify from an asset standpoint. The presumptive disability process can take six months to a year of state review.

26. What is the new DRA regulations timetable and how will they affect eligibility?
The adoption of the Federal Deficit Reduction Act of 2005 and its impact on MediCal are still being determined at the California state level. The timetable is a moving target, with certain regulations already adopted, such as the identification documents referred to in question #20. The major changes, on life estate, annuity recovery, and asset transfers are still to be determined.

For more information on current regulations and how they impact your potential case, please contact Senior Medi-Benefits.

27. Whom should we turn to for help?
Start with Senior Medi-Benefits!
We have an Integrated approach designed to meet your needs. We have picked up the pieces of many improperly prepared Medi-Cal preplans and Immediate Need Medi-Cal denials. It's always easier to get it right the first time.

Our Recommendation: Because every case is different, we recommend that you call us to discuss your specific situation: 888 789-4589.  

Learn important facts about the program that impacts many elderly Californians:
PDF DOWNLOAD A full version of LTC Medi-Cal FAQs.


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