How Medicare and Medi-Cal Work for Long-Term and Short-Term Care

One of the most common issues that Santa Clara elder law attorneys deal with is how to help clients when it comes to both short-term and long-term care.  Folks are living longer than they ever have before, due to advances in both health care and technology.  Certainly, this is what people have been hoping would happen for generations, but it does bring with it some new challenges.  High on that list is the increased need for short-term care (to recover from an illness or injury, for example) and long-term care.  What people so often want their Santa Clara elder law lawyers to explain is how they can afford it and whether Medicare or Medi-Cal can help.

The answers to these questions are, of course, fairly complicated; but it’s worthwhile to have at least a little knowledge to get started.  In the case of Medicare and Medi-Cal, you will find that both of them can help when it comes to paying for rehab services, but under different guidelines.  This is something that Santa Clara elder lawyers spend a lot of time researching, and with laws constantly changing, it’s best to confer with someone knowledgeable about the current status of these programs.

Medicare

If you are over 65, then Medicare might be a reasonable option for you.  While similar to health insurance, Medicare is a federal program.  Whether you live in California or any other state, you can expect the same benefits and requirements.  For example, to qualify, you need to transfer to a rehab facility (or nursing home) only after staying at least three days and three nights in the hospital; and the move needs to take place within 30 days of the hospital stay.

Basically, Medicare is there to help when an unexpected illness or injury arises so that you can get through it and recover.  It’s not a plan for long-term care, rather it’s for those who need skilled care as they’re making their recovery.  For that reason, Medicare will only pay for 100 days of care, and the last 80 days require a co-payment from the patient.

Medi-Cal

Your elder lawyer will tell you, however, that Medi-Cal is a state-run program.  It is in place for those who have a demonstrated financial need.  And that need must be pretty significant.  In fact, you may have to prove that you have less than $2,000 in assets to qualify, and if you have more, you might have to get creative in how to reallocate it to qualify.  Again, an elder law attorney in Santa Clara may be able to offer advice and suggestions on how to do this appropriately.  The good news is that there are some exemptions to this $2,000 worth of assets rule, and you may be able to keep your house and your car while still qualifying.

Getting the most out of Medi-Cal can be difficult to figure out, so gaining clarification from a Santa Clara elder law lawyer is definitely recommended.  Social workers and staff at the hospital may also have suggestions and recommendations.  This is one of those times when it pays to be prepared in advance, too, so that you know what your options will be and can set things up to work to your utmost advantage should you need to rely on Medi-Cal.