This information is for senior couples where one is caring for the other and uncertain if they will be able to continue this care to the level it is needed in the future. Maybe the caregiver is having her/his own medical issues or maybe the care recipient is in need of two-person transferring assistance or nursing-level oversight. Since Medicare does not provide long-term home nor facility care, if this couple does not have the resources to bring in additional care supports, and if they as a couple are not Medi-Cal eligible to access the In-Home Supportive Services Program, then they may feel trapped by their situation.
The Medi-Cal Spousal Impoverishment Provision is one resource that families like this may be able to tap into. But there is a catch; it relates strictly to care received in a Skilled Nursing Facility (also known as a Long Term Care Facility) and does not apply to home care nor residential care facilities/assisted living. Even if they are not Medi-Cal eligible as a couple (typically because their nest-egg exceeds $3,000), the Spousal Impoverishment Provision may allow the care recipient to become Medi-Cal eligible to receive care in a Skilled Nursing Facility while the other spouse (who will not be on Medi-Cal) continues to live life in the community at a comfortable financial level. In 2015, this provision allows the couple to have on hand $119,220 in resources (not including a house nor vehicle) and the community spouse to retain up to $2,981 of the couple’s shared monthly income before having to contribute a “share-of-cost” of the care recipient to receive care in the Skilled Nursing Facility. As with all things related to Medi-Cal, there are subtleties and considerations — one being Medi-Cal Recovery — but for many households, this provision can allow two older adults to meet their individual current and long-term care needs.
If this situation sounds like one your family is struggling with, you may want to contact the local Medi-Cal office to learn more about this provision and whether it might make sense for you.
Kathy Johnson is the Community Resources Specialist for Community Care’s Senior Information & Assistance Program, serving Lake and Mendocino County Seniors Monday through Friday at 468-5132 or 1-800-510-2020.
