Form Dhcs 7102 - Notice Regarding Standards For Medi-Cal Eligibility And Recovery

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State of California—Health and Human Services Agency
Department of Health Care Services
NOTICE REGARDING STANDARDS FOR MEDI-CAL ELIGIBILITY AND RECOVERY
For Distribution by Insurers, Agents, and Brokers
IF YOU OR YOUR SPOUSE ARE CONSIDERING PURCHASING A FINANCIAL
PRODUCT BASED ON ITS TREATMENT UNDER THE MEDI-CAL PROGRAM, READ
THIS IMPORTANT MESSAGE!
You or your spouse do not have to use up all of your savings before applying for Medi-
Cal.
Recovery
An annuity purchased on or after September 1, 2004, shall be subject to recovery by the
state upon the annuitant’s death under the regulations of the Medi-Cal Recovery
Program. Income derived from the annuity must be used to meet the annuitant’s share
of costs and, if the annuitant is married, the income derived from the annuity may
impact the minimum monthly maintenance needs of the annuitant’s community spouse.
An annuity purchased by a community spouse on or after September 1, 2004, may also
be subject to recovery if that spouse is the recipient of past or future Medi-Cal benefits.
Unmarried Resident
An unmarried resident may be eligible for Medi-Cal benefits if he/she has less than
$2,000 in countable resources.
The Medi-Cal recipient is allowed to keep from his/her monthly income a personal
allowance of $35 plus the amount of any health insurance premiums paid. The
remainder of the monthly income is paid to the nursing facility as a monthly share-of-
cost.
Married Resident
Community Spouse Resource Allowance: If one spouse lives in a nursing facility and
the other spouse does not live in a facility, the Medi-Cal program will pay some or all of
the nursing facility costs as long as the couple together does not have more than
$123,600 in countable resources.
Minimum Monthly Maintenance Needs Allowance: If a spouse is eligible for Medi-Cal
payment of nursing facility costs, the spouse living at home is allowed to keep a monthly
income of at least his/her individual monthly income, or $3,090 in monthly income,
whichever is greater.
Fair Hearings and Court Orders
Under certain circumstances, an at-home spouse can obtain an order from an
administrative law judge or court that will allow the at-home spouse to retain additional
resources or income. The order may allow the couple to retain more than $123,600 in
countable resources. The order also may allow the at-home spouse to retain more than
$3,090 in monthly income.
DHCS 7102 (01/18) ENG

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