Exemption of Home Medi-Cal Qualification

The home remains exempt for qualification for Medi-Cal as long as certain conditions are met. Meeting one or more of these conditions is generally easy to do.

For Medi-Cal qualification, there must be a statement in writing by the Medi-Cal beneficiary that he or she intends to return home, or primary residence, even if it is evident that the beneficiary will be in a skilled nursing facility for an extended period of time, or that the beneficiary will never be able to return home. This statement will suffice to make the home an exempt asset for Medi-Cal qualification, even though there is little or no chance that the beneficiary will return home. In addition, such a statement can be provided at the time of qualification for Medi-Cal by the recipient or by the person who is preparing the Medi-Cal application.

The estate planning documents the elder law estate planning attorney prepares will usually include such a document. Statements of intent to return home are also generally included in other estate planning documents as part of the general estate plan which is prepared by the elder law attorney. Another purpose for this statement is to provide peace of mind to the estate planning clients, that they intend to live in their home, and that they will be able to return at any time regardless of their age. This is also a message to the family as to the intent of the older clients.

If the home is a duplex or is considered a multiple dwelling unit, it is usually exempt from Medi-Cal qualification as long as one of the units is the residence of the beneficiary. The home is also exempt if the beneficiary’s spouse, beneficiary’s child under age 21 or a dependent relative lives in the home. In addition, if the beneficiary’s brother, sister, son or daughter has lived in the home continually for at least a year prior to applying for Medi-Cal, the home will be exempt.

In addition, if there are legal or title issues concerning the home, which prevents the Medi-Cal recipient from selling the home, this can be used as a reason for exemption.

Other real property can also be exempt. For instance, property with a net market value, after loans, etc., is less than $6,000, and annual income of 6% is being received by the Medi-Cal recipient. Needless to say, because of the high values of properties in California, this qualification is difficult to meet. Also, at times, real property that is used as a business can be exempt. Certain documentation must be provided to Medi-Cal, including tax returns, etc., which reflect the use of the property as a business, etc.

The Medi-Cal regulations are complex, and this is only a brief outline of the regulations regarding exemption of the home. Before you act, you should seek the advice of an elder law estate planning attorney who is familiar with the Medi-Cal rules and regulations and asset protection.

FEDERAL DEFICIT REDUCTION ACT (DRA) As an aside, the Federal Deficit Reduction Act, (DRA) which was signed by President Bush on February 8, 2006, contains provisions regarding the exemption of the home for qualification for Medicaid, or Medi-Cal as it is known in California, and provides that the individual states shall adapt portions of these provisions. California to date, has not approved any of these provisions, and may not do so for some months to come. Some of the Federal provisions that affect California real property will concern the equity in the home. For instance, if the home has $500,000 or $750,000 in equity, the home may not be exempt. The States are to choose one of these two figures for adoption into their regulations. We are hopeful that the California regulations will use the higher figure for determining exemption of the home for Medi-Cal qualification. We are also hopeful that we will be able to use the “assessed value” as opposed to the “market value” of the home in making this determination for Medi-Cal qualification. The good news is that home remains exempt for Medi-Cal qualification, regardless of value, at least for now. The DRA addresses Medicaid. Medi-Cal is California’s version of Medicaid. A portion of the Medi-Cal funding comes from California, and a portion comes from Medicaid.

ASSET PROTECTION FOR THE HOME Determination of exemption of the home for Medi-Cal qualification is only part of the equation. If the home is in the Medi-Cal recipient’s estate after they pass away, after being on Medi-Cal, the State will attempt to recover from the home the amounts they have paid for the long term care of the Medi-Cal recipient, minus the share of cost contributed by the Medi-Cal recipient. There are numerous regulations which apply recovery. There are also methods that may be utilized for protection of the home from Medi-Cal recovery and still provide a step up in basis for capital gains purposes, and which also will avoid a re-assessment by the County Assessor. Please see an elder law attorney who is familiar with asset protection of the home before taking any action.