Eligibility for Medicaid: Don’t Try to Qualify On Your Own


Achieving eligibility for Medicaid by giving away your home and assets is most likely a mistake. Trying to meet Medi-Cal requirements on your own, without the help of an attorney, could actually delay your entry into a nursing home or other care facility. At our office in Saratoga, nursing homes are regularly a concern for our elderly clients. They don’t want their life’s savings and their children’s inheritance to be eaten by nursing home costs, but they are unsure how to qualify for Medicaid without putting those things in jeopardy.

It is true that to qualify for Medi-Cal (California’s Medicaid program) you must have no more than $2,000 of available cash and be out of assets. But the rules for what counts as part of your assets and what doesn’t can be confusing. Additionally, Medi-Cal officials will look not only at your assets at the time of application, but also the assets you owned in recent years. Many folks attempt to qualify for Medi-Cal on their own and, because they were unaware of certain rules, end up delaying their entry into a nursing home or paying several months or years of their stay out of pocket.

Eligibility for Medicaid and the 5-Year Look-Back

The most important thing to know about Medi-Cal requirements is that you must supply records of your assets for the five years preceding your application. If you give away your house, money or other assets within those five years in hopes to achieve eligibility for Medicaid, those assets are likely to be counted toward your application.

Actually, you can be penalized for assets given away in order to qualify for Medi-Cal. Medi-Cal will take the total equity value of assets given away and divide them by the average monthly cost for staying in a California or Saratoga nursing home ($4,812 in California). The resulting number will be the number of months you will be ineligible for Medicaid. So, if you give away a house with $200,000 in equity within the five months preceding your application, that move could delay your eligibility for Medicaid by more than 40 months — nearly three and a half years!

You May Be Able to Keep Your Home and Still Meet Medi-Cal Requirements

The next thing you should know about eligibility for Medicaid is that you may be able to keep your home and still qualify. Under certain circumstances, Medi-Cal will let you keep your home and not count it toward your assets, especially if it is also home to a spouse, minor child or a blind/disabled person. However, the Medi-Cal requirements for keeping your home are complex and require the help of someone knowledgeable in Medicaid law in order to avoid mistakes and penalties. You may also be able to protect many of your other assets from Medicaid as well.

As you can see, eligibility for Medicaid is a very complex matter and requires planning—preferably far in advance of your need for Medicaid. If you think a nursing home stay may be in your future, I invite you to come down to my office in Saratoga. A nursing home stay, most likely, can be paid for by Medicaid, and I’ll be glad to show you the best way to handle your assets in order to qualify for Medicaid and minimize the assets that can be recovered by Medicaid after your death.

Your initial consultation is always free of charge: (408) 741-3500.

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