The asset limit for Non-MAGI Medi-Cal eligibility will increase to $130,000 per person beginning July 1, 2022. The increased asset limit has nothing to do with Covered California or MAGI Medi-Cal. The higher Non-MAGI Medi-Cal asset limits supersede the previous limits of $2,000 for an individual. The specific programs impacted by the higher asset limit of $130,000 are the Medicare Savings Program (MSP) – dual eligible – and Long-Term Care (LTC) programs.
Higher Asset Limit for Medicare and Long-Term Care Programs
California’s Medi-Cal programs are administered by the Department of Health Care Services. There are a variety of different programs to help low-income residents access affordable health care. To be eligible for many of the Medi-Cal programs there are both income and asset limits. The income limits, that are updated every year, based on the federal poverty level, have not changed for 2022. MAGI Medi-Cal, typically associated with Covered California, has never had an asset limitation.
Household Asset Limits for Non-MAGI Programs as of July 1, 2022.
The populations most affected by the Medi-Cal asset limitations are individuals with Medicare and those people who need long-term care, usually in a skilled nursing facility. The Medicare Savings Program (MSP) can cover – at the highest level – Medicare Part A and B premiums, deductibles, coinsurance, and copayments. For help paying for a skilled nursing facility, the Long-Term Care (LTC) program can cover the cost of the assisted living facility. Of course, in both instances, the individual had to meet the very low asset levels associated with Non-MAGI Medi-Cal.
The higher asset limit applies to non-exempt assets. Generally, assets exempt from the calculation are an individual’s house as a primary residence, one car, burial plot, up to $1,500 in a burial expense account, furniture, and other household and personal items. What has stymied many people from being eligible for some Non-MAGI Medi-Cal programs are the non-exempt assets such as savings accounts, stocks, bonds, or other assets that could be liquidated to pay for health care services.
Medi-Cal Estate Recovery Remains Unchanged
What has not changed is the Medi-Cal Estate Recovery program. Medi-Cal, with its variety of programs and conditions for eligibility, is big and complicated. It is all too easy to over-simplify eligibility conditions and the different rules. Our lives are similarly complicated with homes, cars, income streams, living and irrevocable trusts, life insurance, and retirement funds. Consequently, only a Medi-Cal case eligibility worker can make an accurate determination as to whether an individual may qualify for Non-MAGI Medi-Cal at the higher asset levels. If you think you may be eligible because of the higher asset limits, apply for the extra help.
There are several other Non-MAGI Medi-Cal programs that will benefit from the higher asset income limit. Some of the other programs subject to the higher asset limit are Aged, Blind, and Disabled, Working Disabled, Severely Impaired Working Individual, Aid to Families with Dependent Children, Medically Indigent, Dialysis Special Treatment, Tuberculosis, Refugee Medical Assistance, Disabled Adult Child, Aid to Disabled Widow(er)s.
Below are the different programs and aid codes that are affected by the higher asset limitation for eligibility.
Below are excerpts from publicly available “All County Welfare Directors” letters from the Department of Health Care Services. I quote the content of these letters because they cite some of the specifics with the higher asset limitation policy implementation.
ACWD Letter No.: 21-31, November 19, 2021
Subject: Increases to the asset limits for Non-Modified Adjusted Gross Income Medi-Cal programs.
The purpose of this All County Welfare Directors Letter (ACWDL) is to provide counties and the Statewide Automated Welfare System (SAWS) with guidance regarding changes to the asset limits for Non-MAGI programs, including Medicare Savings Programs (MSP) and Long-Term Care (LTC) programs. These changes, effective July 1, 2022, enacted by Assembly Bill (AB) 133, (Chapter 143, Statutes of 2021), increase the asset limits for Non-MAGI programs to $130,000 per person, and $65,000 for each additional person (up to a maximum of 10 people). These revised asset limits supersede all previous guidance regarding asset limits for Non-MAGI Medi-Cal programs, and should be used in place of the previous limits of $2,000 per person and $3,000 for two people.
In 2021, several health measures were consolidated in AB 133 as part of the Health Omnibus Bill of 2021-2022. This ACWDL addresses only the provisions of AB 133 that added section 14005.62 to the Welfare and Institutions Code (WIC). WIC § 14005.62 establishes a two-phased approach to eliminating the asset limits for Non-MAGI Medi-Cal programs. The first phase, which is effective July 1, 2022, will increase the asset limits to $130,000 person and $65,000 for each additional household member (up to a maximum of 10 people). The second phase, effective January 1, 2024, will eliminate the asset limits for Non-MAGI programs. This ACWDL addresses only the increases in asset limits in the first phase. Additional guidance will be provided to counties regarding the elimination of the asset limits in a future ACWDL.
Effective July 1, 2022, the asset limits for Non-MAGI programs will increase to $130,000 for one person, and $65,000 for each additional person (up to a maximum of 10 people). Please see attached for all affected programs and asset limits by number of people being evaluated. The increased asset limits apply to Non-MAGI programs, including LTC and the MSPs as listed in the attachment below. Counties shall use the revised asset limits as of July 1, 2022. Individuals who apply for benefits in the month of June 2022 and are over the asset limit at that time shall be evaluated for eligibility for the month of July 2022 and ongoing.
SAWS shall make programming changes to automate the new asset limits as outlined in this ACWDL by July 1, 2022. DHCS will work with SAWS to facilitate programming of these changes.
ACWD Letter No.: 22-05, March 15, 2022
SUBJECT: 2022 Statewide Average Private Pay Rate (APPR) for Nursing Facility Level of Care and Reminder of Changes to Asset Limits
This letter announces that the 2022 APPR for nursing facility level of care (NFLOC) is $10,933. Use the 2022 APPR when calculating the period of ineligibility for transfers of nonexempt property for less than fair market value only if an application for an institutionalized individual or institutionalization occurred in 2022, and a disqualifying transfer occurred. Do not update existing periods of ineligibility for NFLOC on an annual basis. Counties must not use this figure to recalculate periods of ineligibility for NFLOC if the dates of application and institutionalization occurred prior to January 1, 2022.
Reminder of Changes to the Asset Limits
On July 1, 2022, the asset limits for Non-MAGI Medi-Cal will be changing. In this context, the term “assets” refers to non-exempt property. The asset limit for one person will increase from $2,000 to $130,000. This change will apply to institutionalized individuals, and therefore must be used when calculating any period of ineligibility for disqualifying transfers of property occurring on or after July 1, 2022. SAWS will be programmed to reflect the increased asset limits prior to implementation.
ACWD Letter No.: 22-06, March 29, 2022
SUBJECT: 2022 Medicare Savings Program Property Limit
Effective January 1, 2022, this letter revises the Medicare Savings Program (MSP) property limit amounts to be used in determining eligibility. This guidance is effective immediately. The Statewide Automated Welfare Systems (SAWS) must make programming changes for the 2022 MSP property limits during the next available SAWS release.
Counties must review all MSP denials and discontinuances back to January 1, 2022, and re-evaluate eligibility based upon the revised property limit amounts.
MSP 2022 Property Limits
The property limits used to determine MSP eligibility will increase in 2022. The limits are $8,400 for an individual and $12,600 for a couple. Federal law sets the MSP property limits at three times the Supplemental Security income property limit plus an annual percentage increase equal to the increase in the Consumer Price Index.
Please note: Effective July 1, 2022, the asset limits for Non-MAGI programs will increase to $130,000 for one person, and $65,000 for each additional person (up to a maximum of 10 people). The increased asset limits apply to Non-MAGI programs, including LTC and the MSPs. Counties shall use the revised asset limits as of July 1, 2022.