The Medi-Cal “Look-Back” period in California is 30 months. “Transfer” means an outright gift or a “sale” made at less than “fair market value.” If a disqualifying transfer of property is made, Medi-Cal will calculate the period of ineligibility for nursing facility level of care. It will be the number of months resulting when the “net fair market value” of the transferred asset, which would have resulted in excess property at the time of the transfer, is divided by the monthly average private nursing facility cost. In 2002, the average cost used to calculate the period length is $4,322 per month. In 2001, this amount was $4,163.
Question: What are the community spousal resource limits for 2002 when qualifying for the Medi-Cal nursing home benefit?
The 2002 community spouse resource allowances are $89,280 in assets and $2,232 in monthly income. For a married couple with one spouse in a nursing home and the other spouse at home, the spouse at home may keep up to $89,280 in resources (property and other assets) while the spouse in a nursing home may keep $2,000. The spouse at home may keep all of the income received in his or her name, regardless of the amount. If the amount is below $2,232 per month, the spouse in the nursing home may allocate income to bring the at-home spouse’s income up to the $2,232 per month limit. The spouse in the nursing home is permitted to keep $35 a month for personal needs. (For 2001, the amounts were $87,000 in assets and $2,175 in income).
The Medi-Cal program determines eligibility for benefits on a “means” tested basis. If a Medi-Cal applicant’s property/assets are over the Medi-Cal property limit, the applicant will not be eligible for Medi-Cal unless they lower their property/assets according to the program rules. The Medi-Cal eligibility worker looks at how much an applicant and their family has each month. If their property/assets are below the limit at any time during that month, the applicant will get Medi-Cal, ifotherwise eligible. If a person has more than the limit for a whole month, Medi-Cal benefits will be discontinued. A person’s home, furnishings, personal items, and one motor vehicle are not counted. A single person is allowed to keep $2,000 in property/assets, more if they are married and/or have a family. (If a person has a Partnership policy, however, each dollar the Partnership policy pays out in benefits entitles the insured to keep a dollar of his/her assets should he/she ever need to apply for Medi-Cal Services.) For example, if a person receives an inheritance that puts their property/asset amount to more than $2,000, they would be required to spend that amount down to $2,000 before Medi-Cal would pay for any further care.
Question: How long does a person have to be living in California before they can be deemed a resident of California for Medi-Cal eligibility purposes?
Reply: There is no time period associated with being a California resident. However, a person does have to be physically present in California with the intent to remain in California permanently or indefinitely.
Question: If a Partnership policy covers a patient’s stay in a private room in the nursing home until policy benefits are exhausted, and the patient transitions into Medi-Cal, with a SOC, and the nursing facility intends to transfer them out of their private room and into a semi-private room, can the patient use their SOC to guarantee their continued stay in a private room?
Reply: Yes, as long as the patient’s SOC, or some combination of their SOC, their assets and/or any remaining insurance, is high enough to cover the rate for the private room. If the nursing facility charges Medi-Cal for any portion of the facility cost, the patient cannot pay the difference between the Medi-Cal covered accommodation and a private roam. The patient may be able to afford to pay the entire cost of the nursing facility charge as their SOC, because they will no longer need to use any of their income to pay for drugs, Medi-Gap (part B) policy co-pays or deductibles, etc.
This is because once the patient is on Medi-Cal; the Medi-Cal benefits will cover all these medically necessary services. The patient’s income therefore, depending on each individual’s circumstances, may be sufficient to pay the facility costs (while meeting their SOC) so they can be sure to remain in a private. If not, the patient may have to move into Medi-Cal covered accommodations. For example, if the private room cost is $3,500 and the policyholder has $3,500 in income, they can use that amount to pay for the private room. Medi-Cal would then be available to cover any other medically necessary item.
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?
Reply: No, the patient can spend their SOC on a variety of medical services. This SOC obligation does not necessarily need to be paid to the nursing home. For example, if the nursing home patient needs four occupational therapy treatments per week, but Medi-Cal only allows two per week, the additional occupational therapy treatments could be paid through the SOC. In this example, even though Medi-Cal covers occupational therapy, any additional services a person wants above and beyond what Medi-Cal would have covered could be paid as the SOC. Therefore, the SOC services paid by the patient must not be Medi-Cal covered services in order for their costs to count toward the Medi-Cal SOC. In addition, services that would usually be covered by Medi-Cal, such as the use of a health aide, can be paid as the SOC if the service provider is not a Medi-Cal provider.
If someone you are caring for has dementia and need to see a dentist you will want to make a dental appointment for early in the day, when the person in question is most alert. Also, make sure to tell him/her where they are going and why.
Let the dentist know ahead of time about the condition of the person with dementia. Communication will make the visit easier.
It is best for someone with dementia to see a dentist as soon as possible after they are diagnosed. And if any procedures are needed, they should get them done as soon as possible. That way, as the disease gets worse, then they should only need easier maintenance treatments
Having sensitive teeth can happen to anyone, at any age. Your gum tissue pulls back from your teeth, uncovering some of the root. This can make the area sensitive to temperature hot and cold.
Periodontitis also known as Gum disease is caused by plaque and made worse by food left in teeth, use of tobacco products, poor-fitting bridges and dentures, poor diets, and certain diseases, such as anemia, cancer, and diabetes, this is often a problem for older adults.
If you are a senior may wonder whether dental implants work just as well for older patients as they do for younger ones. You may also wonder whether your dental implants have a different success rate based on your age.
The answer to that question is that dental implants are just as effective and long-lasting in older patients as they are in younger ones. In fact, dental implants can change the lives of older patients for the better, giving them more confidence and improved physical and mental health.
According to a 2004 study, it reviewed success rates after five years for dental implants in patients over 80 years and those that were under 80. This study found that the two groups had the same success rates.
Generally the implant dentists evaluates an older patients for a possibility of getting dental implants, they look at the following factors:
If you are interested in having dental implants or knowing more about them, don’t let your age be a main factor. Talk to your dentist and go over options that are good for you and your overall all health care.
Question: I am elderly and not very mobile to get to the polling place on my own. A local candidate’s campaign called and offered to take me to the polls on Election Day. Can they do that?
Reply: Yes, but they cannot attempt to influence you or offer you any type of reward or thing of value for voting, or talk to you about how you intend to vote. – Source: Secretary of State CA Gov
Tuesday, November 3rd is the general election for 2020. With the ongoing pandemic, and many people working from home, doing distance learning or concerned about their health, some voters may have extra challenges getting to the polls.
Voting is a critical part of civic engagement and community involvement. In most cases you will be able to find your local voting place online if you are not sure where to go. You can also vote by mail if you are unable to go to the voting location near you.
Adult dental benefits are an optional benefit under Medicaid. As of January 2018, 34 states including the District of Columbia provide at least limited dental benefits for adults beyond emergency services.
Question: I am 68 and I noticed that my teeth seem to becoming very sensitive to both hot and cold food and drinks. I have all my teeth and other then the sensitivity my mouth is otherwise healthy. What could be the cause of this?
Answer: Although there are many reason for sensitive teeth, one that cause that affects seniors is receding gums. As gum tissue pulls back away from your teeth the root of the tooth becomes exposed and causes sensitivity in your teeth. It is important to note that tooth sensitive is a warning side to larger dental issues and it should be address by your dentist. Your dentist will be able to determine why your teeth are becoming sensitive and the correct coarse of treatment.
Dental Health Services, Share of Cost California Dental Plan Review — The Dental Health Services Super SmartSmile HMO Dental Plan. As the subscriber, you may enroll yourself, your spouse (unless legally separated) or your domestic partner, and/or unmarried dependent children who are under 19 years of age. Children 19 years of age and over are eligible if: The child is unmarried and a full-time student solely dependent upon subscriber for support, and is under 23 years of age; or the child is and continues to be both (1) incapable of self-sustaining employment by reason of a mental disability, including but not limited to, mental illness or a physical disability or a combination of those disabilities and (2) chiefly dependent upon the subscriber or member for support and maintenance. There are no deductibles and no yearly limits on most services, and there are no claim forms to fill out. Your savings are in place when you visit network dentist. You just show up for your dental appointment and make your copayment – what could be easier? The dentists must meet the Plan’s standard of quality and service.
All have agreed to provide dental care at a low cost available only to its members. There is no waiting period for your dental services to begin, many pre-existing dental conditions are covered and best of all, the dental plan services start the first day of next month if the company receives your mail-in application by the 10th of this month. Review the sample schedule below and see how easy it is for you or your entire family to enjoy these quality dental services.
The Assurant Employee Benefits dental plan which is the brand name for prepaid (or DHMO) dental products provided by United Dental Care of Arizona. This dental plan offers individual and family dental benefits with attractive prepayment fees for you, your spouse and dependent children as defined by state law.
* There are no deductibles and no yearly limits on services, and there are no claim forms to fill out. Your savings are in place when you visit a network dentist. You just show up for your dental appointment and make your payment – what could be easier? The dentists must meet the Plan’s standard of quality and service. All have agreed to provide dental care at an affordable price to its members. Since there is no waiting period for your dental services to begin, pre-existing dental conditions are covered and best of all, the dental plan services starts on the first day of next month if the application is received by the dental plan on or before the 20th of this month. Review the sample schedule and see how easy it is for you or your entire family to enjoy these quality dental