Los Gatos Medi-Cal Attorney

How Do You Learn About Medi-Cal Benefits?

As an estate planning and elder law attorney, I’m frequently confronted with clients who have been misinformed about the law. This is particularly true regarding Medi-Cal and the coverage of nursing home costs. Conflicting information results in confusion. It also sometimes results in lack of action or taking the wrong action. Make sure you’re talking to someone who really knows the current law.

There are attorneys, Medi-Cal “consultants” and insurance salespeople who pass on erroneous information to clients. This can be extremely harmful. I recently read a published column by an insurance agent who stated that “the loophole that some people used to try to hide assets in order to qualify for Medicaid (Medi-Cal) was closed by the Deficit Reduction Act.” That’s true in most states, but the DRA 2005, which became law in early 2006, has still not yet been adopted in California. Anyone who tells you otherwise simply doesn’t know the law in California.

(Also, if you do things lawfully, you aren’t “hiding” anything at all. That’s ridiculous. Hiding assets will get you charged with Medi-Cal fraud. Following the law is a safer bet.)

One client of mine recently called me after she met with the investment professional at her bank, and she informed me that the investment professional had warned her about trying to get Medi-Cal to pay for her mother’s nursing home expenses “because there is a 60 month look-back period that will mess everything up.”  My response was, “Well, that investment professional must be working in Texas, because that certainly isn’t the law in California.”

These people will also frequently warn about estate recovery and how the government can get back all of the benefits at a later date. That simply isn’t true with proper planning. Don’t be scared away from doing the right thing by people misleading you with false information.

One of the easiest ways to see that an “expert” doesn’t know what they’re talking about is to discuss the look-back period for transfer penalties. I frequently see literature or a website quoting a 36 month or 60 month period. If you see that, don’t make an appointment to see the person, or get up and walk out if you’re already in their office. That isn’t the law in California.

Medi-Cal is a confusing area of the law, and many people take advantage of seniors’ lack of understanding of the Medi-Cal laws to sell them overpriced products and consulting services. CANHR (California Advocates for Nursing Home Reform, a non-profit organization) fights against elder financial abuse and this type of misinformation. CANHR states that the prices for these non-attorney consulting services to “pre-qualify” seniors for Medi-Cal generally ranges from $5,000 to $20,000, and the products being sold generate large commissions. They state that “the prices for these services are typically two-thirds higher than what a licensed estate planning attorney would charge.”

I’ve seen it in my own practice. One client came to me when her son discovered that she had paid for Medi-Cal “consulting” from some insurance people who were currently being sued for selling nearly worthless products to other seniors. She had already paid thousands of dollars in consulting fees to these people, and she wanted to get that money back. Another “consultant” told the client that the consultant “could handle it all, and there was no need to go see an attorney.”  The result was that the man was charged several thousand dollars more than an attorney would have charged.

Protect yourself. Use a licensed attorney who is knowledgeable about Medi-Cal and works with the Medi-Cal regulations on a regular basis.