| In California, Medi-Cal planning for payment of nursing | | | | Maintenance Needs Allowance (MMMNA). If wife's |
| home costs is a somewhat complicated process that | | | | monthly income (through social security, pension, etc.) is |
| should utilize the assistance of a qualified elder law | | | | only $1,000, then she is short $1,610 per month of her |
| attorney. This brief article provides an overview of | | | | allowable MMMNA. |
| how Medi-Cal benefits can be obtained to pay for the | | | | If the ill-spouse (husband) has a monthly income of |
| sky-rocketing costs of long term care in a skilled | | | | $500, then his income can be allocated to his wife in |
| nursing facility. | | | | order to meet her MMMNA. Wife would now receive |
| The first step is to obtain eligibility. As a general rule, a | | | | $1,500 in monthly income, but would still be short $1,110 |
| well-spouse is allowed to keep $104,400 (2008) in | | | | per month of her MMMNA ($2,610 - $1,500 = $1,110). |
| resources. This is called the Community Spouse | | | | Again, the law allows the well-spouse, at a minimum, |
| Resource Allowance (CSRA) and includes cash in the | | | | $2,610 in income per month. |
| bank. If the married couple has more than this amount | | | | Now, if it can be shown that the couple's total |
| in resources, then they will need to reduce the excess | | | | resources, (hypothetically) invested in an interest |
| amount in a way that conforms to Medi-Cal's rules. | | | | bearing account, would still not produce enough |
| One method of spending down is to use the excess | | | | additional monthly income for the wife to meet her |
| money to pay for improvements to the couple's home. | | | | MMMNA, then a request can be made to an |
| Their primary residence is considered an exempt | | | | Administrative Law Judge or to the County Superior |
| asset for Medi-Cal eligibility purposes (regardless of its | | | | Court for an order that allows the couple to retain all |
| value) and therefore Medi-Cal cannot consider it in | | | | of their assets, including the amount in excess of the |
| determining eligibility. Note: The federal Deficit Reduction | | | | CSRA. |
| Act (DRA) may change some of the rules regarding | | | | Are there additional ways to qualify an individual to |
| the exempt status of a home. Any planning strategy | | | | receive Medi-Cal benefits to pay for nursing home |
| must include a thorough review to determine whether | | | | costs? Yes, and some of those planning strategies will |
| California has implemented an applicable provision of | | | | be discussed in subsequent articles. |
| the DRA. | | | | In the meantime, it is important to know that qualifying |
| Even if the couple's resources exceed the allowable | | | | to receive Medi-Cal benefits is only the first of several |
| amount, they may still be able to retain the excess and | | | | major issues that must be addressed in the planning |
| qualify. | | | | process. Avoiding Medi-Cal's attempt to recover the |
| Here's an example: | | | | money that it has paid out on behalf of the Medi-Cal |
| The well-spouse (wife) is entitled to keep $2,610 (2008) | | | | beneficiary (nursing home patient) is of critical |
| a month in income. This is called the Minimum Monthly | | | | importance in any Medi-Cal planning strategy. |