New eligibility rules are a financial salve for nearly 2 million on Medi-Cal
Millions of Medi-Cal beneficiaries can now save for a rainy day, keep an inheritance, or hold on to a modest nest egg, without losing coverage, thanks to an eligibility change phased in over the past year and a half. It also has opened the door for thousands who previously did not qualify for MediCal, the health insurance program for low-income residents that covers over onethird of California's population.
Until Jan. 1, 3 million Medi-Cal beneficiaries, mainly those who are aged, blind, disabled, in long-term care, or in the federal Supplemental Security Income program, faced limits on the value of financial accounts and personal property they could hold to qualify for coverage. Now, nearly 2 million of them will no longer face these restrictions, putting them on par with the roughly 12 million other Medi-Cal beneficiaries who don't have asset limits.
They still must be below Medi-Cal's income threshold, which for most enrollees is currently $1,677 a month for a single adult and $3,450 for a family of four. However, the change will eliminate a lot of paperwork for applicants and the county workers who verify their eligibility.
For a long time, this group of Medi-Cal beneficiaries could have no more than $2,000 in the bank — $3,000 for a married couple — though the home they lived in, as well as one car and certain types of other personal property, were exempt.
“If you had $5,000 in assets, you would have to spend $3,000 on something to prove that you were beneath the limit to qualify,” says Tiffany Huyenh-Cho, a senior attorney at the advocacy group Justice in Aging. “We had people who prepaid rent, spent money on car repairs, bought a new couch or appliances — things to reduce their assets in order to get to the $2,000 limit.”
Now, Huyenh-Cho adds, “you don't have to remain in deep poverty. You can save for an emergency; you can save for retirement or for a security deposit if you want to move.”
And those who have hoped to leave a little something for their children when they die can now do so, even if they need expensive longterm care.
The first phase of the rule change was implemented in July 2022, when the threshold was raised dramatically to $130,000 for an individual and $195,000 for a twoperson household, making it a nonfactor for the vast majority of those concerned. After all, most people with incomes low enough to qualify for Medi-Cal would not have that much saved. For this reason, the total elimination of the so-called asset test ushered in this year is expected to help fewer people financially than the first change did.
Still, there are some people with more than $130,000 in the bank whose savings would have been wiped out in shockingly short order had they needed long-term care in a nursing facility or at home. Now, they can qualify to have Medi-Cal pick up that cost.
Joanne Shinozaki, a resident of Granada Hills, a Los Angeles neighborhood, hired private full-time caregiving last year for her mother, Fujiko, who has dementia. But it cost nearly $11,000 a month, which Shinozaki quickly realized would burn fast through the roughly $200,000 in savings her father had left when he died early last year. Reluctantly, she put her mom in a memory care home, which was less expensive. But after a 10% increase in January, it is now costing $9,000 a month, although that includes food and utilities.
Because of the money Shinozaki's dad left, her mom did not qualify for MediCal under the old rules. But now, that money no longer counts against her. Shinozaki, a veterinarian who quit her job to coordinate her mother's care, needs to return to work soon. She has applied for Medi-Cal for her mom and is waiting for it to be approved.