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February 2026 Medi-Cal Asset Review for Bay Area Seniors: Simple Checklist and Planning Tips
By Jay Patrick Greene, Esq., CPA
Trust, Probate, and Elder Law Attorney
Published: February 9, 2026 | San Francisco, CaliforniaWith Medi-Cal’s 2026 asset limits back in place, Bay Area seniors and couples have a good chance this February to do a basic asset review. This guide gives an easy Medi-Cal asset review checklist for 2026, made for Bay Area homeowners and couples. It helps you tell exempt (protected) assets from countable (ones that count against the limit) under California’s new rules. This February checklist builds on our January overview of asset limits. It gets you ready for long-term care planning, like nursing homes or help at home.
Understanding Exempt vs. Countable Assets in 2026
Under the new non-MAGI Medi-Cal rules that started January 1, 2026, single people can have up to $130,000 in countable assets. Couples can have up to $195,000, plus $65,000 for each extra household member (up to 10 people). There are special rules for married couples if one needs long-term care.
Exempt assets (these don’t count) usually include your main home (if it fits Medi-Cal rules), one car, household items, some burial funds, and certain retirement accounts if you’re taking regular payments. Countable assets (these do count) include extra cash, stocks, vacation homes, or more than one car. In the Bay Area, where homes often cost over $1 million, knowing how Medi-Cal sees your home and other things is key to avoid problems with long-term care eligibility.
The Asset Review Checklist
Use this simple February checklist to sort out your situation and get ready to talk to an expert:
Gather 30 months of financial records. Get bank, investment, and other money statements for at least the last 30 months. California’s nursing-home Medi-Cal rules look back 30 months to check for transfers when you apply, so this helps your lawyer find issues early.
Make a list of all your assets. Write down everything you own with its current value: homes, bank accounts, investments, cars, retirement funds, business shares, and life insurance values.
Sort assets as exempt or countable. Using Medi-Cal rules, mark each one as exempt (like your main home if you or your spouse live there, one car, home items, burial funds) or countable (extra cash, stock accounts, second homes, extra cars).
Check transfers and gifts since mid-2023. Note any gifts or moves of money in the last 30 months—how much, when, and to whom. Transfers for less than full value during this time can delay your Medi-Cal for nursing homes when you file an application.
Find “extra” countable assets. Add up your countable assets and compare to the 2026 limit (like $130,000 for one person or $195,000 for a couple, plus extra for more household members). See how much you might need to spend or change.
Set up a meeting with an elder law lawyer. Take your list and transfer notes to a good elder law attorney. They can check what’s exempt, look at past transfers, and talk about options like special trusts, spouse rules, or safe ways to spend down.
Real-World Example for Bay Area Residents
Think about Elena and Alex, a married couple in San Francisco with a $2.5 million condo. It’s their main home, so it’s exempt under Medi-Cal rules. They have $180,000 in savings. Under 2026 rules, their countable asset limit is $195,000, so they’re under if all $180,000 counts.
If they had $260,000 in countable savings, they’d be $65,000 over. Working with a lawyer, they could do a safe spenddown—like paying debts, adding home safety features (grab bars, ramps, stair lifts), or pre-paying burial costs. This turns extra countable assets into exempt ones and helps meet eligibility. This planning is helpful for Bay Area families where high costs make saving hard.
Tailored Guidance for Bay Area Households
For families with different setups, get papers ready now. This includes marriage papers, shared bill proofs like joint utilities, or statements from family or friends who help with care. These show how your household works and avoid delays. For self-employed people, bring recent tax forms and business records. Medi-Cal might handle changing income in a special way—talk to an elder law lawyer or accountant first.
Medi-Cal 2026 Planning: Frequently Asked Questions
What assets count toward Medi-Cal limits?
Countable assets usually include cash, bank accounts, investments, and extra property like vacation homes. Exempt assets often include your main home, one car, household goods, burial funds, and some retirement accounts in payout.
How much can a couple keep under 2026 rules?
For non-MAGI Medi-Cal, a couple’s basic combined asset limit is $195,000, plus $65,000 for each additional household member, up to 10 people. In long-term care cases, spouse rules may let the at-home spouse keep more.
What is a Medi-Cal spenddown?
A Medi-Cal spenddown means using extra countable assets for okay expenses—like medical bills, debt pay off, needed home fixes, or pre-paid burial plans—so your left countable assets are at or below the Medi-Cal limit, without bad gifts.
Moving Forward with Confidence
This February guide builds on January’s asset-limit overview and sets the stage for March’s application-focused tips, providing a structured way to clarify your exempt vs. countable assets under California’s 2026 Medi-Cal rules. An elder law professional can refine your Medi-Cal asset review checklist and help you implement strategies tailored to your Bay Area household and goals.
Keep Your Planning on Track
Use these steps now to strengthen your plan and better prepare for potential long-term care needs in the Bay Area.
Contact Greene Law Firm, P.C. today. Call 415-905-0215 or email info@greenelawfirm.com—free initial assessment.
Statements in Compliance With California Rules of Professional Conduct
The materials in this article are for educational purposes only and are not legal advice. Consult an estate planning attorney for personalized guidance.
Attorney Jay Patrick Greene, Esq., CPA, founded Greene Law Firm, P.C., which is licensed in California, Alabama, and Florida. He has over 15 years of experience concerning wills, trusts, probate, elder law, and asset protection. For more information, visit:
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The 2025 Medi-Cal Window Closed - What Bay Area Families Can Do Now
By Jay Patrick Greene, Esq., CPA
Trust, Probate, and Elder Law Attorney
Published: January 8, 2026 | San Francisco, CaliforniaOn January 1, 2026, California brought back asset limits for Medi-Cal long-term care. For two years, families could qualify for nursing home coverage regardless of how much money they had. That window is closed. Now, if you have more than $130,000 (individual) or $195,000 (couple), you’ll need to act strategically or risk paying thousands per month out of pocket.
WHAT CHANGED ON JANUARY 1, 2026?
California reinstated Medi-Cal asset limits on January 1, 2026. Individuals can have no more than $130,000 in countable assets; couples, $195,000 (plus $65,000 per additional household member). The state also reactivated the 30-month lookback period, reviewing your financial transfers from the past 30 months. Gifts or transfers can trigger ineligibility penalties.
Why This Matters:
From January 2024 to December 31, 2025, California had no asset test—you qualified for Medi-Cal nursing home coverage based on income alone, regardless of wealth. That temporary relief is gone. For Bay Area families with substantial assets, this means three critical things:
1. You must now report your assets when applying for Medi-Cal
2. Excess assets must be spent down or sheltered legally before you qualify
3. The timing of any financial moves matters enormously because the state reviews 30 months of history
THE NEW MEDI-CAL ASSET LIMITS (EFFECTIVE JANUARY 1, 2026)
What Are the Exact Asset Limits?
Individual: $130,000 (countable assets only; home excluded)
Married Couple: $195,000 (combined for both spouses)
Each Additional Household Member: Add $65,000 (up to 10 household members total)
Institutionalized Spouse: $130,000 (plus community spouse protections)
Community (At-Home) Spouse: Up to $157,920 (special spousal impoverishment rules apply)
What Counts as Assets:
These assets count toward the limit:
• Cash and bank accounts
• Stocks, bonds, mutual funds
• Investment real estate
• Life insurance with cash value (over $1,500)
• Vehicles beyond the first one
What Does NOT Count (Exempt Assets):
These are protected and don’t count:
• Primary residence (your home)
• One vehicle
• Household items and personal effects
• Jewelry within reasonable limits
• Retirement accounts in current payout status
THE 30-MONTH LOOKBACK PERIOD
How Does It Work?
When you apply for Medi-Cal in 2026 or later, California reviews every financial transfer from the past 30 months. If you gave away money, funded a trust, or made large payments to family, the state may impose an ineligibility penalty.
How the Penalty Works:
The penalty is calculated using this formula:
Penalty = Amount Transferred ÷ Average Monthly Nursing Home Cost in Your Area
San Francisco Example:
Let’s say you transfer $80,000 to your daughter on March 1, 2026.
Average monthly nursing home cost in San Francisco: approximately 20,000. Using $15,000 for this calculation:
$80,000 ÷ $15,000 = approximately 5 months
Result: If you apply for Medi-Cal in 2027, you’ll be ineligible for 5 months while you pay privately (about $75,000 out of pocket).
San Francisco Nursing Home Costs (2026):
• Semi-private room: 18,000 per month
• Private room: 25,000+ per month
• Average monthly cost for penalty calculation: approximately 20,000
The Timeline Question: Are Gifts Before or After January 1 Safer?
Gifts Made BEFORE January 1, 2026:
These are safer. If you apply for Medi-Cal in January 2026, the state only looks back to January 2025. Gifts from 2024 or earlier are outside the review window (as long as they occurred more than 30 months before your application date).
Gifts Made AFTER January 1, 2026:
These are subject to the 30-month lookback. If you apply in 2026 or later, gifts from early 2024 forward are under review.
YOUR THREE LEGAL OPTIONS
What are my options if I have more assets than Medi-Cal allows?
You have three main strategies. Which one is best depends on how much you have over the limit and how soon you might need care.
OPTION 1: SPEND DOWN SMARTLY (If 150,000 Over Limit)
When It Works:
You have time (4–6 weeks), and your excess assets aren’t enormous.
How It Works:
Use your extra money on allowed expenses that must be paid anyway. You reduce your countable assets to meet Medi-Cal limits while getting value from the spending.
Allowed Spend-Down Expenses:
You can spend down by paying for:
• Home modifications for safety (ramps, grab bars, accessibility upgrades, stair lifts)
• Medical and dental bills (including unpaid balances)
• Home care and personal assistance services
• Home repairs that protect the property
• Prepaid funeral or burial costs
• Property taxes and insurance
• Paying off personal debt
Timeline Example:
Situation: You have $240,000 in liquid assets; Medi-Cal limit is $130,000
Your overage: $110,000
Action: You spend $110,000 over 4–6 weeks on home modifications, medical debt, and pre-arranged burial
Result: You apply for Medi-Cal with $130,000 left and are approved with no penalty
Advantage: Fast, simple, no penalty period
Disadvantage: Assets are gone (but spent on necessary items)
OPTION 2: SET UP AN IRREVOCABLE TRUST (If $100,000+ Over)
When It Works:
You want to protect assets long-term and reduce Medi-Cal countable assets without immediate spend-down.
How It Works:
You transfer excess assets into an irrevocable trust. The trust holds the assets, so they don’t count toward Medi-Cal limits (after the 30-month lookback period ends).
Important: Trusts created AFTER January 1, 2026 start the 30-month clock. This means:
• You may pay privately for 3–18 months before Medi-Cal kicks in
• After 30 months, the transferred assets are safe and don’t count
• Your family eventually inherits the protected assets
Timeline Example:
Situation: You have $300,000 in assets; Medi-Cal limit is $130,000
Action: You fund an irrevocable trust with $170,000 in January 2026
Medi-Cal lookback begins. Penalty calculation: $170,000 ÷ $15,000 monthly cost = approximately 11 months ineligibility
You pay privately for 11 months: approximately $165,000 out of pocket
Month 12 and beyond: You qualify for Medi-Cal and it pays for care
Result: Assets are eventually protected; your family inherits the remaining wealth after you pass
Advantage: Long-term asset protection; family inheritance preserved
Disadvantage: Private-pay period during lookback; irrevocable (can’t change terms later)
OPTION 3: PAY PRIVATELY FIRST, PLAN LATER (If $200,000+ Assets)
When It Works:
You have substantial wealth and don’t need immediate Medi-Cal approval.
How It Works:
You pay for nursing home care out of pocket now. Over months or years, you and your attorney restructure assets strategically to reduce what Medi-Cal counts. No rushing; no penalties triggered by poor timing.
Timeline Example:
Situation: You have $500,000 in assets; current care costs $18,000 per month
Year 1: You pay privately for 12 months (approximately $216,000 spent)
During this time: Your CPA and elder law attorney implement a long-term asset protection plan
By month 13: You’ve restructured assets or spent down through allowed means
You apply for Medi-Cal: with reduced countable assets
Result: You paid for a year of care, but protected remaining assets strategically
Advantage: Flexibility; no rush; tax-efficient planning possible
Disadvantage: You pay full cost for an extended period
SAN FRANCISCO-SPECIFIC COSTS & PLANNING
How Nursing Home Costs Affect Your Medi-Cal Planning
2026 San Francisco Nursing Home Costs:
• Semi-private room: 18,000 per month (median approximately $15,817)
• Private room: 25,000+ per month
• Annual cost: 300,000+
This high cost means:
1. Penalty divisor is larger: A $100,000 transfer equals fewer months of ineligibility than in lower-cost states
2. You burn through assets quickly: Without Medi-Cal, private pay depletes savings in 3–5 years
3. Planning is urgent: Bay Area families are more likely to exceed Medi-Cal limits
Regional Comparison Example:
$100,000 transfer in San Francisco: $100,000 ÷ $15,000 = approximately 7 months ineligibility
$100,000 transfer in Texas: $100,000 ÷ $8,000 = approximately 12 months ineligibility
San Francisco families trigger shorter penalty periods but face higher absolute costs.
COMMON QUESTIONS ABOUT MEDI-CAL 2026
Question: “Can I give gifts to my family right now without penalty?”
Answer: Technically yes, but expect review. If you give $50,000 to your son today and apply for Medi-Cal in 2027, the state will ask about it and impose a penalty period. A better option: Use an irrevocable trust structure, which is designed for asset protection and has clearer legal standing.
Question: “I’m 62 and healthy. Why plan now if I might never need nursing home care?”
Answer: Two reasons. First, planning now is legally safer—gifts made today are further from your Medi-Cal application date, reducing lookback risk. Second, incapacity (stroke, dementia, accident) can happen at any age. You’d rather restructure assets proactively than under crisis pressure.
Question: “If I need care in 2027, am I stuck with private pay?”
Answer: Not necessarily. If you need care soon (2026–2027) and have excess assets, spend-down option is best. You can reduce countable assets in weeks by paying for home modifications, medical bills, or other allowed expenses. Then apply for Medi-Cal.
Question: “Do I need a lawyer and a CPA?”
Answer: Medi-Cal planning touches both law and taxes. Trusts require legal drafting. Asset restructuring requires tax planning to avoid unintended tax consequences. Working with an attorney and CPA together prevents costly mistakes.
Question: “What if my spouse is in a nursing home but I’m still at home?”
Answer: Spousal impoverishment rules protect you. Your spouse can use $130,000 of countable assets; you (the community spouse) can typically keep $157,920 and your home. California law is more generous than federal rules. Discuss with an attorney to optimize protection.
YOUR ACTION PLAN FOR JANUARY 2026
This Week:
1. List Your Assets: Gather statements for all bank accounts, investments, real estate, vehicles, retirement accounts, and life insurance policies.
2. Calculate Your Medi-Cal Limit: Individual limit is $130,000; couple limit is $195,000. Do you exceed this? By how much?
3. Identify Timing: When might you need long-term care? If soon, spend-down is best. If years away, trust option is better. If no rush, private-pay strategy works.
4. Call for a Free Assessment: Contact Greene Law Firm at 415-905-0215. Jay Greene will review your situation, outline your best options, and discuss penalty risks and tax effects.
By January 20, 2026:
• Have a preliminary plan in place (spend-down vs. trust vs. private-pay)
• Understand your estimated penalty period (if any)
• Know the tax implications of your strategy
• Be informed about whether to move quickly or wait
FREE INITIAL MEDI-CAL ASSESSMENT
What You’ll Get:
• Confidential analysis of your assets and Medi-Cal eligibility
• Review of your best legal option (spend-down, trust, or private-pay strategy)
• Discussion of penalty risks specific to your situation
• No pressure; no obligation
How to Schedule:
Phone: 415-905-0215
Email: info@greenelawfirm.com
Website: www.assetprotectionbayarea.com
ABOUT JAY PATRICK GREENE, ESQ., CPA
Education & Credentials:
Jay Patrick Greene holds a J.D. from Hastings College of Law (2007) and is a licensed California attorney. He is also a Certified Public Accountant (CPA) licensed by the State of California (2002). His specialization is in elder law, asset protection, and Medi-Cal planning.
Experience:
Jay Greene has spent 10+ years helping San Francisco Bay Area families navigate elder law and long-term care planning. As both an attorney and CPA, he addresses legal and tax issues together—preventing costly mistakes and optimizing family wealth protection.
Service Area:
Greene Law Firm serves families throughout:
• San Francisco
• Marin County
• Alameda County
• Surrounding Bay Area communities
Contact Information:
Greene Law Firm, P.C. 447 Sutter Street, Suite 435 San Francisco, CA 94108
Phone: 415-905-0215
Email: info@greenelawfirm.com
Website: www.greenelawfirm.com or www.assetprotectionbayarea.com
IMPORTANT DISCLAIMER
This article is educational in nature and does not constitute legal advice. Estate Planning and Medi-Cal laws are complex and change frequently. Your strategy must be tailored to your specific situation, family dynamics, household composition, asset types, income, and care needs.
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2025 Year-End Checklist: Secure Your Family Assets Before December 31
As families reflect on the year, securing your assets through estate planning is crucial for protecting loved ones and ensuring financial stability. This means establishing at least a minimum estate plan—like a will, powers of attorney, and advance directives—or completing a full plan with trusts to safeguard against uncertainties.
In 2025, with California's Medi-Cal program evolving, major updates effective January 1, 2026, reinstate asset limits at $130,000 per person and $195,000 per couple for most non-MAGI programs, plus $65,000 for each additional household member up to 10 (some spousal protections and program-specific rules apply). This makes it essential to review and update plans now to maintain eligibility and avoid issues. Early action before December 31 helps leverage current rules, navigate rising costs, and protect family legacies in states like California and Alabama.
Options in the Bay Area can complement professional estate planning. For instance, coordinating legal strategies with supportive programs enhances asset protection and peace of mind.
What is a Minimum Estate Plan and Why Does It Matter?
A minimum estate plan provides basic protections to direct asset distribution, healthcare decisions, and financial management if you're incapacitated. It helps families avoid disputes and unnecessary taxes, though it typically requires probate for validation.
Key elements: A last will and testament for inheritance; durable power of attorney for finances; advance healthcare directive for medical choices; beneficiary designations on accounts.
Example: Many clients in San Francisco use a simple will to ensure assets pass to heirs, but it still goes through probate court unless the estate qualifies for small estate exceptions (under $208,850 for personal property in California as of April 1, 2025; a separate higher threshold of $750,000 applies for primary residences under certain conditions).
In 2025, it's vital amid economic shifts and the 2026 Medi-Cal asset reinstatement—failing to plan risks eligibility loss or asset depletion. Benefits: Streamlined inheritance, reduced family stress, and alignment with your wishes.
Key Options for Estate Planning
Minimum Estate Plan: Covers essentials like wills and directives to handle basics. Pros: Quick setup, cost-effective; cons: Typically undergoes probate.
Complete Estate Plan: Includes revocable or irrevocable trusts for advanced protection. Pros: Avoids probate, shields from creditors.
Updating Existing Plans: Reviews documents for life changes or new laws like 2026 Medi-Cal limits. Pros: Ensures compliance, maximizes exemptions.
In California, consider high property values and taxes; in Alabama, focus on probate differences. Common pitfalls: Outdated plans ignoring multi-state assets—professional guidance prevents this.
Step-by-Step: How to Get Started Before December 31
Assess your current setup—review existing documents or note gaps.
Gather key info: Deeds, accounts, insurance policies.
Consult a licensed attorney for tailored advice, incorporating 2026 Medi-Cal shifts.
Draft or update wills, trusts, and directives.
Designate beneficiaries and fund trusts if needed to avoid probate.
Review with family for clarity.
Common Quesions About Estate Planning in 2025
Families often ask:
How much does it cost? Costs depend on the service—expect higher prices for more comprehensive, personalized options.
What are DIY risks? Misses state rules, risking invalid plans; professional review is essential.
How does Medi-Cal fit? Updates in 2026 require asset strategies to preserve eligibility.
When to start? Before December 31 to act under current rules.
Signs You Need Professional Guidance
Property ownership; family changes; multi-state assets; business interests.
With planning rates low, guidance ensures your plan adapts to 2026 changes and addresses probate for wills.
How Greene Law Firm, P.C. Can Assist You
Greene Law Firm, P.C., assists clients with wills, trusts, probate, elder law, and asset protection. Licensed in California, Alabama, and Florida, we provide personalized plans that address family needs and coordinate with resources, drawing from multi-state experience.
Clients: Families, business owners, retirees.
Services: Minimum to complete estate plans, updates.
Approach: Empathetic, thorough consultations.
Ready to Prepare?
Don't wait for 2026 changes to limit your options. Complete your checklist before December 31.
Contact Greene Law Firm, P.C., today. Call 415-905-0215 (San Francisco) or 205-746-2465 (Birmingham), or email jay@greenelawfirm.com—free initial assessment available.
About the Author Attorney Jay Patrick Greene, CPA, founded Greene Law Firm, P.C. Licensed in California, Alabama, and Florida, he has over 15 years in wills, trusts, probate, elder law, and asset protection. For more information, visit: https://greenelawfirm.com
Statements in Compliance State Rules of Professional Conduct: This material is only for general information and is not considered legal advice. Every case is different, and past results do not guarantee future outcomes. No representation is made that the quality of our legal services is greater or less than that of other lawyers. Please consult a lawyer licensed in your state for legal advice about your specific situation.