Medi-Cal Planning for Bay Area Seniors

Medi-Cal, California's Medicaid program, provides health coverage including nursing home and home care for low-income seniors (65+), blind, or disabled individuals—unlike Medicare, which lacks long-term care and has no income test. Jointly funded by federal/state governments, it covers 1 in 6 Californians, but eligibility hinges on income, assets, and medical need.​

For San Francisco Bay Area families, planning ahead protects assets from $8K–$15K/month nursing home costs while qualifying legally.

2025 Medi-Cal Eligibility Requirements

Qualification focuses on countable income/assets; middle-class households can qualify via planning (e.g., asset protection trusts) before depleting savings. Key 2025 limits for long-term care (Nursing Home/HCBS):​

  • Single applicant: Income ≤ $2,901/month (300% FBR); Assets ≤ $2,000 (rising to $130,000 in 2026).

  • Married couple (both applying): Income ≤ $5,802/month; Assets ≤ $3,000.

  • Married (one applying): Applicant assets ≤ $2,000; Spouse allowance up to $157,920 (CSRA).

  • Home equity limit: ≤ $1,103,000 (if intending to return).

Non-countable: Primary home, one vehicle, funeral trusts. Medical need: Nursing Facility Level of Care (ADL limitations). No asset test for children/pregnant women/ACA adults (up to 138% FPL ~$1,799/month).

Benefits of Medi-Cal Planning

Without planning, revocable trusts offer no long-term care protection—assets must pay bills first. Poor strategies risk:​

  • Immediate ineligibility from gifting home (5-year look-back penalty).

  • Loss of control (e.g., child's divorce/bankruptcy exposes assets).

  • Gift taxes or unintended inheritance.

Smart options include Medi-Cal-compliant asset protection trusts (retain control, bypass 60-month wait), annuities, or long-term care insurance ($3K–$5K/year premium vs. one month nursing). Planning is 100% legal, like tax code optimization.

Common Medi-Cal Planning Myths

Myth: Must be broke to qualify. Reality: Strategies protect $100K+ for middle-class families.​

  • Myth: Too late if in nursing home. Reality: Options exist pre-application; hospitals won't advise.​

  • Myth: 36-month wait always. Reality: Certain trusts avoid it; apply only when eligible to dodge penalties.​

2026 changes: $130K asset cap, work rules for some adults, reduced retroactive coverage.

Frequently Asked Questions: Bay Area Medi-Cal

  • Single: $2,901/month income, $2,000 assets. Most income pays care share; spouse gets $600–$934 MNA.

  • Yes, 60-month look-back penalizes transfers; use compliant trusts instead.

  • Yes, if equity ≤ $1,103,000 and intent to return; otherwise, strategies protect it.

  • Yes, fully legal under CA rules—like IRS strategies for taxes.

Protect Your Assets: Contact Us Now

Don't let long-term care drain your savings—60% of seniors need it. Call 415-905-0215 for a free initial assessment. Use the form below to explore Medi-Cal strategies tailored for Bay Area families.

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