The Institutional Spouse is allowed to keep $35 per month for income. Any additional income received is paid to the skilled nursing facility as a “share of cost”. Medi-Cal covers the rest of the unpaid expenses.
Medi-Cal Specialist for Nursing Home Care
(increased every year based on the consumer price index)
(Resources must be reduced to $2,000 by the end of each month)
(Assets you are allowed to have in addition to the Asset Limitations)
The home, regardless of value, is totally exempt if it is the principal residence and the well spouse remains in the house, or, if the institutionalized spouse expresses an “intent to return home.”
One vehicle is exempt if it is used for the benefit of the applicant/beneficiary, or, if it is needed for medical reasons.
Household items and personal effects are totally exempt.
Wedding rings, engagement rings, and heirlooms are totally exempt. Other items of jewelry with a “net market value” of $100 or less per item are also exempt.
Whole life insurance with a total face value of $1,500 or less is exempt.
Term life insurance, which usually includes group policies, is exempt.
Burial plots are exempt.
Most burial plans can be made exempt.
IRA’s (regardless of value) are exempt if the applicant or owner is receiving periodic payments of principal and interest. These payments are treated as Income.
Annuities (reguardless of value) can be made exempt.
What about Income Limitations?
The “at home” or “Well” Spouse may keep all income, from whatever sources, that comes in his/her name only, regardless of the amount. If the Well Spouse receives less than $2,739 per month (MMMNA: Minimum Monthly Maintenance Needs Allowance) in income the Well Spouse may keep enough of the Institution-alized Spouse’s income to bring the Well Spouse’s income up to the $2,739 level.
The Institutionalized Spouse is allowed $35 per month of income. Any monies received in excess of that amount will be paid each month as a “share of cost” to the skilled nursing facility. Medi-Cal will pay the remainder of the skilled nursing facility’s fees.
Why are married couples allowed so much more in Assets?
If a married couple were left with only $2,000 in assets it would be virtually impossible for the Well Spouse to generate enough income to make ends meet. With $109,560 available to the Well Spouse, monthly and emergency expenses can hopefully be met.
Serving Seniors
throughout California
1-866-450-0510
There are things that can be done to preserve assets and bring your available assets within the asset limitations whether married or single. They are legal and fully disclosed when applying for Medi-Cal Long-Term benefits. Care, however, needs to be taken to keep within the transfer rules.
With one phone call I can tell you if you are within the asset limitations, approximate your share of cost, and tell you what will need to be done should you be above the asset limitations. Call toll free 866-450-0510.
What if I am above the limits?