If you are healthy and still living independently, but your spouse needs nursing home care, your primary home will not be counted as a resource when determining eligibility. This means your spouse can still qualify for Medi-Cal and can receive nursing home care while you keep your house.
If the house is in the name of the individual needing nursing home care, there are five exceptions put in place for the individual to be eligible for Medi-Cal while not selling the house.
- The individual states an intent to return to the home at some point.
- The individual’s spouse, dependent relative, or children under 21 still live in the house.
- It is a multi-unit house with people living in the other units.
- There are legal issues preventing the sale of the house.
- A sibling or adult child is living in the home that has an equity interest or has lived there for at least 12 consecutive months prior to the owner going into the nursing home.
Under these exceptions, the well spouse is guaranteed to be able to keep the house and continue living there. However, it is important to note that these rules are for eligibility only. If the Medi-Cal beneficiary dies, and the house is still in his or her name, Medi-Cal can make an estate claim on the house for unpaid expenses.
Check Your Eligibility
The above exceptions also only count for the primary residence. Additional property may not be protected depending on what it is. The rules regarding another property state that the property must be used by the Medi-Cal beneficiary and have a net market value of less than $6,000. Net market value is the assessed value or the appraised value of the property after subtracting encumbrances.
If the property is receiving income, that yearly income must be at least 6% the net market value. If the property does not produce income, the full net market value will be counted when determining eligibility. Depending on the value of the property, it may have to be sold in order to meet eligibility requirements for coverage.
California determines market value somewhat differently than most other states. In California, the market value is either the assessed value according to the current property tax assessment or the appraised value provided by a qualified appraiser. The state will take the lower of the two numbers as the market value of the property.