• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar
  • Skip to footer
  • Home
  • Our Firm
    • Areas We Serve
      • Riverside County
        • Banning
        • Corona
        • Eastvale
        • Hemet
        • Menifee
        • Moreno Valley
        • Murrieta
        • Norco
        • Perris
        • Sun City
      • San Bernardino County
      • Orange County
      • Los Angeles County
      • San Diego County
    • Attorney and Staff Profiles
    • Our Reviews
    • Review Us
  • Elder Law
    • Conservatorships
    • Crisis Planning
    • Estate Planning for the Elderly and Chronically Ill
    • Planning for Long Term Medi-Cal
    • Planning for Veteran’s Aid and Attendance
  • Estate Planning
    • Advanced Estate Planning
      • Asset Protection Lawyer
      • Business Succession Planning
      • California Gun Trust
      • Charitable Planning & Philanthropy
      • Trustee Services
    • Estate Planning Service
    • LGBTQ+ Estate Planning
    • Married Couples Estate Planning
    • Persons with Large Retirement Accounts
    • Pet Planning
    • Special Needs Children
    • Special Needs Trusts
    • Trust Administration
    • Unmarried Couples Estate Planning
    • Unmarried Individuals Estate Planning
  • Probate
  • Will & Trust Contests
    • Conservatorship Contests
    • Probate Litigation
    • Tax Controversy and Tax Planning
    • Trust Litigation
    • Will Contests
  • Resources
    • Riverside, California Elder Law Resources
    • Docubank
    • Downloadable Handbooks
    • Elder Law
      • Elder Law Resources
    • Estate Planning, Elder Law and Tax Law Articles
    • Free Report – Able Account or Special Needs Trust
    • Free Report -Constructing Your Revocable Trust
    • Probate and Trust Administration
      • Bereavement Resources
    • Speaking Engagements
    • Useful Estate Planning, Elder Law and Tax Links
    • Webinars
  • Ask Dennis
  • Webinars
    • Webinar Recordings
    • Upcoming Webinars
  • Blog
  • Contact Us

Inland Empire Estate Planning Attorneys

Sandoval Legacy Group, a division of Holstrom, Block & Parke, a Professional Law Corporation

Connect with us today(855) 513-9876

Text Size A A A
LIVE WEBINARS REGISTER TODAY>>
Home » Long Term Care and Medi-Cal’s Look-Back Period Explained

Long Term Care and Medi-Cal’s Look-Back Period Explained

June 28, 2018Medi-Cal

long-term-care

One of the most important components of a well thought out estate plan is planning for long term care. Part of that planning is Medi-Cal Planning. As you age, Medi-Cal Planning becomes even more important. The need to include long term care planning in your estate plan is directly linked to the increased risk that you, or a spouse, will require long term care services at some point and the prohibitive cost of those services. Failing to plan ahead for the possibility that you will need to qualify for Medi-Cal could result in your application being denied because of Medi-Cal’s “look-back period.” To ensure that doesn’t happen to you, the Riverside Medi-Cal lawyers at Sandoval Legacy Group, A Professional Law Corporation explain the look-back period.

Will You Need Long-Term Care?

There is no way to know whether you, or a spouse, will need long-term care (LTC) in the future. You can, however, consider the odds and plan accordingly. The experts tell us that when you enter your retirement years at age 65 you will already stand at least a 50 percent chance of one day needing LTC. Every year after that your odds of need LTC increase. Keep in mind as well that if you are married, your spouse faces the same odds that you do. Given those odds, it only makes sense to plan for the possibility of incurring LTC costs for you or a spouse down the road.

LTC Costs in California

You probably know that LTC is expensive, but you may not realize just how expensive it is. In 2017, the average cost of LTC nationwide was about $7,000 a month. As you may well imagine, the cost in California is significantly higher than that. For that same year, the average cost of LTC in California was almost $9000 per month or over $100,000. With an average length of stay of 2.5 years, you could be looking at over $250,000 in LTC expenses.

The real problem is that contrary to what most seniors believe, Medicare will not cover LTC expenses for extended periods of time.  Long term stays in a skilled nursing home, and the costs of assisted living and caregiving at home are also not covered by most health insurance plans. In fact, unless you purchased a separate long term care insurance policy at an additional cost, you could face the need to cover your LTC expenses out of pocket. For over half of all seniors in LTC, the only available help for the cost of an extended stay in a skilled nursing home is Medi-Cal. First, however, you will need to qualify for Medi-Cal coverage which is where the need for Medi-Cal planning comes into the picture.

Medi-Cal Eligibility and the Look-Back Rule

If you find yourself faced with the need to pay for LTC, Medi-Cal may be the solution; however, you must first qualify for benefits. Because Medi-Cal is a “needs based” program, Medi-Cal uses both an income and a “available resources” limit when evaluating applicants. The amount of assets, or  available resources, you can have, can be extremely low. The number is based on whether you are married or unmarried and the nature of the assets.  Although some assets, such as a primary residence and a vehicle, are exempt from consideration, it is still easy for a retiree to have non-exempt assets that exceed the limit.  If your available resources exceed the program limits your application will be denied. Once upon a time, an applicant could simply transfer assets out of his/her name in anticipation of applying for Medicaid. That strategy, however, no longer works because Medi-Cal now imposes a “look-back” period that prohibits doing so. The look-back period in most states is 60 months; however, in California, it remains 30 months for the time being. Medi-Cal will review your finances for that 30 month period preceding your application. Asset transfers made for less than the fair market value during the look-back period may trigger the imposition of a penalty period. The length of the penalty period will depend on the value of the assets you transferred and the average monthly cost of a skilled nursing home stay as determined by the State of California. For example, let’s look at an example where a parent gifts assets valued at $120,000 to an adult child during the look-back period. In the example, we will use the 2018 APPR (Average Private Pay Rate – the calculation of the monthly cost of a skilled nursing facility as determined by the Department of Health Care Services) to determine the penalty period. Medi-Cal would impose a penalty period of 13 months ($120,000/$8,841=13.57). You would be responsible for covering your LTC expenses for the thirteen months after you transfer the the $120,000. Once the penalty period has run, you could apply for Long Term Care Medi-Cal coverage.

To prevent running afoul of the look-back period in the future, make sure you include Medi-Cal planning in your estate plan today.

Contact Riverside Medi-Cal Attorneys

If you have additional questions or concerns about Planning for Long Term Care, contact the experienced Riverside Medi-Cal lawyers at Sandoval Legacy Group, A Professional Law Corporation by clicking here or by calling (951) 888-1460 to schedule an appointment.

 

 

Have a question? Ask Dennis.
















  • Author
  • Recent Posts
Dennis Sandoval
Dennis Sandoval
Dennis Sandoval is the only attorney in California who has certifications in the three areas of estate planning, elder law and taxation. In 2014, the National Academy of Elder Law Attorneys (NAELA) designated Dennis as a Fellow, an award given to less than 100 elder law attorneys across the United States. He received his Certified Estate Planning, Trust and Probate Law Specialist designation from the California Bar Board of Legal Specialization in 1998 and his Certified Taxation Law Specialist designation in 2000 from the same organization. He is a Certified Elder Law Attorney (CELA), a designation he proudly received in 2004 after meeting all the requirements established by the National Elder Law Foundation (NELF) and the American Bar Association. Dennis has also holds the designation as an Accredited Estate Planner® (AEP) from the National Association of Estate Planners and Councils.
Dennis Sandoval
Latest posts by Dennis Sandoval (see all)
  • 5 Reasons to Hire a Lawyer to Help You Probate an Estate - June 23, 2021
  • How Do I Become My Father’s Guardian? - June 26, 2020
  • 5 Steps for an Executor to Take Control As Soon As Possible - June 26, 2020

Other Articles You May Find Useful

Riverside Medi-Cal planning
Understanding the Medi-Cal “Waiting” Period for Nursing Home Care
Riverside Medi-Cal planning attorneys
Why Is Long Term Care Medi-Cal Planning Necessary?
elder law lawyers
Elder Law Lawyers Preserve Legacies
Southern California Estate Planning Attorneys
Parkinson’s Awareness Day

About Dennis Sandoval

Dennis Sandoval is the only attorney in California who has certifications in the three areas of estate planning, elder law and taxation. In 2014, the National Academy of Elder Law Attorneys (NAELA) designated Dennis as a Fellow, an award given to less than 100 elder law attorneys across the United States. He received his Certified Estate Planning, Trust and Probate Law Specialist designation from the California Bar Board of Legal Specialization in 1998 and his Certified Taxation Law Specialist designation in 2000 from the same organization. He is a Certified Elder Law Attorney (CELA), a designation he proudly received in 2004 after meeting all the requirements established by the National Elder Law Foundation (NELF) and the American Bar Association. Dennis has also holds the designation as an Accredited Estate Planner® (AEP) from the National Association of Estate Planners and Councils.

VIEW RECORDED WEBINARS

“How To Create a Peace of Mind Out of Chaos” Recorded Wednesday, September 16 @ 11AM WATCH NOW

Inland Empire Estate Planning Attorney

Inland Empire Estate Planning Attorney

BLOG SUBSCRIPTION

  • This field is for validation purposes and should be left unchanged.

Follow Us

  • Facebook
  • Instagram
  • LinkedIn
  • RSS
  • YouTube

Where We Are

Sandoval Legacy Group, A Professional Law Corporation

See Larger Map Get Directions

Office Hours

Monday8:00 AM - 5:00 PM
Tuesday8:00 AM - 5:00 PM
Wednesday8:00 AM - 5:00 PM
Thursday8:00 AM - 5:00 PM

Friday by appointment only

Map

4300 Latham St., Riverside, CA 92501
SLG Riverside Office | 4300 Latham St., Riverside, CA 92501  •  Corona | 1897 California Ave., Ste. 102, Corona, CA 92881  •  Newport Beach | 4940 Campus Dr., Ste. A, Newport Beach, CA 92660  •  Temecula | 40810 County Center Drive, Ste. 150, Temecula, CA 92591  •  Riverside | 3780 12th Street, Riverside, CA 92501  •  San Diego | 3110 Camino Del Rio S., Ste. 308, San Diego, CA 92108  •  Vista | 380 S. Melrose Dr., Ste. 347, Vista, CA 92083

  • Disclaimer
  • Privacy Policy
  • Sitemap
  • Contact Us

Connect To Us

  • Facebook
  • LinkedIn
  • RSS
  • Twitter
  • YouTube
footer-logo

© 2023 Sandoval Legacy Group
A division of Holstrom, Block & Parke,
A Professional Law Corporation.
All Rights Reserved.