Estate Planning for Long Term Care

Did you know that Medicare does not cover nursing home care after one hundred days? This article will provide some basic information about why you need to plan for possible nursing home care and some strategies for doing so, with information published by the California Advocates for Nursing Home Reform, which can be found here:

Medi-Cal is a source for long-term care.

  • A common misconception is that Medicare covers long-term care. In California, Medi-Cal is a need-based program designed to help people pay for medical care such a skilled nursing facility or nursing home.

Medi-Cal eligibility requirements have changed as of January 1, 2024.

  • One piece of good news for many California residents, is that Medi-Cal will no longer count assets to determine eligibility. California is the first state to make this change to Medicaid eligibility.

Medi-Cal is income only now.

  • Now eligibility is determined by income, which at present is $1732 per month max. See
  • If a Medi-Cal beneficiary’s available countable income exceeds their maintenance needs level, then an otherwise eligible Medi-Cal beneficiary has a share of the cost.

How does a trust benefit a person who may need Medi-Cal coverage?

  • An article published by the Lake County News provided a good summary and examples of how a trust may impact a person seeking Medi-Cal eligibility, and a few highlights are quoted below. For the full article, see
    • A trust, whether revocable or irrevocable, minimizes a person’s available countable income and share of cost. Income received by a trust (with income producing assets) does not count as income to the trust beneficiary for determining Medi-Cal share of cost.
    • Direct distributions by the trust to the beneficiary count as available income.
    • But, if the trust were instead to pay a portion of a person’s support and maintenance needs, called, “in kind support and maintenance,” but not 100% of any support/maintenance cost (e.g., rent), then such payments do not count for Medi-Cal share of cost.
    • If the trust were directly to pay for other expenses and purchases other than certain necessities of life (buying clothes) then such other trust purchases do not count as income for share of cost.

Contact an Experienced Estate Planning Attorney

Planning for and navigating the complexities of Medi-Cal can be a daunting process for some California residents, but planning for long term care can be a crucial step in safeguarding your future. At the Law Office of David Knecht, we have extensive experience in all aspects of estate planning and can help you prepare an estate plan that is right for you and your loved ones. Estate planning is like setting the coordinates for a journey, and it will help create a more confident and smoother ride through the later part of your life. Contact us today at 707-451-4502.