Estate PlanninG
Recovering Medi-Cal

Medi-Cal Recovery

San Ramon Elder Law Lawyer Providing Assistance

Medi-Cal is a government program (California's Medi-Cal program) that pays for health care for individuals who cannot afford to pay for such services themselves. Many individuals who take advantage of this program are senior citizens who are on fixed incomes. When Medi-Cal recipients pass away, their estates sometimes become subject to estate recovery claims. This means that the estates they leave behind will have to be used to pay the state back for their Medi-Cal costs. In some cases, the state can place liens on the estates of Medi-Cal beneficiaries who are still alive, essentially placing certain assets of these individuals on hold until the beneficiaries pass away.

There are ways to limit the amount of assets that are taken for Medi-Cal recovery, or even to prevent any assets from being taken altogether. To learn more about the Medi-Cal recovery process and how you and your family can best protect your assets, it is best that you consult with knowledgeable legal counsel. At Santaella Legal Group, APC, we have skilled San Ramon elder law attorneys who can provide you with helpful legal advice and advocacy.

Nursing Home Exemption

In the state of California, Medi-Cal recovery liens generally cannot be placed on the homes of beneficiaries who live in nursing homes, nor can such liens be placed on their surviving spouses. The exception, however, is when the Medi-Cal beneficiary's home is not considered exempt and the home is being put up for sale. In these types of situations, liens can then be placed on the homes of Medi-Cal beneficiaries who are still living.

Proving Disability or Blindness of a Surviving Child

One way to get a claim for estate recovery removed is to show proof that the deceased beneficiary's surviving child was disabled or blind at the time that the claim was made, according to information provided by the California Department of Health Care Services (DHCS). This can be done by showing that the child receives benefits (or has had his or her status verified) through the Federal Social Security Administration (SSA), or through his or her enrollment in Medi-Cal with a disability or blindness aid code. When there is no existing form or proof, the son or daughter of the decedent—or his or her representative—can request that an official disability determination be made. Once the department is notified that proof of disability or blindness will be provided, the recovery collections can be stopped for 60 days from the notification.

Proving Substantial Hardship

If someone is a recipient of an estate and making payment on a Medi-Cal estate recovery claim would cause him or her substantial hardship, that person could be able to get DHCS to waive his or her proportionate share of the claim. The waiver application must be submitted within 60 days of receiving the estate recovery letter.

Here are just a few of factors that can lead to a waiver for substantial hardship:

  • The inheritance from the estate will allow the individual to stop being eligible for medical assistance programs and/or public assistance payments
  • Taking the estate property from the individual would lead to the loss of the person's primary source of income; or the property from the estate is part of business that produces income (such as a ranch or farm)
  • When a blind, disabled or elderly person has lived in the home (part of the estate) for at least one year before the death of the previous estate owner; the blind, disabled or elderly person must continue to live there and must not be able to obtain financing in order to pay for the medical debts

Challenging Medi-Cal recovery claims can be very complex. Make sure you have the help of a competent elder law attorney when dealing with these types of issues. Contact our firm for assistance!

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