Medi-Cal Planning: What Can the Healthy Spouse Keep in California? www.norcalplanners.com 1
CALIFORNIA MEDI-CAL PLANNING
- WHAT CAN THE HEALTHY SPOUSE KEEP?
“To be comprehensively prepared for the future, you should
be fully cognizant of the eventualities of aging.”
TIMOTHY P. MURPHY NORTHERN CALIFORNIA CENTER FOR ESTATE PLANNING AND ELDER LAW
Medi-Cal Planning: What Can the Healthy Spouse Keep in California? www.norcalplanners.com 2
To be comprehensively prepared for the future, you should be fully cognizant of
the eventualities of aging.
No one wants to consider this, and it can be hard to wrap your head around it
when you are younger. However, according to the United States Department of
Health and Human Services, most senior citizens are going to need help with
their activities of daily living at some point in time.
In fact, 70 percent of people reaching the age of 65 will someday need long-
term care.
Medi-Cal Planning: What Can the Healthy Spouse Keep in California? www.norcalplanners.com 3
You may not be concerned because you will be qualified for Medicare coverage
when you attain senior citizen status. However, this is a mistake, because
Medicare will not pay for long-term care.
If you need living
assistance, this is
considered to be
custodial care.
Medicare will pay for up
to 100 days of
convalescent care after
surgery, but it will not
pick up the tab for
custodial care.
Paying out-of-pocket is simply out of reach for many people. In the state of
California, the median cost for a private room in a nursing home exceeds
$100,000 annually according to Genworth Financial.
People often require multiple years of nursing home care, with around 10
percent of nursing home residents remaining in the facilities for at least five
years.
Medi-Cal Planning: What Can the Healthy Spouse Keep in California? www.norcalplanners.com 4
THE MEDI-CAL SOLUTION
For a high percentage of people who need long-term care in California, Medi-Cal
is the solution. Medi-Cal is a jointly administered federal/state health insurance
program. This program will pay for long-term care if you can qualify.
Medi-Cal is only available to
people who have very limited
financial resources. For an
individual, the limit on
countable assets is just
$2000.
People who were never
especially poor qualify for
Medi-Cal through a measured
divestiture of assets. You
could simply give resources to loved ones who would have otherwise been
inheriting them after you pass away. If you plan things effectively, you would
have very little left in your own name if and when you qualify for Medi-Cal
coverage.
Medi-Cal Planning: What Can the Healthy Spouse Keep in California? www.norcalplanners.com 5
RIGHTS OF HEALTHY SPOUSE
In many cases, one
spouse will need long-term
care while the other
spouse is still capable of
living independently.
Under these
circumstances, the Medi-
Cal program allows the
healthy spouse to retain
ownership of a certain
store of assets.
The healthy spouse is referred to as the community spouse. The community
spouse can remain in the family home with no equity limit, and this is certainly a
huge relief to many people.
If someone is applying for Medi-Cal, under program rules most of his or her
income would typically go toward for the cost of care. However, if the
community spouse is relying on income that is drawn by the institutionalized
spouse, this requirement is waived.
The healthy spouse can continue to receive income that is due to the spouse
who is receiving long-term care if it is needed. This is called a Monthly
Maintenance Needs Allowance.
Medi-Cal Planning: What Can the Healthy Spouse Keep in California? www.norcalplanners.com 6
In the state of California in 2014, the Monthly Maintenance Needs Allowance is
$2931.
In addition to the Monthly Maintenance Needs Allowance, the healthy spouse can
keep half of the shared countable assets, but there is a limit. This is called the
Community Spouse Resource Allowance.
For the rest of this year, the maximum Medi-Cal Community Spouse Resource
Allowance is $117,240, and this is also the minimum. The minimum allowance
gives the community spouse the right to keep no less than $117,240, even if this
is more than half of the total assets in question.
SUMMARY
To summarize, Medi-Cal is a government health insurance program. Because
Medicare does not pay for long-term care, many people who were never
financially needy seek Medi-Cal eligibility late in their lives.
Because Medi-Cal is a program that is based on financial need, there are income
and asset limits that you must stay within if you want to qualify.
When one spouse is staying at home while the other spouse is entering a long-
term care facility, the healthy spouse is entitled to certain property rights. The
community spouse can remain in the family home, and he or she can continue to
draw income that is brought in by the spouse who needs living assistance.
Medi-Cal Planning: What Can the Healthy Spouse Keep in California? www.norcalplanners.com 7
The healthy spouse may also keep half of shared countable assets up to a
certain limit.
To learn more about long-term care and Medi-Cal planning, schedule a
consultation with a licensed elder law attorney.
REFERENCES Genworth Financial https://www.genworth.com/corporate/about-genworth/industry-expertise/cost-
of-care.html
LongTermCare.gov http://longtermcare.gov/
Medi-Cal Planning: What Can the Healthy Spouse Keep in California? www.norcalplanners.com 8
About the Author
Timothy P. Murphy
Timothy P. Murphy is an estate planning and elder law attorney
whose practice emphasizes helping people to build, preserve and pass on their wealth. He works with his clients to
accomplish their goals while avoiding unnecessary court proceedings and minimizing or eliminating exposure to death taxes. Mr. Murphy also assists families facing the myriad of
problems associated with dealing with a loved one’s declining health and rising needs for care. He has practiced law in the Sacramento area for
29 years, first with a large firm, and then with his own firm since 1987.
Tim has written a regular column on legal issues for Senior Magazine. He also
was a regular featured guest on the Money Experts radio program heard locally on KFBK (AM 1530). Tim has been featured in the Sacramento Bee, Sacramento
Business Journal, Sacramento Magazine, Comstock’s Magazine and other publications on estate planning and related topics. He also assisted local Channel 3 (KCRA) in an investigative report on the trust mill problem in the Sacramento
area and was featured on Channel 10 (KXTV) in its series on personal financial planning.
Northern California Center for Estate Planning and Elder Law
www.norcalplanners.com SACRAMENTO 2277 Fair Oaks Boulevard
Suite 320 Sacramento, CA 95825-5599
Phone: (916) 437-3500 ROSEVILLE
3017 Douglas Blvd. Ste. 300
Roseville, CA 95661 Phone: (916) 437-3500