HAVING A HOME AND RECEIVING MEDI-CAL
Medi-Cal (California’s Medicaid Program) is a means-tested program or also known as needs-based. Meaning, that there are certain income, asset/resource requirements to qualify to be eligible for Medi-Cal.
For Medi-Cal eligibility determination, a home is an exempt asset/resource; meaning it is not counted as a resource when a beneficiary or his/her spouse is on Medi-Cal under any of the following situations:
- If during any absence, including nursing home stays, the beneficiary intends to return home, and states so in writing. If the beneficiary is mentally incapacitated, a family member or someone acting on her or his behalf may so state this intent.
- If the beneficiary’s spouse, child under age 21, or “dependent relative” continues to reside in the home.
- The residence is inhabited by the recipient’s sibling or son or daughter who has resided there continuously for at least one year prior to the date the recipient entered the nursing home.
- There are legal obstacles preventing the sale and the applicant/beneficiary provides evidence of attempts to overcome such obstacles.
- The home is a multiple dwelling unit, one of which is the principal residence of the beneficiary.
Is My Home Protected from Medi-Cal Recovery?
Even though a home is an exempt asset/resource for Medi-Cal eligibility requirements, it does not exclude the home from estate recovery. If the home is still in the Medi-Cal recipient’s name when he/she passes, the state has the right to make a claim against the home to recover Medi-Cal benefits that were paid out. This does not only apply to the home, it applies to any assets remaining in the Medi-Cal recipient’s name.
According to CANHR (California Advocates for Nursing Home Reform) and the Department of Health Care Services Estate Recovery Program, this is further explained as below:
“For individuals who pass before January 1, 2017, the old Medi-Cal Recovery laws will apply. If the home was still in the name of the Medi-Cal beneficiary at death, the State may make a claim against the estate of a beneficiary who was 55 years of age or older at the time he or she received Medi-Cal, or of any age, if the person received Medi-Cal in a nursing home, unless there is a surviving spouse, a minor child, or a blind or disabled child of any age.”
“For individuals who die on or after January 1, 2017, Medi-Cal Recovery claims have been severely restricted. The new recovery law:
- Prohibits claims on the estates of surviving spouses and registered domestic partners;
- Limits recovery for those 55 years of age or older to nursing home and home and community based services;
- Limits recovery to only those assets subject to probate under California law;
- Restricts the amount of interest that the state can charge on liens;
- Requires the state to waive the claim as a substantial hardship when the estate subject to recovery is a homestead of modest value, i.e., a home whose fair market value is 50 percent or less of the average price of homes in the county where the homestead is located; and
- Requires the state to provide a current or former beneficiary or their authorized representative a copy of the amount of the Medi-Cal expenses that may be recoverable.”
Can I transfer My Home?
Under Federal law, and according to the Department of Health Care Services for the State of California the principal residence may be transferred to the following individuals at any time without affecting an individual’s Medi-Cal eligibility:
- A spouse;
- A son or daughter under age 21 or who is blind or permanently disabled;
- A sibling who has equity in the home and who was residing there for at least one year immediately prior to the individual’s admission to a nursing home;
- A son or daughter who was living there for at least two years immediately prior to the individual’s admission to a nursing home and who provided care which enabled the parent to live at home;
- To anyone so long as the home was exempt at the time of transfer.
We strongly urge that individuals reach out to an attorney that specializes in Estate Planning for specific questions and the best course of action or an expert that specializes in public benefits. To find your local county department visit http://www.dhcs.ca.gov/services/medi-cal/Pages/CountyOffices.aspx.
DISCLAIMER: The information provided by CPT is for informational purposes only and is intended to be used as a non-legal guide prior to consultation with an attorney familiar with your specific legal situation. CPT is not engaged in the practice of law or in rendering legal advice or counsel. No such legal advice or counseling is either expressly or impliedly intended. This form is not a substitute for the advice or counsel of an attorney. If you require legal advice, you should seek the services of an attorney. © 2017 CPT All rights reserved.