What are the Medi-Cal Income Limits for 2021?

Medicaid is a federal health program that is wide-ranging and available for low-income individuals of any age, providing them with health care benefits. California residents aged 65 or over can qualify for Medicaid through California’s Medicaid program called Medi-Cal. In addition to paying for health care programs, Medi-Cal also pays for non-medical support services that help seniors remain in their homes. Every year, California updates the income limits for Medi-Cal qualification based on federal poverty guidelines. 

Medi-Cal Income and Asset Limits for Eligibility

There are several different long-term care programs offered by Medicaid to which California seniors may be eligible. All of these programs have slightly different eligibility requirements and different types of benefits. The three critical types of Medicaid programs include the following:

  • Nursing Home/Institutional Medicaid: This program is an entitlement program meaning that anyone eligible for the program will receive assistance. This program pays for long-term care in a nursing home or Institution.
  • Medicaid Waivers/Home and Community-Based Services (HCBS):  This Medicaid Program is only available to a limited number of participants. Typically, some waitlists exist to become eligible for this program. Those who qualify can receive assistance at home, in an assisted living facility, or adult daycare.
  • Regular Medicaid / Aged Blind and Disabled: This is also an entitlement program. Those who meet the eligibility requirements will receive services. Beneficiaries can receive benefits from an adult daycare or at home.


Medi-Cal Income Limits for Single Applicants

As mentioned above, the income limits depend on whether you are single or married and whether one spouse or both spouses are applying for Medi-Cal. First, we will consider an applicant who is single and applying for Medicaid. If that individual is seeking institutional or nursing home Medicaid, there is no income limit. There is an asset limit of $2,000, and the applicant will need to prove that he or she needs nursing home care.

When a single applicant applies for Medicaid waivers, Home and community-based services, the income limit is currently $1,481 per month. The asset limit is $2,000, and the applicant will need to prove that he or she requires nursing home level care. Finally, when a single applicant applies for regular Medicaid, he or she will need to prove that his or her income is at $1,481 per month or less and owns less than $2,000 of assets. Applicants to this Medi-Cal program do not need to prove that they require any certain level of care.


Medi-Cal Income Limits for Married Applicants With Both Spouses Applying

When both spouses apply for institutional nursing home Medicaid, they do not have an income limit, but their asset limit is $3,000. They will need to prove that both spouses require nursing home level care. When both spouses apply for the Medicaid waiver home health and Community Based Services Program, they will need to prove that their income limit is at or beneath $2,003 per month and that they do not own over $3,000 in assets. Finally, when both spouses apply for regular Medicaid, their income limit cannot be more than $2,003 a month, and their assets must be under $3,000. They do not need to prove that they need a certain level of care.


Medi-Cal Income Limits for a Married Couple When One Spouse is Applying

When one spouse is applying for institutional or nursing home Medicaid, there is no income limit. There is an asset limit of up to $2,000 per applicant and up to $130,380 for the non-applicant spouse. The spouse applying for Medicaid needs to prove that he or she needs nursing home level care. When one spouse is applying for home and community-based services, his or her income level cannot be higher than $1,481 per month. The asset limit cannot be higher than $2,000 for the applicant and $130,380 for the non-applicant. 

Finally, when one spouse is applying for regular Medicaid, the income limit must be $2,068 per month, and the asset limit is up to $3,000. The eligibility process is more complicated when one spouse lives in the community, and one spouse applies for Medicaid coverage for a nursing home. The spouse who lives in the community can receive a minimum monthly maintenance needs allowance of $600 per month.


Are You Eligible for Medicaid Benefits?

Eligibility for these three programs is complicated because the criteria vary with a person’s marital status. Additionally, the state of California offers multiple pathways to become eligible. The American Council on Aging has a Medicaid Eligibility Test people can take online to determine if they are immediately eligible for Medicaid. This is simply an online test to give people an idea of whether they will qualify for Medicaid. 


Discuss Your Medicaid Eligibility With an Estate Planning Lawyer

If you would like to discuss your case more in-depth, the best thing you can do is consult an estate planning attorney. The income limits for Medicaid change every year, and California has complex rules related to eligibility. An experienced estate planning lawyer can help you understand which types of benefits for which you qualify. At the Law Office of Daniel Hunt, our lawyers have helped many California residents successfully prepare for nursing home stays. We can help you protect your estate so you will not spend all of your hard-earned income and assets on nursing home care. 

You will have more money to provide for your family and loved ones, and you will not need to worry about qualifying. However, you must begin this process as soon as possible. Medicaid has a five-year lookback period. If you transfer your assets within five years of applying for Medicaid so you can be underneath the income limits, those transfers will count against you. Contact our Sacramento estate planning law firm today to schedule your initial consultation and learn more about how we can help you prepare for the future.

Law Offices of Daniel A. Hunt

The Law Offices of Daniel A. Hunt is a California law firm specializing in Estate Planning; Trust Administration & Litigation; Probate; and Conservatorships. We've helped over 10,000 clients find peace of mind. We serve clients throughout the greater Sacramento region and the state of California.