Navigating the Medi-Cal Process and Preserving Your Elderly Parents’ Assets

When your elderly parents need long-term care, the financial reality can be overwhelming. Nursing home costs in California average $10,000 to $15,000 per month—expenses that can rapidly deplete a lifetime of savings. For many families, Medi-Cal (California’s Medicaid program) represents the only viable solution for covering these costs. However, qualifying for Medi-Cal while preserving assets requires navigating complex regulations, strict deadlines, and sophisticated planning strategies.

This is where the expertise of a seasoned elder law attorney becomes invaluable. Attorney Susan B. Geffen has dedicated over 30 years to helping California families successfully navigate the Medi-Cal process while protecting their parents’ hard-earned assets. With a Master’s degree in Gerontology and experience as a former elder law professor, Susan brings both legal acumen and deep understanding of the unique challenges facing elderly individuals and their families.

Understanding Medi-Cal for Long-Term Care

Medi-Cal provides essential health coverage for eligible low-income California residents, including coverage for long-term care in nursing homes and assisted living facilities. Unlike Medicare, which provides limited skilled nursing coverage, Medi-Cal can cover extended stays in long-term care facilities for those who qualify.

However, Medi-Cal is a needs-based program with strict financial eligibility requirements. For 2025, a single individual generally cannot have more than $2,000 in countable assets, while married couples face a limit of $3,000 (with additional protections for the community spouse). These limits create a pressing dilemma: How do you qualify for benefits without losing everything your parents worked their entire lives to build?

The answer lies in proper Medi-Cal planning—and that’s where Attorney Geffen’s expertise becomes crucial.

The High Cost of Waiting: Why Early Planning Matters

One of the most critical mistakes families make is waiting until a crisis occurs before seeking legal guidance. Perhaps your mother has just suffered a stroke, or your father’s dementia has progressed to the point where he needs 24-hour care. In the panic of an emergency, families often make hasty financial decisions that can have devastating long-term consequences.

Medi-Cal has a five-year “look-back” period for asset transfers. This means that any gifts or asset transfers made within five years of applying for Medi-Cal can result in penalties and delayed eligibility. Families who transfer assets without proper planning may find themselves facing months or even years of Medi-Cal ineligibility—during which time they must privately pay for care at rates that can exceed $180,000 annually.

Attorney Susan B. Geffen emphasizes the importance of proactive planning. “The families who fare best are those who plan ahead,” she explains. “Even if long-term care isn’t immediately needed, having a strategy in place provides options and protections that simply aren’t available during a crisis.”

Attorney Geffen’s Proven Approach to Medi-Cal Planning

With over three decades of experience in elder law, Attorney Geffen has developed a comprehensive approach to Medi-Cal planning that protects assets while ensuring her clients receive the care they need. Her process combines technical legal expertise with compassionate understanding of the emotional challenges families face.

Comprehensive Asset Analysis

The first step in any successful Medi-Cal strategy involves thoroughly analyzing your parents’ complete financial picture. Attorney Geffen examines:

• Countable vs. Exempt Assets: Not all assets count toward Medi-Cal’s eligibility limits. The family home (up to certain equity limits), one vehicle, personal belongings, and certain other assets may be exempt. Susan carefully identifies which assets must be spent down or protected and which are automatically exempt.
• Income Streams: Social Security benefits, pensions, retirement account distributions, and other income sources all impact Medi-Cal planning. Understanding how income is treated—and how it can be redirected to protect the community spouse—requires sophisticated analysis.
• Joint Ownership Issues: Many elderly couples hold assets jointly, creating complications for Medi-Cal planning. Attorney Geffen expertly navigates joint ownership issues to protect the community spouse while qualifying the institutionalized spouse for benefits.
• Hidden Assets: Families are often surprised to discover assets they didn’t realize could affect eligibility, such as life insurance cash values, pre-paid burial plots, or mineral rights. Susan’s thorough review ensures nothing is overlooked.
• Strategic Asset Protection Techniques

Once the financial landscape is clear, Attorney Geffen implements sophisticated strategies to preserve assets while achieving Medi-Cal eligibility. Her toolkit includes:

Spousal Protection Strategies: When one spouse needs long-term care while the other remains at home, Medi-Cal provides special protections for the “community spouse.” Attorney Geffen maximizes these protections through strategies such as:

• Spousal refusal (in appropriate cases)
• Strategic spend-down on exempt assets
• Income-first rules optimization
• Community Spouse Resource Allowance maximization

1. Irrevocable Trusts: Properly structured irrevocable trusts can remove assets from Medi-Cal’s reach while allowing families to retain some benefit from those assets. However, these trusts must be established well before care is needed and require precise drafting to avoid penalties.
2. Medi-Cal Compliant Annuities: In certain situations, converting countable assets into income streams through Medi-Cal compliant annuities can preserve resources for the community spouse while helping the institutionalized spouse qualify for benefits.
3. Caregiver Agreements: If family members have been providing unpaid care, formal caregiver agreements can compensate them for past services, reducing countable assets in a Medi-Cal compliant manner.
4. Home Equity Conversion: The family home is often a family’s largest asset. Attorney Geffen helps families understand options for protecting home equity, including life estates, promissory notes, and strategic timing of transfers.
5. Expert Application Assistance

The Medi-Cal application process itself is notoriously complex, with extensive documentation requirements and strict deadlines. Attorney Geffen guides families through every step:

• Gathering required financial documentation
• Completing application forms accurately
• Responding to requests for additional information
• Appealing denials or inadequate eligibility determinations
• Coordinating with care facilities and county workers

Her experience means applications are done right the first time, avoiding delays that could cost thousands in private pay nursing home costs.

Real-World Success: How Attorney Geffen Makes a Difference

The true measure of an attorney’s expertise lies in results. Clients consistently praise Attorney Geffen’s ability to navigate even the most challenging Medi-Cal situations. As one grateful family member shared:

“My parents and I retained Susan Geffen’s legal services to navigate through the Medi-Cal process and to preserve my parent’s assets. The process was long and hard, but Susan hung in there with us, even when my parents seemed reluctant and indecisive. Susan showed her professionalism and concern for the elderly by continuing to provide legal services and guidance without payment during a period between the two phases of our journey. I would recommend Susan to anyone in need of legal services relating to the elderly and elder care.”

This testimonial reflects Attorney Geffen’s commitment to her clients that extends beyond simply filing paperwork. She understands that Medi-Cal planning involves difficult family decisions, emotional challenges, and often, elderly parents who are resistant to change. Her patience, compassion, and dedication to achieving the best possible outcome set her apart.

The Unique Qualifications That Set Attorney Geffen Apart

Not all elder law attorneys are equally equipped to handle complex Medi-Cal planning. Attorney Susan B. Geffen brings a rare combination of credentials and experience:

• Master’s Degree in Gerontology: Attorney Geffen is one of only a handful of attorneys nationwide who holds a Master’s degree in Gerontology—the scientific study of aging and the particular problems of older adults. This advanced degree provides her with deep insights into the physical, psychological, and social aspects of aging that inform her legal strategies.
• Former Law Professor: As a former elder law professor, Attorney Geffen doesn’t just practice elder law—she taught it. This academic background ensures she stays current with the latest developments and approaches her work with scholarly precision.
• Author and Educator: Susan authored “Take That Nursing Home and Shove It!”—a comprehensive guide to avoiding nursing homes through proper planning. Her “Raising UP Your Parents” seminars have educated over 20,000 adult children, professionals, and elderly individuals throughout California.
• Three Decades of Focused Practice: For over 30 years, Attorney Geffen has concentrated exclusively on elder law, conservatorships, estate planning, and Medi-Cal planning. This focused experience means she’s encountered virtually every scenario and knows how to navigate even the most complex situations.
• Recognized Expertise: Attorney Geffen’s reputation among her peers is impeccable. Her referral network includes geriatric care managers, financial planners, and other professionals who trust her to provide stellar service to their clients.

Common Medi-Cal Planning Mistakes to Avoid

Even well-intentioned families can inadvertently jeopardize Medi-Cal eligibility. Attorney Geffen helps clients avoid these common pitfalls:

• Transferring Assets Without Legal Guidance: Simply giving away assets or adding children to bank accounts can trigger transfer penalties without actually protecting assets. Proper transfers must be structured carefully to comply with Medi-Cal rules.
• Failing to Document Transactions: Medi-Cal requires extensive financial documentation. Undocumented transactions—even legitimate ones—can raise red flags and cause application delays or denials.
• Ignoring the Community Spouse: When one spouse needs care, families sometimes focus solely on qualifying that spouse for Medi-Cal without considering protections available for the spouse remaining at home. This can leave the community spouse impoverished unnecessarily.
• Waiting Until After Institutionalization: The best planning opportunities often exist before someone enters a nursing home. Once institutionalized, options become more limited and time-sensitive.
• DIY Medi-Cal Planning: While online resources abound, Medi-Cal law is complex and constantly evolving. Well-meaning but inexpert planning can result in costly mistakes that proper legal counsel would have avoided.

The Medi-Cal Planning Timeline

Understanding the timeline for Medi-Cal planning helps families take action at the right time:

• Five+ Years Before Care is Needed (Ideal): This is the optimal time for comprehensive Medi-Cal planning. All strategies are available, including irrevocable trusts and strategic asset transfers that will be outside the look-back period when care is eventually needed.
• Two to Five Years Before Care: Many protective strategies remain available, though some long-term options are foreclosed. Attorney Geffen can still implement effective asset protection while planning for future eligibility.
• Immediate Need for Care (Crisis Planning): Even when care is needed immediately, experienced counsel can often protect significant assets through spousal protections, proper spend-down strategies, and aggressive application assistance. However, options are more limited and time-sensitive.

Beyond Medi-Cal: Comprehensive Elder Law Services

While Medi-Cal planning is a critical service, Attorney Geffen provides comprehensive elder law guidance to address all aspects of aging and long-term care:

• Conservatorships: When elderly parents can no longer manage their affairs, conservatorships may be necessary. Attorney Geffen evaluates whether conservatorship is realistic and necessary, then guides families through this serious legal process with knowledge and compassion.
• Estate Planning: Wills, trusts, and powers of attorney form the foundation of any elder law plan. Attorney Geffen ensures these documents work in concert with Medi-Cal planning to protect assets and honor wishes.
• Trust Litigation: When disputes arise over estate administration, Attorney Geffen provides skilled advocacy to protect her clients’ interests and ensure estates are administered according to the decedent’s wishes.
• Elder Financial Abuse: Sadly, financial exploitation of seniors is common. Attorney Geffen’s expertise in geriatrics helps her identify and address elder financial abuse, protecting vulnerable seniors from those who would take advantage of them.

Taking the First Step: Your Consultation with Attorney Geffen

The journey to protecting your parents’ assets while securing quality care begins with a consultation. Attorney Geffen offers thorough one-hour consultations where she will:

• Review your parents’ complete financial and health situation
• Explain Medi-Cal eligibility rules in understandable terms
• Outline specific strategies available for your family’s circumstances
• Answer your questions and address concerns
• Provide clear guidance on next steps and timeline

As one client noted: “Often a one hour consultation can take a lot of weight off your shoulders.” Many families leave their initial consultation with Attorney Geffen feeling relieved, informed, and confident they have a path forward.

Serving Families Throughout Los Angeles and Orange County

Attorney Susan B. Geffen maintains offices throughout the Los Angeles area to serve families conveniently:

• Encino
• South Bay
• Pasadena
• Los Angeles

She proudly serves clients from Beverly Hills, Santa Monica, Torrance, Manhattan Beach, Redondo Beach, and throughout Los Angeles and Orange County.

Don’t Face This Alone: Contact Attorney Geffen Today

Navigating the Medi-Cal process while preserving your parents’ assets is too important and too complex to handle without expert guidance. The stakes are simply too high—one misstep can cost your family tens of thousands of dollars or delay critical care.

Attorney Susan B. Geffen has the experience, credentials, and compassionate approach your family needs during this challenging time. For over 30 years, she has helped California families successfully navigate Medi-Cal planning, protecting assets while ensuring loved ones receive quality care.

Don’t wait until a crisis forces hasty decisions. Contact the Law Offices of Susan B. Geffen today at (800) 285-2659 to schedule your consultation. Whether your parents need care immediately or you’re planning ahead for the future, Attorney Geffen can provide the expert guidance your family deserves.

Your parents worked their entire lives to build their assets. With proper planning and experienced legal counsel, you can protect that legacy while ensuring they receive the care they need and deserve.