Fact Sheet: Medi-Cal
Nursing Home Care and the Single Person

Medi-Cal has three tests that must be met for a single person to be eligible for nursing home benefits. First, the person must be 65 or older, or blind, or disabled. Second, the person's condition must require nursing home care. Third, the person's assets must be within the asset limits, explained below:

• When a person applies for Medi-Cal, the person's assets are listed in the application.
• A single person may have only $2,000 of "countable" assets. Most cash-type assets (cash, bank accounts, CD's, stocks, bonds, mutual funds, cash value insurance, etc.) count.
• Some very significant assets do not count. Examples: the person's home (based on an intent to return); one automobile; 401(k) and employment-related IRA accounts (if currently paying principal and interest); and prepaid burial arrangements. (Under coming rule changes, home equity limits of $500,000 or more may affect eligibility for some individuals.)
• Note that it is possible to change a countable asset into a non-countable asset. As examples, a person can turn countable cash into non-countable assets by spending cash to fix up the person's home or buy a new car.
• A person is always permitted to spend countable assets on himself or herself (travel, entertainment, other things the person enjoys, etc.).

Giving away assets can make a person ineligible for Medi-Cal nursing home care for a period of time. Currently, Medi-Cal divides the value of what was given away by the average private pay rate to determine the number of months of ineligibility. Ineligibility starts with the month in which the gift was made. Warning: The Medi-Cal gifting rules will be changing. Anyone contemplating making gifts should work with an experienced and capable advisor.

Eligibility does not depend on monthly income.

Medi-Cal keeps track of what it pays, and when the person dies often seeks repayment from assets owned by the person at the date of death.

This Fact Sheet focuses on the "medically-needy" rules. Different rules may apply to people eligible for Supplemental Security Income (SSI).

July 2006