A fellow estate planning attorney reached out to me recently for help with a difficult situation.
Her clients were trying to protect their assets and income so they could qualify for Medi-Cal benefits. The husband has Parkinson’s disease and now requires 24/7 care. Their goal was to keep him safely at home, hoping to get assistance through IHSS (In-Home Supportive Services).
IHSS is a Home and Community-Based Service (HCBS) with very strict income limits:
-$1,801/month for a single person
-$2,433/month for a married couple to receive services without a share of cost.
If you exceed these amounts, you enter “Share of Cost.” This means you keep only $600 (single) or $800 (married) of income each month, and the rest must be spent on care before Medi-Cal pays anything.
The couple owned their home plus two rental properties, and their combined Social Security income was $2,800 monthly, so qualifying for help was possible.
I have a Medi-Cal Asset Protection Trust that could potentially work in this scenario. Put simply, this type of trust allows you to legally transfer assets so they don’t count for Medi-Cal eligibility (especially if the asset test comes back). The trust is like a locked treasure chest: you put in your assets, and hand the keys to someone else (the Trustee), who controls everything.
But here’s the critical catch:
The Trustee must be absolutely trustworthy.
The law requires that any diverted income go to the trustee or another beneficiary, never back to the couple. If the trustee mishandles the funds, the consequences can be catastrophic.
Unfortunately, this couple didn’t have anyone they trusted. Their children were not financially stable, and both were partnered with people the parents did not trust at all.
After careful review, I recommended they plan to privately pay for in-home care instead. The risk of appointing a child as trustee—and having them misuse the money—was simply too great. Losing everything to theft would leave them truly destitute.
Planning for long-term care is not just about qualifying for public benefits. It requires an honest look at who you can count on and whether the benefits outweigh the real risks. Sometimes, preserving control and security is worth more than any government program.
If you or a loved one are weighing these decisions, give me a call. Together, we’ll build a plan that protects you in the way that’s right for your family.
