Tuesday, January 28, 2014

An Estate Planning Attorney Answers: What is Medi-Cal?

Medi-Cal is short for California Medical Assistance Program.  This public health insurance program offers health care services to low-income individuals and families, seniors, people with disabilities, foster care children, pregnant women, and people suffering from tuberculosis, breast cancer or HIV/AIDS.  Medi-Cal is jointly administered by the California Department of Health Care Services (DHCS) and the Center for Medicare and Medicaid Services (CMS), with many services implemented at the local level by the counties of California.














Dwight Edward Tompkins, an estate planning attorney in Orange County, advises clients to study the Medi-Cal program thoroughly as it can provide a low-cost or zero-cost health care protection.

The benefits provided by Medi-Cal are stipulated in the Affordable Care Act and are known under the umbrella term as “essential health benefits” or “medically necessary” health care.  These encompass a whole set of packages for those qualified under the program, including:   

                Physician’s fees including house calls
                Hospital confinement
                Pregnancy care and delivery
                Convalescence home care
                Preventive and wellness consultation
                Mental health and substance abuse disorder rehab, including prescription drugs and devices used
                Outpatient lab and pathological tests
                Dental care, vision care and speech therapy are covered fir those age 21 and below

With the enactment of Patient Protection and Affordable Care Act (PPACA), otherwise known as “ObamaCare,” the minimum income limit to qualify for Medi-Cal has been increased to 138% of the federal poverty level. In actual dollar terns, this means that people with an annual income of $15,856 or less can get Medi-Cal benefits.     

The increased limit however still excludes many residents from qualifying for Medi-Cal benefits.  If this is the case, there are several other ways to qualify. For example, small businesses and individuals with higher incomes may choose some plans under Medi-Cal  through Covered California. 

Another option is through purchase, transfer and acquisition of one’s assets and having these reflected in a Living Trust.  This is why Dwight Tompkins, an estate planning attorney in Orange County, recommends the inclusion of a special Medi-Cal language in the execution of your Living Trust.  It is always prudent to include Medi-Cal as an option when preparing for retirement because you can never guarantee your financial condition in the future.   Including Medi-Cal in your Living Trust will provide you more health care options at a time when you need health insurance the most.