Limits for qualification

  • Non-Exempt Resources
    Well Spouse - $92,760 CSRA (2004 Limits)
    Institutionalized Spouse - $2,000
    Both Spouses Institutionalized - $4,000
    Income: Not Counted
  • Unlimited Exempt Resources
  • Income; Excessive Income Toward Share of Costs
    Well Spouse - $2,267/month MMMNA (2004 Limits)
    Institutionalized Spouse/Individual - $35/month
    Name on the Instrument Rule applies
    Joint income to well spouse up to maximum

Exempt Resources

  • Home
  • Other Real Property - $6,000 or less equity or Business Property (Not Rentals)
  • Jewelry and Musical Instruments
  • Household Goods and Personal Effects
  • One Medically Required Automobile
  • Prepayed Funeral/Burial (Irrevocable plans: no $ limits and $1,500 designated burial fund)
  • Burial Plot - Recipient and immediate family
  • $1,500 Face Amount of Life Insurance (Term Life Insurance excepted)
  • Tools of Trade
  • Pensions/IRA's/401k's/TSA's

Planning Techniques for Spend Down

  • Purchase Home
  • Pay Off Mortgage on Home
  • Purchase of Interest in Child's Home (provided parent intends to live there)
  • Purchase Home Furnishings or Appliances
  • Do Home Repairs or Deferred Maintenance
  • Pay Off Unsecured Debts
  • Do Medi-Cal Planning or Update Estate Plan
  • Purchase Musical Instruments or Jewelry
  • Prepay Burial Arrangements
  • Purchase Automobile
  • Make Assets Unavailable: i.e. Place Real Estate on market
  • Purchase Immediate Annuity
    • Married Couple
    •  > Purchase may be made for the sole benefit of either spouse
    •  > Payment may be used to increase income of community spouse to
          MMMNA (minimum monthly maintenance needs allowance)
    •  > Immediate Annuity for life or shorter period of time
    • Single Person
    •  > Immediate Annuity for life or shorter period of time
    •  > Questionable means of preserving assets

Other Options; Caution; Ineligibility Period May Apply

  • Gift giving (Real property appraised at assessed value)
    • Outright Gifts
    • Irrevocable Trusts
  • Exempt Assets
  • Nonexempt Assets
    • Timing
    • Transfer of property for less than fair consideration = gift
    • Look back period for Medi-Cal ineligible. 36/60 or number of months the gift money would have paid for care
    • Average Private Pay Rate (APPR), $4,415.00 per month (2003 limits)
  • Private Annuities
  • Self-Canceling Notes

Special Trusts

  • Special Irrevocable Trusts
    • Income Only
    • Income only/Special Power of Appointment
  • Special Needs Trust
    • Disabled family members
    • Surviving spouse's special needs trust (must be Probated)

Legal Actions

  • 3100 Petition - Substituted Judgement
    • Gift to spouse
  • Conservatorship - Substituted Judgment
    • Gift
  • State Fair Hearing
    • Increase CSRA