A FEW FACTS ABOUT MEDI-CAL

 
I. ELIGIBILITY FOR MEDI-CAL

Criteria:	(1)	Must be over 65 yrs of age; disabled or blind
	(2)	Resources (property, assets) *exempt -- do not count in determining eligibility *nonexempt -- single applicant ($2,000) married applicant ($2,000 for "ill spouse" and "well spouse" may retain $84,120.00)
	(3)	Monthly Income

II. WHAT ARE EXEMPT ASSETS?

No Limit On Value:

1. Principal Residence;
   *must intend to return home.
2. Household Furniture and Furnishings;
3. Personal Effects & Jewelry - heirlooms, wedding and engagement rings.
4. Car
   * car must be used for transportation by or on behalf of the person who is applying for Medi-Cal.
5. Term Life Insurance
6. Irrevocable Burial Contract for Services
7. Burial Plots, Vaults And Crypts - For Use by Any Member of the Family
8. Pension Funds And Annuities Under Limited Circumstances
   1. Pension Plans - must take periodic distributions.
   2. Annuities - must take periodic payments of interest and principal and payments must be scheduled to exhaust the balance of the annuity on or before the end of the annuitant's life expectancy.
9. Musical Instruments

Limit On Value:

1. Whole Life Insurance - Policies with total face and cash surrender value of $1,500.00 or less on life of any individual applying for Medi-Cal, or his or her spouse.
2. Designated Burial Fund - $1,500 or less

III. PATIENT'S INCOME

The income of a patient (person receiving Medi-Cal benefits) will be reviewed by Medi-Cal in order to determine his/her "share of cost" (how much the patient will pay for his/her care). If a patient has private health insurance premiums, that monthly cost will be deducted from the patient's income before determining his/her share of cost. The patient is also permitted to keep $35.00 per month as a "personal needs allowance."
Example:

Total Monthly Income	1,200.00
less private insurance	-115.00
less personal needs allowance	- 35.00
Patient's Share of Cost.	1,050.00

1. What If Medi-cal Recipient Is Married?
   1. The "well spouse" (patient's spouse) can keep all income that comes in the well spouse's name.
   2. If the "well spouse's" monthly income is less than $2,103.00 per month [Minimum Monthly Maintenance Needs Allowance (MMMNA)], the well spouse may be able to keep as much of the ill spouse's income as he/she needs to earn $2,103.00 per month.

IV. GIFTING ASSETS TO SPOUSE OR FAMILY MEMBERS

1. There is no penalty for gifting or transferring assets between spouses.
2. Period of ineligibility arises when patient gifts assets to someone other than a spouse.

Written by R. Christine Brown

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