Debunking Medi-Cal Myths

Medicaid was considered a complicated program when President Lyndon B. Johnson first signed it into law at the Truman Library in Independence, Missouri, over thirty years ago, as part of the President’s War on Poverty. The program has grown increasingly complex each year since its enactment. Although Medicaid is a federal program, each state is required to administer the program. In California, the program is administered as Medi-Cal, under a combination of Federal and California laws and regulations. These laws and regulations are constantly being changed by the federal and state legislatures and administrative agencies. As a result, it is no wonder there are many myths and inaccuracies surrounding the program.

“My mother heard about someone who…” All too often, our clients relate horror stories to us that they have heard from well meaning friends or family members. These stories, for instance, have prompted people to give away their home or all of their assets to a child for the purpose of impoverishing themselves, hoping that this will immediately qualify them for Medi-Cal. Unfortunately, they may soon find out that these transfers were unnecessary, and that they result in ineligibility to receive benefits for several months or even years after the transfers are made. In addition, these transfers may have created unintended tax consequences.

“My father is already in a nursing home so there’s nothing we can do now.” In many cases, these clients can be helped. It is true that a family can wait longer than they should to contact an elder law attorney, but it is rarely too late to establish a good plan. As a rule of thumb, the earlier a plan is put into place, the more assets can be preserved. Certainly, an elder law attorney should be contacted if a loved one will need nursing home care. This may be due to a diagnosis of a terminal or debilitating illness, such as Alzheimer’s, Parkinson’s or ALS. In addition, an elder law attorney should be contacted if a loved one is being discharged from the hospital and told that he or she will be unable to care for themselves at home. At a very minimum, and of course before incompetency occurs, the loved one should have Powers of Attorney in place for financial and health care decisions. It is important that the financial Powers of Attorney contain the correct language so that Medi-Cal planning is possible in the case of disability.

“The Medi-Cal office can just give me the paperwork.” Those who work at the Medi-Cal office cannot offer legal advice, nor can they represent individuals. An elder law attorney can give advice on the laws and procedures that, for instance, may allow the client to receive Medi-Cal assistance and still keep part or all of his spouse’s income as well as his own, or to increase the amount of assets that the well spouse can keep. At times, an administrative hearing or court procedure may be required.