What Will Medi-Cal Pay For?

If you or a family member has recently been diagnosed with a condition that calls for nursing home support, you’re probably thinking about paying for this care. It’s important to have a basic understanding of what it takes to apply for this coverage so that you can take action steps in advance.

While it would be ideal if you never needed to tap into Medi-Cal because no one needs nursing home care, you want you and your spouse to have the option of applying for and getting this support as quickly as possible if you’re able.

Medi-Cal is not just in place for elderly people who need nursing home care. It’s also available for children under 21, pregnant women, low-income people over 65 who are blind or disabled, and low-income people with dependent children.

In general, Medi-Cal covers costs that are deemed “medically necessary.” Funds can also support certain dental care expenses, hearing aids, lab and X-ray costs, eyeglasses, ambulance services, adult day health service, and physician visits.

Nursing home care support from Medi-Cal is covered if a physician has already provided prior authorization. Physicians look at whether or not a person has challenges with one or more activities of daily living. If a person is unable to do things like eating or toileting due to a medical issue, a doctor might recommend that more advanced support in a nursing home be provided to the patient.

Medi-Cal does not automatically pick up the bill for a California. You’ll also need to know if you meet the basic income requirements with regards to your personal property, too. Working with a Pasadena estate planning lawyer is a great way to discuss spending down assets in your estate and creating transfer plans well in advance in the event that you or or your spouse need Medicaid help in the future for nursing home plans.

Need help with getting started? Contact our Pasadena estate planning firm for further details.

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