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Dear Advocate…
Medi–Cal for Long Term Care


Dear Advocate,

My parents currently live together at home. Recently my father’s dementia has gotten a lot worse, and we need to put him in a nursing home. My mom, however, is in good health and will be staying at home. My parents have $50,000 in a joint checking account. My mother only receives $450 social security, so it is my father’s monthly income of $1,800 that pays their bills. I’m worried that my parents will have to spend down all of their money in order for my father to become eligible for Medi–Cal, and that my mother will have insufficient income to pay for her own expenses at home.

Sincerely,
Worried in Westlake

Dear Worried in Westlake,

Under the Medicaid Spousal Impoverishment laws, your father will be eligible for Medi–Cal, and, thanks to the Community Spouse Resource Allowance (CSRA), your mother can retain all of the assets. The CSRA allows the community spouse (the spouse at home) to keep up to $104,400 (in 2008) in liquid assets – not including the home and other exempt assets – in order for the institutionalized spouse to become eligible for Medi–Cal. Since your mother’s assets are well below that amount, she can keep all $50,000.

Additionally, your mother can retain most of your father’s income. Under the Minimum Monthly Maintenance Needs Allowance (MMMNA), a community spouse is allowed to supplement his/her income from the institutionalized spouse’s monthly income, bringing it up to $2,610. In your mother’s case, she can keep all of your father’s monthly income – except for $35 – giving her an income of $2,215 a month. He will be allowed to keep his $35 for personal needs ($450 + $1,800 = $2,250 – $35 = $2,215). If his monthly income put your mother over the $2,610 MMMNA, then he would have to pay the remaining amount to the nursing as his Medi–Cal Share of Cost.

You can read more about these rules in CANHR’s fact sheet, "Overview of Medi–Cal for Long Term Care." You should also know that if your father does receive Medi–Cal, any property he leaves in his name when he dies will be subject to estate recovery. So, if your mother wants to avoid estate recovery, she should see an attorney regarding transferring the home to her name alone. Call the CANHR office for more information: (800) 474–1116.