Medi-Cal For Long Term Care – Income Limits

Medi-Cal for long term care is a health care program for California seniors aged 65 and over, who are either residing at home, in a nursing home, or in an assisted living facility. Unlike long term care programs in most states, Medi-Cal pays for many non-medical support services for seniors who live in their homes.

Eligibility for these programs is determined by several criteria that include income levels, marital status, medical need, disability, and so on. The table below provides a quick reference for seniors to ascertain the long term care benefits they may be eligible for under the Medi-Cal program.

APRIL 2021 – MARCH 2022 Medi-Cal Long Term Care Eligibility
[click to zoom on the table]

What is “Share of Cost” ?

The resident must pay a “share of cost” towards his or her care and the higher the monthly income, the higher the share of cost. To compute the resident’s monthly share of cost – monthly income less $35 / month for a personal needs allowance, less Medicare premiums and spousal allowance (if applicable) – results to the remaining amount of income that the resident must pay to the nursing home as a share of cost each month.

What defines “Income”?

Employment wages, alimony payments, pension payments, Social Security Disability Income, Social Security Income, IRA withdrawals, and stock dividends are considered countable income when determining eligibility for Medi-Cal Long Term Care Benefits. It is worth noting that Covid-19 stimulus checks (both previous and subsequent payments) are not considered income and therefore do not affect eligibility.

For married couples with only one spouse applying for Medi-Cal, only the income of the applicant is counted and the income of the non-applicant spouse is disregarded. To be clear, income is counted differently when just one spouse of a married couple applies for regular Medi-Cal. In this situation, the income of both the applicant spouse and the non-applicant spouse is calculated towards the applicant’s income eligibility.

What are considered “Assets”?

Cash, stocks, bonds, investments, credit union, savings, and checking accounts, and real estate (with the exemption of your home residence) are considered countable assets.

Assets that are exempt from being counted are personal belongings, household furnishings, an automobile, irrevocable burial trusts, and one’s primary place of residence. Incidentally, there is no maximum home equity value limit under Medi-Cal unlike in most states.

IMPORTANT: When applying for Medi-Cal, it is important to note that California has a Look-Back Period of 30 months preceding the application date (most states have a 60-month look-back). Reviewers will check on your application to ensure no assets were sold or given away under fair market value during this timeframe. Violators will incur penalties.

What’s Next?

Once you’ve determined your income eligibility, book your free consultation meeting with our team at Crider Law and we’ll help you process your application for Medi-Cal’s long term care benefits.

Whether it’s your first time to file a claim, pursuing an appeal or just want to learn more about your entitlements under the Medi-Cal Long Term Care program, we will support you every step of the way.


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