Medi-Cal Increases Access to Benefits
It’s been over three decades since Medi-Cal updated the asset limit test. In January 2022, Medi-Cal returned to a fee-for-service model. Now, there are two ways to be approved for benefits:
MAGI Medi-Cal: Income-based with no share of cost
Traditional Medi-Cal: Assets-based with a share of cost
Before July 1, 2022, the asset limit to qualify for Traditional Medi-Cal was $2,000 for a single applicant, $3,000 for couples or $137,400 for a married applicant if in long-term care.
As of July 1, 2022, changes to the asset limits include:
• For a single applicant the asset limit is now up to $130,000.
• For additional family members (maximum of 10) the asset limit is now up to $65,000.
• Medi-Cal rules for exempt and non-exempt assets remain the same.
• Medi-Cal income rules and share of cost calculations remain the same.
• July 1, 2024, Medi-Cal intends to do away with the asset test altogether.
Medi-Cal Qualification Considerations:
If a family/individual was denied before July 1, 2022, they can reapply for benefits if they meet the new guidelines
The asset test counts money from savings, checking, cash surrender values of life insurance and other cash assets.
Regulations have stayed the same for other exempt and non-exempt assets, which need to be evaluated before applying for Medi-Cal.
The share of cost equation for Medi-Cal beneficiaries has not changed.
Transfer regulations are still in place for Long-Term care applicants. This may reduce the need to spend-down gift assets to qualify for benefits. In some cases, transfers and changes to the financial profile may still be necessary to qualify.
The utilization of Medi-Cal benefits is granted for navigation of the healthcare system, insurance programs, and implementation of care for the individual in the home, community, or placement with a Medi-Cal facility.
Have questions or want feedback on your Medi-Cal process?
Click here for a FREE follow-up consultation on your Medi-Cal needs!