California Probate and Trust
Medi-Cal Planning Attorney
Private Consultation with an Attorney
Medi-Cal Planning Attorney Sacramento
Protect your home, your savings, and your spouse from the devastating cost of long-term care. California State Bar Certified Specialist serving Sacramento and Placer County.
⚠️ Major Medi-Cal Change — July 1, 2027 Deadline
California reinstated Medi-Cal asset limits on January 1, 2026. If you are 65 or older, disabled, or in a nursing home:
Now through June 30, 2027
$130,000
asset limit per person
Starting July 1, 2027
$21,000
asset limit per person — a $109,000 drop
If your assets exceed these limits when you renew Medi-Cal, you could lose coverage. The window to plan is now — before July 2027. A Medi-Cal Asset Protection Trust can move assets out of your countable estate before the lower limits take effect.
The Long-Term Care Crisis Most Families Are Not Prepared For
Skilled nursing facility care in the Sacramento area costs between $10,000 and $15,000 per month — $120,000 to $180,000 per year. Memory care and specialized facilities cost more.
Most people assume Medicare will cover it. It will not — Medicare covers short-term skilled nursing care after a hospital stay, typically for no more than 100 days. After that, you are on your own.
A family with $500,000 in savings could see everything consumed in three to four years. Then what? Medi-Cal — California's Medicaid program — kicks in when your assets fall below the eligibility threshold. But there is a catch: Medi-Cal estate recovery. The California Department of Health Care Services (DHCS), headquartered in Sacramento, will make a claim against your estate after death for every dollar Medi-Cal paid on your behalf.
Your home is the primary target.
The good news: with proper planning — done before a crisis — Sacramento and Placer County families can protect their home and savings while still qualifying for Medi-Cal long-term care benefits.
Medi-Cal Planning Services
Medi-Cal Asset Protection Trust (MAPT)
A MAPT is an irrevocable trust that removes your home and savings from your countable assets for Medi-Cal eligibility purposes. After the applicable look-back period, assets in the MAPT are protected from Medi-Cal estate recovery. This is the most powerful tool for protecting a Sacramento home from nursing home costs.
- ✓ Protects primary residence from DHCS estate recovery
- ✓ Can include savings, investments, and other assets
- ✓ Preserves ability to qualify for Medi-Cal
- ✓ Works alongside your estate plan
Medi-Cal Estate Recovery Defense
After a Medi-Cal recipient dies, DHCS sends a claim to the estate. We defend Sacramento families against Medi-Cal estate recovery claims — challenging improper claims, identifying exemptions, and protecting surviving family members.
- ✓ Challenge DHCS estate recovery claims
- ✓ Surviving spouse and minor child exemptions
- ✓ Hardship waiver applications
- ✓ Trust and probate coordination
IHSS — In-Home Supportive Services
IHSS is a California Medi-Cal program that pays for in-home care — personal care, domestic services, and paramedical services — so that elderly and disabled individuals can remain safely at home. Keeping a loved one at home with IHSS is far less costly than a nursing facility, and preserves assets.
- ✓ IHSS eligibility planning
- ✓ Medi-Cal qualification for IHSS
- ✓ Coordination with Sacramento County IHSS office
- ✓ Caregiver agreements and documentation
PACE — Program of All-Inclusive Care for the Elderly
PACE is a Medicare and Medi-Cal program for seniors 55+ who qualify for nursing home level of care but can safely live in the community. PACE covers medical care, prescriptions, adult day care, transportation, and more — all coordinated through a single PACE team. An alternative to nursing home placement.
- ✓ PACE eligibility assessment
- ✓ Medi-Cal enrollment coordination
- ✓ Sacramento-area PACE program guidance
- ✓ Alternative to skilled nursing facility
Skilled Nursing Facility Planning
When a loved one enters a skilled nursing facility in Sacramento, Roseville, Folsom, or the surrounding area, the financial clock starts immediately. We help families understand their options, protect remaining assets, and plan for Medi-Cal qualification while a loved one receives care.
- ✓ Crisis Medi-Cal planning
- ✓ Spend-down strategies
- ✓ Spousal protection planning
- ✓ Asset conversion to exempt categories
Medi-Cal Long-Term Care Planning
Proactive planning done years before a crisis is far more effective than crisis planning. We help Sacramento County families understand the Medi-Cal rules, the 30-month look-back period for long-term care, and how to structure assets to maximize protection and future eligibility.
- ✓ 30-month look-back period guidance
- ✓ Asset and income limits explained
- ✓ MAPT timing and strategy
- ✓ Medi-Cal application assistance
Understanding the Medi-Cal Asset Protection Trust (MAPT)
The MAPT is the cornerstone of Medi-Cal planning for Sacramento homeowners. Here is how it works:
You create an irrevocable trust
The MAPT is irrevocable — meaning you give up direct ownership and control of the assets placed inside it. In exchange, those assets are protected from Medi-Cal estate recovery.
Your home is transferred into the trust
Your Sacramento home — or other assets — are deeded into the MAPT. You typically retain the right to live in the home for life. The trust owns the property, not you.
The look-back period runs
California has a 30-month look-back period for Medi-Cal long-term care. Assets transferred to the MAPT must be done at least 30 months before applying for Medi-Cal long-term care benefits. This is why early planning matters.
Medi-Cal eligibility is preserved
After the look-back period, the assets in the MAPT are no longer counted against your Medi-Cal eligibility. You may qualify for Medi-Cal long-term care without spending down those assets.
Estate recovery is blocked
Because the assets are in the trust — not your estate — DHCS cannot make a recovery claim against them after your death. Your home passes to your beneficiaries, not to the state.
Who Needs Medi-Cal Planning in Sacramento?
You should consider Medi-Cal planning if:
Medi-Cal Planning FAQ
What is a Medi-Cal Asset Protection Trust (MAPT)?
A MAPT is an irrevocable trust that removes your home and savings from your countable assets for Medi-Cal eligibility. After the 30-month look-back period, assets in the MAPT are protected from Medi-Cal estate recovery. It is the most effective tool for protecting Sacramento homeowners from nursing home costs.
Does Medi-Cal take your house in California?
Yes — after a Medi-Cal recipient dies, DHCS can make a claim against the estate for benefits paid. Your home is the primary target. A MAPT, properly drafted and funded, can protect your home from Medi-Cal estate recovery.
What is IHSS and how do I qualify?
IHSS (In-Home Supportive Services) is a Medi-Cal program that pays for in-home care so elderly and disabled individuals can remain at home instead of a nursing facility. You must be Medi-Cal eligible and have a functional need for assistance with daily activities. The Sacramento County IHSS office handles local assessments.
What is the PACE program?
PACE (Program of All-Inclusive Care for the Elderly) is a Medicare and Medi-Cal program for seniors 55+ who qualify for nursing home level of care but can safely live in the community. PACE covers all medical care, medications, adult day care, transportation, and more through a single coordinated team — often as an alternative to nursing home placement.
How much does nursing home care cost in Sacramento?
Skilled nursing facility care in the Sacramento area costs $10,000-$15,000 per month, or $120,000-$180,000 per year. Memory care facilities often cost more. Most families cannot sustain these costs for long without Medi-Cal assistance.
Is there a look-back period for Medi-Cal in California?
California has a 30-month look-back period for Medi-Cal long-term care (nursing home level). Transfers made within 30 months of applying for Medi-Cal long-term care may result in a period of ineligibility. There is no look-back period for community Medi-Cal. This is why early planning is critical.
What are the Medi-Cal asset limits in 2026 and 2027?
California reinstated Medi-Cal asset limits on January 1, 2026. Through June 30, 2027, the limit is $130,000 for one person (plus $65,000 per additional household member). Starting July 1, 2027, the limit drops sharply to $21,000 for one person and $31,000 for two people. If your assets exceed the limit when you renew Medi-Cal, you could lose coverage. Planning before July 2027 is critical for anyone with savings over $21,000.
What counts as an asset for Medi-Cal in 2026?
Countable Medi-Cal assets include bank accounts, cash, second vehicles, and second homes. Assets that do NOT count include your primary home (if you plan to return or a spouse lives there), your primary vehicle, household items, and retirement accounts receiving regular payments. A Medi-Cal Asset Protection Trust moves assets out of your countable estate.
Can I protect my house if my spouse is already in a nursing home?
Yes, crisis planning is still possible. California has spousal protection rules that protect the community spouse (the one remaining at home). We can help Sacramento families implement crisis Medi-Cal planning even after a loved one has entered a skilled nursing facility.
Related Services
Protect Your Home From Nursing Home Costs
Talk to Certified Specialist Dustin MacFarlane about Medi-Cal planning for your Sacramento family.
The earlier you plan, the more options you have. Do not wait for a crisis.