San Jose California Medi-Cal (Medicaid) Planning Attorney
Last updated on May 7, 2026
Helping California Families Protect Assets and Access Long-Term Care Benefits
Long-term care in California can cost over $10,000 per month, making Medi-Cal planning essential for many families. At the Law Offices of Berge & Berge in San Jose, we help seniors and their loved ones qualify for California Medi-Cal benefits while protecting homes, savings, and other hard-earned assets. With over 30 years of experience focused exclusively on estate planning, elder law, and public benefits planning, attorney James Berge — a board-certified specialist in estate planning, trust, and probate law — provides the knowledge and strategies you need to navigate Medi-Cal eligibility, avoid unnecessary estate recovery, and secure quality long-term care.
Don’t wait until a crisis strikes. Call our San Jose Medi-Cal planning attorneys today to schedule a confidential consultation.
Table of Contents
What Is Medi-Cal Planning?
Medi-Cal is California’s version of the federal Medicaid program, providing health coverage for low-income individuals and families, including coverage for long-term care in skilled nursing facilities.
Medi-Cal planning is the process of arranging your finances and legal affairs to qualify for these benefits while protecting your home, savings, and other assets from unnecessary loss.
How You Benefit From Proper Medi-Cal Planning
Contrary to what most people believe, you do not need to have completely diminished your personal resources to be eligible for Medi-Cal benefits when you require long-term care later in life. If you plan now, you can qualify for long-term care benefits that take the pressure off of you, your loved ones and your legacy when you have increased medical support needs due to the challenges of advanced age.
Taking the initiative to work with an elder law and estate planning attorney to help ensure you qualify for Medi-Cal if you need it can be beneficial for multiple reasons. Medi-Cal planning involves making strategic moves at least 30 months before applying to meet the strict limitations on income and countable assets to qualify.
The most obvious benefit of medical planning is the protection of your assets. You do not have to engage in an aggressive spend down later in life if you make strategic gifts and transfer property to an irrevocable trust in advance.
Additionally, you can avoid a look-back penalty. Any large transfers or gifts made in the 30 months before you apply can trigger a costly penalty. The state determines how many months of care you could have afforded based on those gifts and transfers. You then need to find a way to cover your own care costs for that many months before Medi-Cal coverage begins.
When your health declines, your spouse’s may not. If there is a significant age gap or if you have pre-existing medical conditions, your spouse could be left in a very vulnerable position when you require Medi-Cal coverage. Without appropriate planning, the penalties imposed during the look-back period could leave your spouse struggling to afford their basic needs.
Finally, the peace of mind that you derive from proper planning is all but invaluable. Knowing that you have access to benefits, your spouse has financial stability and your legacy will not end up consumed by Medicaid estate recovery efforts can help you make the most of your golden years.
Why Medi-Cal Planning Matters
Long-term care in California can cost over $10,000 per month. Without proper planning, these costs can quickly drain your life savings.
With careful structuring—using strategies allowed by law—you can:
- Qualify for Medi-Cal without spending all your assets
- Preserve your home for your spouse or heirs
- Avoid unnecessary recovery claims after death
- Provide for your spouse and dependents without disrupting benefits
When to Start Medi-Cal Planning
The best time to plan is before you need care, but even in a crisis situation—such as when a loved one is already in a nursing home—it’s often possible to preserve significant assets with the right guidance.
Common Medi-Cal Planning Strategies
We tailor each plan to your situation. Common legal and financial tools include:
- Medi-Cal Asset Protection Trusts
Move assets into an irrevocable trust to safeguard them from countable resources. - Spousal Protections
Use the Community Spouse Resource Allowance and income-shifting strategies. - Exempt Asset Structuring
Convert countable assets into exempt resources such as home improvements, a vehicle, or burial arrangements. - Gift & Transfer Planning
Transfer assets within the allowed “look-back” rules to preserve eligibility. - Income Planning
Reallocate income sources to avoid disqualification.
Our Process
- Initial Consultation – We review your assets, income, and care needs.
- Eligibility Analysis – We determine your current eligibility and identify any shortfalls.
- Custom Plan – We create a legal and financial plan to protect your assets and qualify you for benefits.
- Implementation – We prepare all necessary legal documents and assist with Medi-Cal applications.
- Ongoing Support – We help maintain eligibility and handle renewals or appeals.
Why Choose Us
- California-Specific Expertise – We know the nuances of California’s Medi-Cal rules.
- Comprehensive Solutions – We integrate estate planning, elder law, and tax strategies.
- Compassionate Approach – We understand these decisions involve more than numbers—they affect your family’s future.
Frequently Asked Questions About Medi-Cal Planning
Can I keep my home and still qualify for Medi-Cal?
Yes. In California, your primary residence is generally an exempt asset for Medi-Cal eligibility purposes, but planning may be necessary to protect it from estate recovery after your death.
What is the Medi-Cal “look-back” period?
Medi-Cal currently has a 30-month look-back period for certain transfers of assets, meaning gifts or transfers for less than fair market value within that time may affect eligibility.
Does my spouse have to spend all our savings for me to qualify?
No. California’s Community Spouse Resource Allowance allows the healthy spouse to keep a significant amount of assets and income without affecting the ill spouse’s eligibility.
Is Medi-Cal the same as Medicare?
No. Medicare is a federal health insurance program, while Medi-Cal is a needs-based program that covers long-term care costs Medicare does not.
Can I apply for Medi-Cal after I’m already in a nursing home?
Yes. Even in a crisis situation, planning can often protect substantial assets while obtaining benefits quickly.
Will Medi-Cal take all my assets when I die?
Medi-Cal may seek repayment from your estate through its estate recovery program, but proper planning can reduce or eliminate recovery.
Long-Term Care and Public Benefits Planning
Do you WANT to:
Understand your long-term care and payment options?
Contrary to popular belief, neither traditional health insurance nor Medicare covers long-term care, meaning most people will either have to have private long-term care insurance or simply have enough life savings or income to pay for it themselves. Fortunately, there is a form of public healthcare and long-term care insurance that is available for those who qualify for it, called Medi-Cal, and you don’t need to be broke to qualify for it. If you want to explore your options, give us a call, we can help.
Qualify for long-term care benefits under Medi-Cal?
In general, you can qualify for Medi-Cal if you’re disabled, elderly, or blind, own a home, including household furniture and furnishings, clothing, car, jewelry, and personal effects, have lots of money in retirement savings and non-qualified annuities, and even income-producing properties, you can qualify for Medi-Cal. And, if you are married, your (healthy) spouse can even have an additional $195,000 or more in the bank. If you want to explore your options, give us a call, we can help.
Qualify for monthly cash payments under SSI?
In general, you can qualify for regular monthly cash assistance for your food and shelter needs under Supplemental Security Income if you are disabled, elderly, or blind, own your own home, including household furniture and furnishings, your own car, and retirement savings, but only if you have limited income. If you want to explore your options, give us a call, we can help.
Qualify for monthly VA aid and attendance benefits?
In general, you can qualify for VA aid and attendance benefits if you (or your widow) need assistance with activities of daily living, you are a veteran of a declared wartime who received an honorable discharge, regardless of whether your disability is service-related, where your qualified monthly medical and long-term care expenses exceed your regular monthly income, and where your available cash resources are below $80,000. If you think you might qualify, give us a call, we can help.
Qualify for in-home supportive services benefits under Medi-Cal?
In general, IHSS will pay you to pay for someone (including a relative) to help you with activities of daily living in your own home when you’re unable to do them yourself, but to qualify, you will need a Medi-Cal benefits card and a separate application. In general, IHSS will pay for up to 20 hours a week at $12/hour based on demonstrated need. If you want to explore your options, give us a call, we can help.
Apply for long-term care benefits under Medi-Cal?
If you want (or need) help in completing your Medi-Cal application, or putting together your required documentation in support thereof, or attending your initial eligibility interview, or handling your post-interview follow-up, or even appealing a denial of benefits, give us a call, we can help.
Apply for in-home supportive services under Medi-Cal?
If you want (or need) help in completing your Medi-Cal and/or IHSS application, or putting together your required documentation in support thereof, or attending your initial eligibility interview, or handling your post-interview follow-up, or even appealing a denial of benefits, give us a call, we can help.
Respond to a Request for Notice of Redetermination under Medi-Cal?
If you want (or need) help in completing your Annual Request for Redetermination of Medi-Cal Benefits, or putting together your required documentation in support thereof, or attending an eligibility interview, or handling your post-interview follow-up, or appealing a denial of benefits, give us a call, we can help.
Appeal a denial of benefits due to “excess resources”?
If you want (or need) help in appealing a recent denial of benefits due to “excess resources” or for any other reason, give us a call, we can help.
Decrease your “share of cost” under Medi-Cal?
If you feel your “share of cost” is too high or you may want to lower it, give us a call, we can help.
Understand how to legally “spend down” your estate?
“Spenddown” refers to a plan to reduce “excess resources” in order to qualify for Medi-Cal, SSI, VA Aid and Attendance, or other needs-based public welfare program. In general, spenddown can be accomplished in one of three ways: a true expense, the purchase of a non-countable resource, such as a home, or a true gift of money or property. A good spend down plan will accelerate initial eligibility and protect assets from Medi-Cal estate recovery.
Protect your home and other exempt resources from estate recovery claims?
In general, the only way to avoid estate recovery claims upon the death of a Medi-Cal recipient is to give away all your property during life so that you own nothing when you die. There are three ways to make a lifetime gift that don’t jeopardize eligibility, avoid estate recovery, and are very protective of the donor: gift of property subject to a life estate; gift of property subject to a retained right of occupancy agreement; and the transfer of property to an irrevocable personal residence trust or a Medi-Cal Asset Protection Trust. Each has its pros and cons involving property tax, gift and estate tax, income tax, and asset protection considerations to both the donor and the donee. But before you consider any of these alternatives, you should consider whether estate recovery is a real possibility in the first place. In some instances, there is no Medi-Cal usage and thus no recovery. In other instances, Medi-Cal benefits were received before an individual was age 55 and thus no recovery. Or, in still other instances, there is no recovery until the surviving spouse dies, or no recovery if a Medi-Cal recipient is survived by a disabled child, whether a minor or an adult. There is also a caregiver exception to recovery which should be considered. If you need advice, give us a call, we can help.
Create and fund a personal residence trust?
An irrevocable personal trust is perhaps the best way to protect a home from estate recovery claims while also being highly protective of the donor homeowner. The donor maintains control over the property and the trustee and the beneficiaries while achieving a variety of property tax, gift and estate tax, and income tax benefits, and asset protection benefits for the beneficiaries. If you want to know more about this type of trust and its suitability in your particular circumstances, give us a call, we can help.
Provide financial support to a person with a disability?
In general, you can provide financial support to a person with a disability without causing a loss of benefits to them as long as you do not pay them directly or pay for something that their public benefits currently provide to them. The issue can arise however when a person with a disability inherits money from a friend or relative or receives a windfall payment causing resources to build up, or when you would like to leave something to a person with a disability when you die. There is no need to disinherit a person with a disability simply to avoid a loss of benefits to them. If you want to know more about this topic, give us a call, we can help.
Create and fund a special needs trust for a person with a disability?
A special needs trust, also known as a supplemental support trust, is a great way to provide financial support to a person with a disability, without jeopardizing public benefits. Sometimes, this type of trust can be created by a parent, grandparent, conservator, or a court, for the person with a disability, funded with property belonging to the person with a disability, and sometimes, this type of trust can be created by someone other than the person with a disability for the benefit of the person with a disability and funded with property not belonging to the person with a disability. The trust can sometimes be revocable, and other times, it must be irrevocable. The trust is generally created to provide for the special needs, or the needs not otherwise met through any public welfare program, of the person with a disability, including the purchase of a home. If you want to know more about this type of trust and its suitability in your particular circumstances, give us a call, we can help.
Understand your rights as a patient in a hospital or residential care facility?
Patients have rights, even if it appears that they do not. Just because you’re married or have children or gave an advanced healthcare directive to someone or a physician order for life sustaining treatment (POLST) to a doctor, or just because you’ve been admitted to a hospital or residential care facility, such as a nursing home or assisted living facility, does not give them rights superior to yours. Only a court can take away your right to make medical and personal care decisions for yourself and then only after notice and a hearing and the right to have counsel by your side. If you feel that your rights are not being respected, give us a call, we can help.
Petition the court to increase your CSRA under Medi-Cal?
If you are married and your spouse is receiving care in a nursing home, and you have too many resources to qualify for Medi-Cal nursing home benefits, give us a call. The law permits a community spouse (also known as the healthy spouse) to retain enough money and other property (referred to as resources) to generate enough income to maintain his or her lifestyle while the nursing home and Medi-Cal take care of the healthcare and personal care needs of the institutionalized spouse (also known as the ill spouse). This property reserve is referred to as a community spouse resource allowance and can consist of otherwise countable resources. If the standard CSRA, established annually by Medi-Cal, is inadequate to meet the lifestyle needs of the community spouse, it can be increased by a court or an administrative law judge.
Petition the court to establish a CSIA?
If you are married and your spouse is receiving care in a nursing home, and your spouse’s “share of cost” seems too high to allow you to maintain the lifestyle to which you’ve become accustomed, give us a call, we can help. There is a way for us to lower your spouse’s “share of cost” to acceptable levels by going to court to create a community spouse income allowance, similar to an alimony award if you were divorced. Among the allegations required are insufficient resources to produce the amount of income needed by you to support your accustomed lifestyle.
Petition the court to authorize a gift from one spouse to another?
In general, a Medi-Cal recipient may not have more than $130,000 in cash and other countable resources at date of application or any other time. If married, the community spouse is allowed to have much more than this, but the institutionalized spouse must remove his/her name from the account within 90 days of the application date. If the institutionalized spouse is incompetent at the time and has failed to give a valid power of attorney to someone to make this happen, problems with eligibility can arise, necessitating a court order. Also, to avoid estate recovery claims being made against property belonging to a Medi-Cal recipient on the death of the Medi-Cal recipient and his/her spouse, a gift from one spouse to another is highly recommended. Again, if the institutionalized spouse is incompetent at the time and has not given a valid power of attorney authorizing gifting to someone, problems can arise, necessitating a court order. If either of these two situations concern you, give us a call, we can help.
If you answered YES to any of these questions, you need an experienced Public Benefits Planning Attorney to help you. We, at the Law Offices of Berge & Berge, are attorneys who specialize in the field of Public Benefits Planning. With over 30 years of proven Public Benefits Planning experience serving the entire South Bay Area, we can help you. Please give us a call at 669-244-3546 or send us an email at [email protected].
Do You Need Legal Help Paying For Long-term Care Or Avoiding Estate Recovery? Contact Us Today.
Don’t wait until it’s too late. Call 669-244-3546 or fill out our contact form below to schedule a consultation. Let us help you protect what you’ve worked for and ensure you get the care you deserve.
Disclaimer: This information is for educational purposes only and does not constitute legal advice. Every situation is unique. Consult with an attorney before taking action.
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