California Community

Medi-Cal Has Booby Trap For Some Estates

Brooke Phillips, CWCMS
Editor | Shield HealthCare
09/09/14  11:13 PM PST
Medi-Cal estate recovery program

Many low-income Californians who became eligible for Medi-Cal, the state’s version of Medicaid, under the Affordable Care Act were happy to get free health care. But for those 55 and older, it came with a booby trap. When they die, the state will attempt to recover anything it spent on their health care from their estates, including their home.

This so-called estate recovery program has been a feature of Medi-Cal for many years, but the act allowed California to expand Medi-Cal coverage to a much larger group of people, including those with low incomes but unlimited assets. Some who are 55-plus are deeply concerned about asset recovery, because the rules are confusing and it’s hard to know how much of their estate is at risk.

It could range from hundreds of dollars a month if the person is in a managed care plan to an unlimited amount if the person is in a fee-for-service plan, in which Medi-Cal pays all the person’s health care costs. About 70 percent of Medi-Cal enrollees are in managed care, including all who became newly eligible this year under the act.

“If you received Medicaid services from age 55 and on, you are subject (to estate recovery) even if you are not receiving them at death,” says MaryBeth Musumeci, associate director with the Kaiser Family Foundation.

The state Senate has passed SB1124, which would scale back estate recovery in California, with bipartisan support. It is awaiting a vote in the Assembly. The California Department of Finance opposes the bill because it would reduce estate-recovery revenue, which help fund Medi-Cal. If the bill passes, there’s a chance Gov. Jerry Brown would veto it.

“It’s a concern. He’s penny pinching,” says Pat McGinnis, executive director of the California Advocates for Nursing Home Reform, which is co-sponsoring the bill.

Read Full Article from SFGate.