July 1, 2022 California increased the asset limit for certain Medi-Cal programs, and is expected to eventually remove asset limit requirements altogether. The state raised the Medi-Cal asset limit for a single individual to $130,000, $195,000 for a couple, and $65,000 for each additional family member. On January 1, 2024, the state is expected to eliminate the Medi-Cal asset limit completely.
What were the previous asset limits?
Medi-Cal is a combined federal and California state program designed to help pay for medical care for public assistance recipients and other low-income persons. Historically, seniors and people with disabilities who applied for Medi-Cal had to be beneath an asset limit of $2,000 for a single individual and $3,000 for couples.
Are there other changes to Medi-Cal?
Medi-Cal income guidelines and share of cost calculations remain the same. The rules for exempt and non-exempt assets also remain the same. For information on exempt and non-exempt resources under Medi-Cal, read CANHR’s Resource Limits fact sheet: http://canhr.org/factsheets/medi-cal_fs/html/fs_medcal_limits.htm.
The asset limit changes only apply to California’s Medi-Cal program. Individuals who receive SSI benefits, or other public benefit support programs, will still need to comply with asset limit rules under those programs.
Medi-Cal Recovery rules will not change. If a beneficiary used certain services under Medi-Cal, it is possible that the State may make a claim against their estate when they die, if the estate is subject to probate under California law. There are simple steps people can take to protect their home, or other assets, from Medi-Cal Recovery. Read CANHR’s guide on Medi-Cal Recovery for additional information:
Will the asset limits change if I am married or have a registered domestic partner?
Family members can be defined as individuals included within the Medi-Cal Family Budget Unit (MFBU). The MFBU is the number of people Medi-Cal includes in your household when determining a person’s or family’s eligibility and share of cost. Married couples and registered domestic partners may, or may not be included in the same MFBU depending on the type of services they receive under Medi-Cal.
Asset Limit Examples of Couples in the Same MFBU
Examples of Couples Under Spousal Impoverishment Provisions
There must be a community spouse for spousal impoverishment protections to be established, meaning at least one spouse must not be on Medi-Cal, and the other, deemed institutionalized either through placement in a skilled nursing facility, or through eligibility for an HCBS program. Once spousal impoverishment is applied, couples are separated into their own MFBUs, giving them separate asset limits. The community spouse retains up to the Community Spouse Resource Allowance (CSRA), and the Medi-Cal spouse retains up to the asset limit. Both couples above have similar asset limits. The Medi-Cal beneficiary may keep up to $130,000, and the community spouse up to $148,620 under the CSRA.
Examples of Couples Both Receiving Medi-Cal in Separate MFBUs
If the community spouse applies for Medi-Cal, only the income protections under spousal impoverishment will continue to apply, meaning income allocation is still allowed. However, the community spouse will no longer be able to keep the CSRA and will be subject to the asset limit for a single person. If the community spouse also requests HCBS, there is no longer a community spouse, and income allocation will no longer be allowed. The spouses remain in separate MFBUs. Once a Medi-Cal beneficiary transitions to Long Term Care Medi-Cal, they are considered to be in their own MFBU.
Will there still be transfer penalties after July 1, 2022?
Penalties for transferring or gifting away non-exempt assets will still only apply if a Medi-Cal beneficiary or applicant enters a nursing home. The transfer rules apply only to non-exempt (countable) assets. For example, there will be no transfer penalties for someone who has $125,000, and transfers $100,000, which is under the new $130,000 asset limit. Transfers of assets over the new asset limit may create a transfer penalty, depending on the amount.
Please note that a transfer penalty only applies to those subject to the 30-month look back period when they are entering a nursing home. A transfer penalty does not apply when the person is in the community, but they should take into consideration how and when transfers are made, in the event they enter a nursing home in the future.
ACWDL 21-31: Increases to the Asset Limits for Non-Modified Adjusted Gross Income Medi-Cal Programs
ACWDL 21-34: Regarding Spousal Impoverishment Caps, includes changes to the Asset Limit and Spousal Impoverishment evaluations
ACWDL 23-01: 2023 Spousal Impoverishment Caps
MEDIL 22-02: Older Adult Expansion and Asset Limit Changes Global Outreach LanguageDHCS Asset Limits Webpage: https://www.dhcs.ca.gov/services/medi-cal/eligibility/Pages/Asset-Limit-Changes-for-Non-MAGI-Medi-Cal.aspx