The Aged and Disabled Medi-Cal program pays for long-term care in a skilled nursing facility and care at home through In Home Support Services (IHSS). In order to qualify for this type of Medi-Cal, you must meet an income test, or have a share of cost if your income is too high, and you are limited in the amount of assets you are allowed to have. Currently, to qualify, your assets are limited to: a personal residence, one car, furniture, clothing, other household items, and $2,000 in other property. In addition, if you are married, the spouse not trying to qualify for Medi-Cal for skilled nursing only (not IHSS) is allowed to have $130,380.
As a part of legislation passed in 2021 and the California Advancing and Innovating Medi-Cal (CalAIM) initiative, big changes are coming to Medi-Cal. The asset test is being phased out! As of July 1, 2022, the Medi-Cal asset test will increase from $2,000 to $130,000 for an applying individual and $65,000 for each additional family member. The asset limits for the following Medicare Savings Programs (MSPs) will also increase to $130,000: Qualified Medicare Beneficiary (QMB), Specified Low-Income Medicare Beneficiary (SLMB), Qualified Income (QI), and Qualified Disabled Working Individual (QDWI). MSPs assist low-income Medicare recipients pay for Medicare out-of-pocket expenses, including premiums and share of cost.
The best news: the asset test will be fully eliminated for these Medi-Cal programs effective July 1, 2024!
The Department of Health Care Services, the California agency that implements Medi-Cal, will send outreach notices to all individuals who were denied Medi-Cal or who were dropped from Medi-Cal for being over the asset limit in the 90 days preceding the date the new test goes into effect.
Please note, however, that the asset test increase and eventual elimination for Medi-Cal do not change the asset limit test for SSI, Supplemental Security Income, which is a federal program administered by the Social Security Administration. While this means that an individual may now qualify for Medi-Cal when they have more than $2,000, they would not necessarily qualify for SSI, which still has an asset limit of $2,000.
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