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Medi-Cal Regulation Specialists

So what are the services MRS offers?
What is the cost of your services?
How do you advocate on a clients behalf?
Can you tell me about your advocacy prices?
What is a fair hearing?
What if I already have California Medi-Cal?
What if I have been denied eligibility already?
Doesn’t Medi-Care pay for my Long Term Care at the Convalescent home?
Do I have too much income to receive Medi-Cal benefits?
Must I lose all my assets and my savings to receive Medi-Cal?
I was told if my husband and I have over $101,540 in countable assets we are automatically ineligible is that true?
Can Medi-Cal place a lien on my home?
Will my Revocable Living Trust protect my assets from Medi-Cal Recovery?
An insurance agent recommended I put all my assets in an annuity does this work?


So what are the services MRS offers?
MRS offers both consulting and advocacy services in the application process for Medi-Cal eligibility. When a prospective client makes contact we offer a free assessment as to whether or not our services are compatible to the clients needs. Once it is determined that MRS services can and should be rendered we will schedule a day and time for a personal hour long consultation with Kathryn Humphres the owner of MRS. This consultation can be rendered face to face or over the phone. Our phone consultations are the most popular due to the convenience of not having to travel and the fact that it allows the service to be performed throughout the state of California. Once the consultation is scheduled MRS will either fax or mail a consultation packet informing you as to what information you will need to have available for the consultation.

The consultation starts off with a question and answer series that allows Kathryn to establish exactly where you currently stand in regards to your eligibility for Medi-Cal. Following the establishment of the parameters of eligibility she will open the stage for any questions you may still have in regards to the options of your particular case. At this point Kathryn will advise you of all the appropriate steps you will need to take to complete the process on your own.
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What is the cost of your services?
This one hour consultation is only ninety dollars. For only ninety dollars the consultant will answer all of the questions that haunt your thoughts like, “Will I lose my home?” “Do I have too much money?” “What will the state recover?” etc. You will know exactly where you stand and what to do when going through the confusing Medi-Cal application process, so that you will not be intimidated by Eligibility Workers at the Department of Health Services. After the consultation, you will have an invaluable knowledge of your own situation. With that knowledge you will be able to enter the application process with the control and confidence that people often lack when proceeding blindly into the often overwhelming application process for Medi-Cal long term care eligibility.
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How do you advocate on a clients behalf?
If at this point the application process is still overwhelming and you do not have the time to take care of your loved one in the hospital and deal with the Department of Social Services, instead allow MRS to deal with it. If you are the child of the patient in question and are either not in the right position to handle their paperwork or if you live out of state or find the process to be too time consuming, MRS can help. For a flat fee established by the estimated amount of work involved, MRS will represent your case to the County by completing all the paperwork and help gather all the related verifications involved with the application process.

Once the application is completed and submitted, MRS will follow up with any paperwork requested by the Department of Health Services, and aggressively pursue the approval. As an advocate for your case, MRS will be the primary contact for the county so that you or your family are not bothered in a time when you have enough to worry about.
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Can you tell me about your advocacy prices?
Our prices for complete representation throughout the Medi-Cal application process is usually between Fifteen Hundred to Twenty Eight Hundred dollars. You may ask yourself how it is that a person seeking Medi-Cal can afford that kind of money. First of all if the individual’s case is a simple case they will be capable of completing the application on their own after their consultation with Kathryn.

When the family case is more complex and advocacy is required the total price of the advocacy is still less then one month’s stay at a convalescent facility. In other words, once our services are retained and the application is submitted and approved, Medi-Cal will reimburse all funds spent on the convalescent home dated back to the month the application was submitted. If you pay us Twenty Five Hundred dollars to complete your application process and your hospital cost are around Forty Five Hundred dollars a month, in all reality, we have saved you Two Thousand dollars by submitting your application in a speedy process.
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What is a fair hearing?
A fair hearing is the process of going before an Administrative Law Judge with the request to retain assets above the Medi-Cal allowance of $101,540. Under certain situations, if the At Home Spouse’s monthly income is low enough, they may retain more than the $101,540 allowed by the state. MRS has successfully represented many clients through this process. For an example of how a fair hearing can help, one of our clients was allowed to keep over $700,000, due to a very low income. In fact this particular client could have kept up to $1,000,000 dollars in assets.

The approval of a fair hearing allows the client to retain full control of all their money. In comparison a Medi-Cal annuity will lock all their money away, leaving them with a monthly payment and under no case can they receive more than the set amount. If the fair hearing is applicable to your specific situation, it can be a much better option than the “spend down” or “gifting” options that requires the client to disperse all their money as gifts to other people thereby losing control of their finances. The fair hearing is a method used to avoid leaving the At Home Spouse in a state of complete poverty.
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What if I already have California Medi-Cal?
If you already have California Medi-Cal and you are visiting this website then it is assumed that you probably feel your monthly share of cost needs to be re-evaluated. You may have unexpectedly come into money and you are now worried you are going to lose your benefits. If your situation is something like this and you do not want to consult your eligibility worker out of fear of saying the wrong thing, then contact MRS and set up a consultation to completely evaluate your situation, and set you on a course that best represents your needs. Due to the fact that everybody’s situation is different, generalized answers to questions are very dangerous, so a complete consultation would definitely be in order.
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What if I have been denied eligibility already?
If you have been denied coverage in the past and you feel the denial to be unjustly rendered then give us a call. MRS has been responsible for the reopening of numerous cases, finding the error in the determination and then having the denial reversed. Often times Eligibility Workers can become overwhelmed by the large case loads they are responsible for and make a mistake. This mistake in return causes an inappropriate denial. It is under these circumstances that MRS would have the case reopened, and the client would be appropriately reimbursed.

Sometimes the entire county in which the client is seeking eligibility may be misreading the regulations themselves. This was the case in a particular County where possibly thousands of clients were denied for being over property, until Kathryn, submitted an application for a client which was denied due to the clients’ IRA putting them over the allowed property limit.

The problem here is that an IRA, when distributions are correct, is an unavailable asset. In fact, it was the County that was out of compliance, not the client. MRS then proceeded to show the County Department of Health Services where the regulations were being misinterpreted by their eligibility workers. It was at this time Kathryn was told that she was wrong in her interpretation of the regulations.

Knowing that she was correct from her years of experience, Kathryn then contacted the Property Specialists of Medi-Cal in Sacramento; Sacramento then contacted the County and corrected them of their mistake. Due to the expertise of Kathryn Humphres, people in this particular County will no longer be inappropriately denied for Medi-Cal benefits due to their IRA’s.
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Doesn’t Medi-Care pay for my Long Term Care at the Convalescent home?
Answer: No, Medi-Care will only pay for the first 100 days of hospitalization and rehabilitation as long as there is constant improvement. Once the patient is no longer improving the patient will be released either home or to a convalescent home under custodial care. At which time custodial cost are paid privately or paid by Medi-Cal.
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Do I have too much income to receive Medi-Cal benefits?
Reply: One of the biggest misconceptions about Medi-Cal eligibility is that it’s based on income. This is totally false! Medi-Cal eligibility is based solely on your countable assets not your income. The only time Medi-Cal will look at your income is after eligibility is established to determine your monthly share-of-cost.
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Must I lose all my assets and my savings to receive Medi-Cal?
Answer: No! What you must do first is identify your countable verses your non-countable (exempt) assets. Only once all assets are correctly allocated and set properly and classified correctly with California Medi-Cal will you then be able to determine Medi-Cal eligibility. But keep in mind what portion of your estate is countable and what is exempt is and can be very complicated. That is where Kathryn Humphres’ 13 years of Medi-Cal experience becomes invaluable to the protection of your estate.
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I was told if my husband and I have over $101,540 in countable assets we are automatically ineligible is that true?
Answer: No! Under certain circumstances the “at home” spouse is allowed to retain more then the $101,540 in countable asset limits set by Medi-Cal. This is accomplished through a “fair hearing”. Through a fair hearing the “at home” spouses resource allowance (countable assets) can be raised very dramatically. In some cases as high as $818,000 dollars, depending on the income of the “at home” spouse. We here at MRS specialize in Fair Hearings when appropriate.
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Can Medi-Cal place a lien on my home?
Answer: The Medi-Cal recovery branch has the right to file claims against the estate of a deceased beneficiary of Medi-Cal benefits. But if the spouse of the Medi-Cal beneficiary is still living, then Medi-Cal can not place a claim until after the death of both of the spouses. Also when set up correctly a home can be legally transferred.
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Will my Revocable Living Trust protect my assets from Medi-Cal Recovery?
Answer: No! This is a very common misconception. A Revocable Living Trust is great tool in regards to tax exemptions and in helping your family avoid probate. A living trust will not help protect your home and other assets from Medi-Cal recovery. Nor does it protect the assets when eligibility for Medi-Cal is being established.
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An insurance agent recommended I put all my assets in an annuity does this work?
Answer: Annuities can be a valuable tool in protecting yourself from impoverishment. However annuities are only one option! (And usually the only option an insurance agent will use.) You need to know all your options to plan effectively! Medi-Cal Regulation Specialists prides itself in advising a family of all their options. When an annuity is found to be a partial help MRS works with a qualified agent with Medi-Cal (Medicaid) specific products to insure the acceptance of your annuity through the California Medi-Cal Application process.
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