frequently asked questions
M.R.S. offers consulting and advocacy services for the planning and application process for Medi-Cal eligibility.
When a prospective family first contacts M.R.S. we provide a brief free assessment to determine whether our services are needed.
Once it is determined that MRS can help we schedule an hour long $95 telephone consultation. Our consultations are conducted over the phone which enables all family members, regardless of location, to participate and ask questions directly to M.R.S. Consultants, and eliminates the inconvenience of travelling to meet with us.
Once the consultation is scheduled MRS will send the family a preliminary questionnaire requesting the general information that M.R.S. will need to counsel and advise the family as to their options to navigate their specific challenges and concerns.
The consultation starts off with a question and answer series that allows Kathryn to clarify exactly where the Applicant currently stand regarding potential eligibility for Medi-Cal. Following her conclusion of the family’s options for establishing eligibility she will open the stage for all questions family representatives may still have regarding the Applicants case. At this point Kathryn will advise you of all the appropriate steps you will need to take to successfully complete the process.
You will also have the option of having M.R.S. act as your Authorized Representative through the application process. At the conclusion of the consultation, after seeing the specifics of your families’ case we will provide a quote for M.R.S.’s retainer agreement to act on your families’ behalf.
M.R.S. clients are guided through a process that starts with being provided a complete summary of the consultation, a document request list for the paper trail needed for the application, and an assorted set of the formal application forms each with their own instructions. We complete the application forms, our clients never have to go to Medi-Cal, and will never have to speak with the Medi-Cal worker. Our clients are reminded that they are to direct the DHS Worker directly to M.R.S.’s toll free number if they ever were to receive a call from Medi-Cal.
The whole Medi-Cal process is inherently stressful and to attempt to navigate its’ bureaucracy during what is already a highly emotional and stressful time becomes too much to manage alone. Family care manager representatives are often overwhelmed with their own lives and then on top of monitoring the challenges of their loved one who are acclimating to a senior care home, the Care Manager is further tasked with the burdensome and daunting process of spending countless hours attempting to navigate the bureaucracy that is Medi-Cal? M.R.S. is here to help!
With over thirty years of experience in Medi-Cal we are confident enough to Guarantee our families an Approval!
When a prospective family first contacts M.R.S. we provide a brief free assessment to determine whether our services are needed.
Once it is determined that MRS’ services are appropriate we schedule an hour long $95 consultation. Our consultations are conducted over the phone which enables all family members to participate and ask questions directly to M.R.S. and provides the convenience of not having to travel to meet with us.
For only $95 our Consultants will evaluate your potential for Medi-Cal benefits and will answer all of the questions that cause apprehension and un-needed stress like; “Will I lose my home?” “Do I have too much money?” “Will the state try to recover from my Estate?” etc.
After completing our consultation, you will have an invaluable knowledge of your own specific situation. With that knowledge you will be able to enter the application process with the control and confidence that people often lack when proceeding blindly into the often-overwhelming application process for Medi-Cal eligibility.
You will know exactly where you stand and how to represent your family through the Medi-Cal Application Process. You will be empowered and not be in the dark when going through the Medi-Cal application process, so that you will not be easily intimidated by ticking clocks and over worked Eligibility Workers at the Department of Health Services.
You will also have the option of having M.R.S. act as your Authorized Representative through the application process. At the conclusion of the consultation, after seeing the specifics of your families’ case we will offer you a quote for M.R.S.’s retainer agreement to act on your families’ behalf.
Our prices for complete representation throughout the Medi-Cal application process is usually between Eighteen Hundred to Thirty-five hundred dollars depending on the complexity of the Families’ Estate and the Program that we are applying for.
M.R.S. clients are provided with a summary of the consultation, request list for the needed paper trail needed for the application, we complete the application forms, our clients never have to go to Medi-Cal, and will not have to speak with Medi-Cal, and in fact our clients are able to refer a Medi-Cal Eligibility Worker to M.R.S. toll free number if they ever were to call the family. With over thirty years of experience in Medi-Cal we are confident enough to Guarantee our families an Approval!
It seems that our most valuable commodity these days is time, so it is important to have an avenue to find information that can help to efficiently accomplish the tasks that we face. While Google is an amazing technological achievement, I have compassion for anyone whose only option is to search the web for information about “Medi-Cal” and then attempts to navigate these bureaucracies without expert assistance.
The myriad of misinformation available for these inherently complicated programs is staggering, and the attitude and fees of many of the attorneys and advocates are shameful.
For only $95 our Consultants will evaluate your potential for Medi-Cal benefits and will answer all of the questions that cause apprehension and un-needed stress like; “Will I lose my home?” “Do I have too much money?” “Will the state try to recover from my Estate?” etc.
After completing our consultation, you will have an invaluable knowledge of your own specific situation. With that knowledge you will be confident to proceed with the application process on your own. You can trust that the information we provided to you and your family is accurate which empowers a family with the confidence that is often lacking when proceeding blindly into the daunting application process for Medi-Cal eligibility.
Ultimately, after the Consultation you will know exactly where you stand and how to represent your family through the Medi-Cal Application Process. You will be empowered and not be in the dark when going through the application process, so that you will not be easily intimidated by ticking clocks and constant demands of an often over worked and utterly stressed out Eligibility Workers at the Department of Health Services.
After the consultation, a family will also have the option of retaining M.R.S. to act on their families’ behalf, acting as their Authorized Representative throughout the application process. At the conclusion of the consultation, after seeing the specifics of your families’ case, we will offer a quote for M.R.S.’s retainer agreement to act on the families’ behalf.
M.R.S. clients are then provided with a summary of the consultation, a request list for the needed documentary paper trail needed for the application, we complete all of the formal application forms, our clients never have to go to Medi-Cal, and will never have to speak with Medi-Cal. In fact, our clients are able to simply refer a Medi-Cal Eligibility Worker who calls to M.R.S.’s toll free number.
Once the application is completed and submitted, MRS will follow up with any documents requested by the Department of Health Services, and aggressively pursue the approval. As an advocate for your case, MRS will be the primary contact for the county so that you or your family are not bothered in a time when you have enough to worry about.
With over thirty years of experience in Medi-Cal we are confident enough in our expertise and knowledge, to Guarantee our families an Approval from Medi-Cal!
At the conclusion of M.R.S.’s Ninety-Five-dollar consultation, a family have the option of retaining M.R.S. to act on their families’ behalf, as their Authorized Representative throughout the application process.
After seeing the specifics of your families’ case during the consultation, our Consultant will provide the family a quote for M.R.S.’s retainer agreement to act on the families’ behalf.
Our prices for complete representation throughout the Medi-Cal application process is usually between Eighteen Hundred to Thirty-five hundred dollars depending on the complexity of the Families’ Estate and the Program that we are applying for.
You may ask yourself how it is that a person seeking Medi-Cal can afford to pay for M.R.S.’s services?
First, if the family’s case is uncomplicated due to minimal assets, the family will be empowered and capable after the consultation with M.R.S. to complete the application on their own behalf should they so desire.
When the family’s case is more complex and advocacy is either required, or just desired, the total price of the M.R.S.’s advocacy is less than one month’s stay at a convalescent facility.
Many people privately pay for the first month in Long Term Care because they are overwhelmed with the task of supporting the ill spouse’s acclimation into the new LTC Community.
Our job is to secure a successful result from Medi-Cal for that first month’s costs in the facility and thus by retaining M.R.S. the family avoids paying $9,000 from their savings.
The Common scenario is:
A family retains M.R.S. for $2,500 to advocate on their behalf thru the application process.
Their Long-Term Care Convalescent Facility cost are approximately $9,500 a month.
The family realizes a savings of $7,000 the first month by hiring M.R.S. to submit the application in a timely manner.
In other words, once our services are retained, families will usually have saved two to three times more money in the first month on LTC, than they paid to retain M.R.S. to advocate on their family’s behalf.
A fair hearing is the process of going before an Administrative Law Judge with the request to retain assets above the Medi-Cal allowance of $130,640. Under certain situations, if the At Home Spouse’s monthly income is low enough, they may retain more than the $130,640 allowed by the state.
MRS has successfully represented many clients through this process. For an example of how a fair hearing can help, one of our clients was allowed to keep over $700,000, due to a very low income. In fact this particular client could have kept up to $1,000,000 dollars in assets.
The approval of a fair hearing allows the client to retain full control of all their money. In comparison a Medi-Cal annuity will lock all their money away, leaving them with a monthly payment and under no case can they receive more than the set amount. If the fair hearing is applicable to your specific situation, it can be a much better option than the “spend down” or “gifting” options that requires the client to disperse all their money as gifts to other people thereby losing control of their finances. The fair hearing is a method used to avoid leaving the At Home Spouse in a state of complete poverty.
If your situation is similar to this and you are hesitant to report information to your eligibility worker out of concern that it will negatively affect eligibility then contact MRS and we will, at a $150 an hour rate, undergo a complete evaluation of your situation, present you with your options, and set you on a course that best represents your needs.
Due to the fact that everyone’s situation is different, off the cuff generalized answers create a liability for M.R.S., and because of that we will need to complete a thorough evaluation before we offer a current Medi-Cal beneficiary advice and guidance.
If you have been denied coverage in the past and you feel the denial to be unjustly rendered, then give us a call. MRS has been responsible for the reopening of numerous cases where we find error in a negative determination.
DHS Medi-Cal Eligibility Workers are over-worked and overwhelmed by the large number of caseloads that they are responsible for and thus make errors in the determination for benefits. These mistakes in return can cause inappropriate denials. It is under these circumstances that MRS would have the case reopened, and the client would be appropriately reimbursed.
Sometimes the entire county in which the client is seeking eligibility may be misinterpreting regulations. This was the case in a particular County where thousands of clients were denied erroneously for being over property because of their IRAs. So, Kathryn submitted an application for her client which was wrongfully denied due to Medi-Cal inappropriately counting the value of the clients’ IRA. The value in the IRA put Kathryn’s client over the allowed countable asset property limit.
The problem with DHS County interpretation here is that an IRA that is set up to take proper distributions, is an “Exempt Asset.” The County was out of compliance, not the client.
Kathryn then proceeded to call that Counties’ DHS Supervisor and informed them that regulations were being misinterpreted by their eligibility workers. Kathryn was told by the Supervisor that she was wrong in her interpretation of the regulation.
The County was corrected by the State Property Analyst and immediately closed their offices for a couple of days to retrain their eligibility workers as to the proper treatment of IRAs.
Due to the expertise of Kathryn Humphres, applicants in that County are no longer inappropriately denied Medi-Cal benefits due to their IRAs.
Answer: NO.
Medi-Care will only pay for the first 100 days of hospitalization and rehabilitation as long as there is constant improvement. Once the patient is no longer improving the patient will be released either home or to a convalescent home under custodial care. At which time custodial cost are paid privately or paid by Medi-Cal.
One of the biggest and most common misconceptions about Medi-Cal eligibility is that it is based on an applicants’ income!
Not true!
We constantly hear people say that they had been told, or that they had heard that they made too much income to get help from Medi-Cal.
Medi-Cal eligibility is based solely on an applicants’ “countable assets.”
What is a Countable Asset?
Probably easier to list what is Not a Countable asset…
It is complicated but in general an applicants’ Home, one Vehicle, IRAs, Irrevocable Burial Policies, some Life Insurance Policies, and Pensions are “NOT Countable Assets.”
Medi-Cal will only look at income after eligibility has been established. They do so to determine the Medi-Cal budget. Depending on the Medi-Cal program applied for, and level of income, a Medi-Cal recipient may be required to pay a portion of their monthly care costs which is what is called a monthly “share-of-cost.”
Answer: NO!
MRS is different in that we want to share ALL legal options during our Ninety-Five-dollar phone consultation with families regarding planning and preserving estates.
We want our clients to explore all options that DHS Medi-Cal legally allows and let the family choose what is best for their situation. Medi-Cal allows for many planning tools that are efficient and legal for preserving an Estate.
One of our most important priorities is to help senior couples, and more specifically the well spouse.
DHS Spousal Impoverishment Regulations allow our “Well Spouses” to have up to $267,400 in countable assets in addition to their home, pensions, IRAs, vehicle, … which are not countable, and still receive assistance with their “Ill Spouses” ongoing Health Care Costs.
Answer: NO!
Under certain circumstances the “at home” spouse can retain more than the $267,400 allowed in countable asset limits set by Medi-Cal.
This is accomplished through a “fair hearing.” Through the process of a fair hearing the “well spouse” can petition the Administrative Law Judge and request that their Assets and/or Income resource allowance be increased
We have seen the Courts allow assets as high as $818,000.
We here at MRS specialize in Fair Hearings when appropriate.
Answer: No. DHS Recovery do not initially place a lien against the Estate. The Medi-Cal Recovery branch does however file “claims” for recovery against the estate of a deceased beneficiary of Long-Term Care Medi-Cal benefits.
However, Medi-Cal Recovery Branch cannot initiate a recovery claim until after the death of both spouses.
However, when the Primary Residence is funded into a Living Trust it is no longer subject to the Medi-Cal Recovery Branch.
