Long-term health care (LTC) expenses are tolling for most seniors. If you aren’t prepared to cover these costs, you will most likely turn to Medi-Cal for assistance. Getting approved for Medi-Cal is challenging and can be almost impossible if you do not plan ahead. This lack of planning can cause you to risk your hard-earned assets. Even worse, if you try to conceal those assets, you may end up facing legal consequences for fraud that could result in prison. With proper planning, Medi-Cal can still help.
Medi-Cal May Be Your Only Hope for Help
The older population (65 and older) in the United States is ever-growing and is expected to surpass the younger generation (age 21 and younger) for the first time in history by the year 2050. Long-term care (LTC) in the United States will continue to become necessary and important as the average life expectancy steadily increases. Experts anticipate the average cost of LTC across the nation to exceed $150,000 a year per person receiving care by 2036.
The length of stay on Medicare is at 2.5 and this puts the future average LTC bill at almost $400,000. While Medicare may cover most seniors’ health-care related expenses, it ceases to cover LTC costs except under very specific circumstances for a limited amount of time. Unless you have previously purchased a LTC rider for an additional cost, most basic health insurance plans will also exclude LTC expenses. For the majority of all seniors that count on LTC, Medi-Cal is their only option.
Qualifying for Medi-Cal
Medi-Cal will only cover LTC costs if you qualify for benefits. Medi-Cal imposes a “countable resources” limit that applicants cannot exceed and will sometimes impose an income limit. Medi-Cal is strict about these limits because of their mission to help low income applicants.
The current income limit is based directly off the Federal Poverty Level (FPL) in the geographic area that an applicant lives and will adjust each year. While this income limit may inhibit some seniors that are on a fixed income, this is not usually where the issues with applications lie. Most applicants are denied due to the extremely low “countable resources” limit. Many states have a “countable resources” limit that is as low as $2,000 for an individual applicant. This issue has caused applicants to conceal resources, and therefore being subject to fraud charges.