Elder Law Services of Ventura County

Craig R. Ploss - Attorney at Law

Medi-Cal Services provided by Elder Law Service of Ventura County

ELIGIBILITY PLANNING (Phase I)

This legal service is designed for a family facing the prospective placement of a family member into a skilled nursing facility (SNF). The service provides a focused approach to develop an eligibility strategy to ensure that the individual requiring care meets all of the financial eligibility and qualification requirements for Medi-Cal SNF benefits

  • Consultations regarding Long Term Care resources and California’s Medi-Cal program.
  • Preparation of a comprehensive, written Eligibility Plan presenting the various Medi-Cal eligibility strategies available to the applicant and family to use in qualifying the family member for Long Term Care Medi-Cal benefits.
  • Assistance in implementing the Eligibility Plan, to include coordinating all asset transfers and conversions with the client’s financial advisers, and advising on all eligible gifting.
  • Written Information on local nursing homes regarding their levels of care, services offered, and their histories, if any, of state law violations and Department of Health Care Services’ citations.
  • Review of or amendment to relevant revocable living trusts and durable powers of attorney to insure they contain the necessary provisions giving the trustee/agent the needed flexibility to transfer, gift, and re-title estate assets.
  • Preparation of additional revocable or irrevocable trusts as may be needed, for the protection and management of an applicant’s transferred assets.

 

QUALIFICATION SERVICE (Phase II)

This service is designed for the family facing the imminent placement of a family member into a skilled nursing facility (SNF), or where placement has already occurred, and the family requires Medi-Cal Long Term Care benefits to pay the SNF costs. This service implements the eligibility plan for the individual, prepares and files the application for long term care benefits, and further ensures the protection of the individual’s and family’s assets from Medi-Cal recovery claims. Specific elements include:

  • Providing the applicant/family with a detailed listing of the required asset, income, and personal information verification documents that the Medi-Cal case worker will be requesting
  • Preparation and filing of a comprehensive, tailor-made Medi-Cal Application Package, with all required verification documentation
  • Representation of the applicant and applicant’s authorized representative in dealing directly with the County Eligibility Worker and Appeals Coordinator throughout the application process
  • Legal representation of the applicant at any agency Fair Hearing proceedings (e.g. opposing denial of benefits actions, increasing the Community Spouse Resource Allowance, increasing the community spouse’s Minimum Monthly Maintenance Needs Allowance, etc.)
  • Preparation of necessary documentation to protect the applicant’s home from Medi-Cal spend down requirements, lien or estate claim (e.g. an Intentionally Defective Grantor Trust, Irrevocable Life Estate, or direct gift deed, as appropriate)

 

VA Pension Benefit Services provided by Elder Law Services of Ventura County

VA Eligibility Planning

  • Consultations regarding Long Term Care in-home and assisted living resources and VA benefits and eligibility rules
  • Review of the applicant’s/family’s Estate Planning Documents (Living Trusts, Durable Powers of Attorney for Health Care and Financial Affairs, etc.)
  • Preparation of, or amendment to, a revocable Living Trust, Durable Powers of Attorney for Financial Affairs, and Advance Health Care Directives for the Veteran and/or Spouse to enable asset and estate protection
  • Preparation of a comprehensive, written VA Eligibility Plan, to include:
    • Outlining the various non-service connected VA benefits available to the Veteran, or Surviving Spouse
    • Outlining the eligibility strategies best available to use in qualifying the Veteran or Surviving Spouse for the applicable non-service connected benefits
    • A companion analysis of California’s Medi-Cal Long Term Care (nursing home) benefits’ program re the potential pitfalls and conflicts with VA eligibility planning
  • Assisting client(s) with implementation of the Eligibility Plan, to include coordinating asset transfers and conversions with the client’s financial advisers, and devising the applicable eligible gifting plan(s)
  • Preparation of personal care contracts (PCCs), in-home care agreements for non-licensed in-home caregivers, or assisted living facility care statements
  • Preparation of an Intentionally Defective Grantor Trust (as needed)
  • Preparation of a 3rd Party Special Needs Trust (as needed)

 

VA Claim Preparation and Filing

  • Preparation of the actual VA Claim package for Non-Service Connected benefits, together with all supporting forms
  • Filing of the Claim package with the VA and representing the Veteran/Spouse thereafter with the VA eligibility case worker; responding to the VA’s requests for additional information and substantiating documentation
  • If initial claim denied, filing the Request for Reconsideration and/or Notice of Disagreement (NOD) with the VA
290 Maple Court, Suite 118, Ventura CA 93003
(805) 642-8407 - FAX (866) 379-2149