Is there such a thing as a “Medi-Cal Friendly Annuity”?

Friday, Jan. 15th 2021 3:03 PM

There is no such thing as a Medi-Cal-friendly annuity. The balance of an annuity is considered unavailable as long as the owner receives equal monthly payments for a number of years, less than or equal to life expectancy (based upon life expectancy tables designated by Health Care Financing Administration for this purpose). The final payment may be smaller to exhaust the annuity. If payments are not equal and monthly, the cash surrender value is counted. If payments extend beyond life
expectancy, a period of ineligibility for nursing facility level of care may result. Some annuities pay very small amounts, with a balloon payment at the end. These annuities, even though set up to exhaust within life expectancy, are not annuitized in accordance with DHS rules. The cash surrender value is counted in determining eligibility. In many cases, these annuities are irrevocable and do not have a cash value and there is nothing to count. Individuals who purchase this type of annuity lose financial control while cashing in their life insurance policies, stocks, bonds, etc. Many times they have to pay heavy capital gains taxes and surrender penalties in the process.

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Posted on Friday, Jan. 15th 2021 3:03 PM | by Share of Cost | in Medi-Cal, Share of Cost | No Comments »

The institutionalized spouse has $200,000 of assets protected through a Partnership policy. The spouse at home gives $200,000 to a child on January 1,1999, and applies for Medi-Cal on February 28, 2000. Is there a penalty under the rules for transfer of property?

Tuesday, Jan. 12th 2021 5:29 AM

In this example, assuming the couple has no other countable property (all they have is $200,000 in assets) at the time of the transfer, the transfer of the protected assets is considered a transfer of exempt property. Therefore, there is no period of ineligibility for nursing facility level of care. This above exemption only applies during the lifetime of the institutionalized spouse for eligibility purposes. After the institutionalized spouse dies, this exemption no longer applies. For estate recovery purposes, however, the $200,000 of asset protection continues even after the death of the protected spouse

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Posted on Tuesday, Jan. 12th 2021 5:29 AM | by Share of Cost | in Medi-Cal, Share of Cost | No Comments »

Are assets from a prior marriage exempt for eligibility purposes? What about estate recovery?

Saturday, Jan. 9th 2021 5:20 AM

The term “exempt” applies to a “type” or “classification” of property given exempt status by statute or regulation. Assets from a prior marriage are not a type of property that is exempt. Property from a prior marriage may be considered separate property if it has not been combined with the property of the current spouse. If the property is separate property, it may or may not be counted, as in the living situations described above. Estate recovery can file a claim against any asset (e.g., the community property interest) that passes from the deceased person to the surviving spouse upon his or her death. Estate recovery only takes place, however, when the surviving spouse dies.

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Posted on Saturday, Jan. 9th 2021 5:20 AM | by Share of Cost | in Medi-Cal, Share of Cost | No Comments »

Anxiety and Heart Disease

Thursday, Jan. 7th 2021 2:16 PM

Anxiety Increases Risk Of Complications For Heart Disease Patients

Patients with heart disease who also suffer from an anxiety disorder have a significantly higher risk of having a heart attack, heart failure, stroke and death, compared to other heart disease patients, according to Dutch scientists. You can read about this study in the peer-reviewed medical journal Archives of General Psychiatry

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Posted on Thursday, Jan. 7th 2021 2:16 PM | by Share of Cost | in Medi-Cal, Share of Cost | No Comments »

Are assets my spouse inherits disregarded for eligibility purposes when I apply for Medi-Cal? For the purpose of estate recovery?

Monday, Jan. 4th 2021 5:12 AM

In the case of an inheritance, the assets disregarded for determining eligibility are the same as those in a pre-nuptial agreement. The estate recovery program can only file claims against the assets that pass from deceased Medi-Cal beneficiaries to their surviving spouses upon death. Any assets that pass to the surviving spouse before the death of the Medi-Cal beneficiary are not recoverable.

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Posted on Monday, Jan. 4th 2021 5:12 AM | by Share of Cost | in Medi-Cal, Share of Cost | No Comments »

Inflammation In Heart Disease

Thursday, Dec. 31st 2020 5:04 AM

Degree Of Lifetime Stress Exposure Linked To Inflammation In Heart Disease

Greater lifetime exposure to the stress of traumatic events was linked to higher levels of inflammation in a study of almost 1,000 patients with cardiovascular disease led by researchers at the San Francisco VA Medical Center and the University of California, San Francisco.

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Posted on Thursday, Dec. 31st 2020 5:04 AM | by Share of Cost | in Medi-Cal, Share of Cost | No Comments »

How Does Alzheimer’s Disease Develop?

Tuesday, Dec. 29th 2020 5:03 AM

A second pathway through which Alzheimer’s develops has been discovered after researchers identified a new set of genetic markers for the disease. Most Alzheimer’s genetic research focuses on amyloid-beta, which contributes to the formation of plaques found in the brains of people suffering from Alzheimer’s. In this study, published in the journal Neuron, researchers were able to identify genes linked to the tau protein, a protein which develops in the brain as Alzheimer’s slowly progresses.

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Posted on Tuesday, Dec. 29th 2020 5:03 AM | by Share of Cost | in Medi-Cal, Share of Cost | No Comments »

Are the assets identified in a pre-nuptial agreement disregarded for the purpose of eligibility when an individual applies for Medi-Cal? What about estate recovery?

Saturday, Dec. 26th 2020 5:59 AM

With a prenuptial agreement, the county considers the living situation of the individual at the time of application in order to determine Medi-Cal eligibility. Let us take at look at three living situations: Example #1: Both spouses are at home. All non-exempt property over $3,000 (including assets
identified in a pre-nuptial agreement) is counted in determining Medi-Cal eligibility. Example #2: Both spouses are in board & care or only one spouse is in board & care and one remains at home or both spouses are in long-term care. The property of the non-applicant spouse that is established as separate property in the pre-nuptial agreement (as long as it remains
separate) is disregarded for purposes of establishing eligibility. Half of the community property is also disregarded.

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Posted on Saturday, Dec. 26th 2020 5:59 AM | by Share of Cost | in Medi-Cal, Share of Cost | No Comments »

How are retirement annuities treated for Medi-Cal eligibility?

Sunday, Dec. 13th 2020 5:52 AM

Annuities are not considered exempt unless they are IRAs, KEOGHS, or work-related pension funds held in the name of a person who does not want Medi-Cal for him- or herself. If payments are being received, however, those payments are considered income. The cash surrender value of IRAs,
KEOGHS and work-related pension funds held in the name of an individual who does not want MediCal is counted until the individual takes steps to receive either the cash lump sum or periodic payments of principal and interest. The periodic payments are considered income and the balance is considered unavailable.

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Posted on Sunday, Dec. 13th 2020 5:52 AM | by Share of Cost | in Medi-Cal, Share of Cost | No Comments »

What percentage of nursing homes is Medi-Cal approved? Medicare approved?

Wednesday, Dec. 9th 2020 5:50 AM

Nearly 88% of the 1,400 nursing homes in California accept Medi-Cal:
Title 18 only (Medicare): 8.3%
Title 18/19 (Medicare/Medi-Cal): 80.4%
Title 19 only (Medi-Cal): 7.3%
No Participation 4.0%

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Posted on Wednesday, Dec. 9th 2020 5:50 AM | by Share of Cost | in Medi-Cal, Share of Cost | No Comments »

Share of Cost – Partnership Policy Covers

Sunday, Dec. 6th 2020 4:48 PM

Question: If a Partnership policy covers a patient’s stay in a private room in a nursing home until policy benefits are exhausted, and the patient transitions into Medi-Cal, with a Share of Cost (SOC), do they have to spend the SOC for services specifically pertinent to the nursing home?

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Posted on Sunday, Dec. 6th 2020 4:48 PM | by Share of Cost | in Medi-Cal, Share of Cost | No Comments »

How much does a person have to pay for services while on Medi-Cal?

Friday, Dec. 4th 2020 1:42 PM

The county looks at the applicant’s income after he or she establishes eligibility for Medi-Cal by spending down assets to no more than $89,280 for a couple with one spouse institutionalized or $2,000 for a single individual. The county looks at the income the individual receives in his or her own name and divides in half the income received in the name of both spouses. Of the income that counts as the income of the applicant, all (less $35) of the applicant’s income is considered his or her “share of cost” for Medi-Cal. This works like a regular health insurance deductible. The applicant pays or obligates him or herself to pay that much each month on medical expenses before Medi-Cal pays the remainder of Medi-Cal covered services.

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Posted on Friday, Dec. 4th 2020 1:42 PM | by Share of Cost | in Medi-Cal, Share of Cost | No Comments »

What if the above transfer was to a family member, such as an adult child?

Monday, Nov. 30th 2020 5:34 AM

The transfer by the applicant’s spouse must be a real gift transfer. If the adult child, for example, is only holding the assets, it probably really is a trust. In that case, the transfer could either cause a period of ineligibility or simply result in the assets continuing to be counted as available to the applicant.

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Posted on Monday, Nov. 30th 2020 5:34 AM | by Share of Cost | in Medi-Cal, Share of Cost | No Comments »

If a Medi-Cal applicant’s spouse transfers assets, will that result in any period of ineligibility for nursing home care?

Thursday, Nov. 26th 2020 5:31 AM

Generally, California will not impose any period of ineligibility for nursing home care on the applicant if his or her spouse previously transferred assets. The exception is if the asset/resource transferred originally belonged to the applicant. In that case, a disqualification period will be imposed if the spouse received the assets from the applicant before the applicant went into the nursing home and then transferred them to a third party. This is because the Medi-Cal rules differ for a “community spouse” and an “individual spouse”. If the spouses wait until one of them goes into the nursing home, the spouse will be a “community spouse”. Then a transfer of property from the spouse in the nursing home to the community spouse that is then transferred to a third party, does not trigger any period of ineligibility

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Posted on Thursday, Nov. 26th 2020 5:31 AM | by Share of Cost | in Medi-Cal, Share of Cost | No Comments »

If a person applies for Medi-Cal, can they have a principal residence in another state (outside of California) and still qualify for Medi-Cal?

Sunday, Nov. 22nd 2020 5:28 AM

Yes, but the person has to distinguish between “principal residence” and “primary residence”. In other words, they can have a principal residence anywhere, as long as they eventually return to it to live. In order to qualify for Medi-Cal, a person must show that they are presently living in California with the intention to remain permanently, or for an indefinite period. A person could be living in a California nursing home with the intention to remain indefinitely, but still have the intention to eventually return to
their principal residence out-of-state.

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Posted on Sunday, Nov. 22nd 2020 5:28 AM | by Share of Cost | in Medi-Cal, Share of Cost | No Comments »

Can a nursing home resident give away their income, or does it need to be spent on medically necessary care? Let us say a person is in a nursing home and wants to give their grandchild $50 for their birthday. Can they do that?

Monday, Nov. 16th 2020 5:43 AM

There is currently no transfer of income penalty in California. However, a nursing home resident’s income must be used to meet their SOC, or Medi-Cal will pay for NO services during that month. The nursing home resident is allowed only $35 for personal needs. It is fine if he/she wants to give their $35 away, but then there will be nothing for personal needs unless the individual wants to dip into their $2,000 property reserve. Funds from their $2,000 property reserve may also be given away without penalty. When funds are used from the $2,000 property reserve, the reserve can be increased the following month to the $2,000 limit

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Posted on Monday, Nov. 16th 2020 5:43 AM | by Share of Cost | in Medi-Cal, Share of Cost | No Comments »