Medi-Cal Planning
What is Medi-Cal?
Medi-Cal is California’s Medicaid program. It helps eligible individuals pay for healthcare expenses, including doctor visits, hospital care, prescription medications, and long-term care services such as skilled nursing facility care. Unlike Medicare, Medi-Cal is a needs-based program with financial and medical eligibility requirements.
Does Medicare Cover Long-Term Nursing Home Care?
Usually not. Medicare may provide limited short-term coverage for rehabilitation or skilled nursing care following a qualifying hospitalization, but it generally does not pay for long-term custodial nursing home care. Many families eventually explore Medi-Cal planning when long-term care becomes necessary.
What Does Medi-Cal Cover?
Depending on eligibility and medical necessity, Medi-Cal may cover:
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Physician visits
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Hospital care
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Prescription medications
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Skilled nursing facility care
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Rehabilitation services
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Laboratory services
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Medical equipment
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Certain home health services
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Hearing aids and eyeglasses in some situations
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Long-term care services
Some services may require prior authorization or additional eligibility requirements.
What Are the 2026 Medi-Cal Asset Limits?
Beginning January 1, 2026, California reinstated asset limits for many Medi-Cal programs involving seniors and long-term care planning.
For many non-MAGI Medi-Cal programs:
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An individual may generally retain up to approximately $130,000 in countable assets.
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Married couples may generally retain approximately $195,000 in countable assets.
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Additional protections may apply for married couples when only one spouse requires long-term care.
Because Medi-Cal rules are complex and continue to evolve, families should verify current eligibility standards before making financial transfers or planning decisions.
Does Medi-Cal Count Every Asset?
No. Medi-Cal distinguishes between exempt and non-exempt assets.
Assets that are often exempt may include:
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A primary residence
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One vehicle
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Household furnishings and personal belongings
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Certain retirement accounts receiving periodic payments
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Some burial arrangements
Non-exempt assets may include:
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Excess cash
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Additional real estate
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Certain investment accounts
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Some non-retirement financial accounts
Asset treatment depends heavily on the facts of each case.
Can I Keep My Home and Still Qualify for Medi-Cal?
Possibly. A primary residence is often considered exempt for Medi-Cal eligibility purposes under certain circumstances.
However:
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Estate recovery issues may later arise.
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Transfers of the residence can create eligibility penalties.
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Proposition 19 property tax issues may also need to be evaluated.
Proper planning is important before transferring or restructuring real property.
What is the Medi-Cal Look-Back Period?
California now applies a look-back period for certain long-term care Medi-Cal transfers.
For transfers made on or after January 1, 2026:
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Medi-Cal may review transfers occurring during the prior 30 months.
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Improper gifts or transfers may create periods of ineligibility for long-term care benefits.
Certain transfers may still be permitted without penalty under applicable rules and exceptions.
Can a Trust Help With Medi-Cal Planning?
Possibly. Trust planning may sometimes be used as part of a broader Medi-Cal strategy.
However:
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Not all trusts protect assets.
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Revocable living trusts generally do not shield assets for Medi-Cal eligibility purposes.
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Certain irrevocable trusts may sometimes be appropriate depending on timing, goals, and circumstances.
Trust planning should be coordinated with tax planning, estate planning, and property tax considerations.
What is Medi-Cal Estate Recovery?
After a Medi-Cal recipient passes away, the State of California may seek reimbursement from certain remaining assets or portions of the recipient’s estate for benefits paid.
This process is commonly called estate recovery.
Proper planning may help reduce estate recovery exposure in some circumstances.
When Should Medi-Cal Planning Be Done?
The best time for Medi-Cal planning is before a healthcare crisis occurs.
Early planning may:
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Preserve more options
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Reduce financial stress
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Protect spouses and family members
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Better coordinate tax and estate planning goals
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Avoid rushed decisions during emergencies
Even crisis planning shortly before nursing home placement may still create important opportunities in certain cases.
Can Medi-Cal Planning Be Combined With Estate Planning?
Yes. Medi-Cal planning is often coordinated with:
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Revocable living trusts
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Powers of attorney
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Advance healthcare directives
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Proposition 19 planning
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Trust administration planning
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Long-term care planning
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Asset protection strategies
A coordinated plan may help families address healthcare, legal, tax, and inheritance goals together.
Why is Medi-Cal Planning Important?
Long-term care costs in California can be extremely expensive and may quickly deplete savings and family wealth.
Proper planning may help:
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Preserve family assets
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Protect a spouse remaining at home
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Coordinate healthcare decision-making
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Reduce stress during incapacity
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Minimize unnecessary financial hardship
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Protect generational wealth where legally possible