QIM 33 | Part 2 of 5 | Elder Law & Medi-Cal Planning
Three separate thresholds have to be crossed before a transfer costs you anything.
A conversation between Ava and Michael
Ava:
There is a 30-month look-back now. Does Medi-Cal review two and a half years of my mother's finances?
Michael Benavides, Esq.:
Not yet, and there are three filters before any of it bites. First, timing. DHCS is explicit: transfers before January 1, 2026 are not counted.
CANHR cites DHCS letter MEDIL I25-23 confirming transfers from January 1, 2024 through December 31, 2025 are excluded outright.
Ava:
So the clock started at zero and has been filling since.
Michael Benavides, Esq.:
Exactly. It grows one month per month toward the full 30. A gift made in 2019, or 2023, or December 2025 is permanently outside the window, no matter the size.
Ava:
What is the second filter?
Michael Benavides, Esq.:
Who it applies to.
CANHR states that transfer penalties can only be applied to those entering a nursing home on Medi-Cal, and not to applicants or beneficiaries living in the community.
Ava:
Michael, I have read two official-sounding sources that do not quite agree. DHCS's page says giving assets away could delay coverage if you live in a nursing home or may need long-term care in the future. CANHR says nursing home entrants only. Those are not the same sentence.
Michael Benavides, Esq.:
They are not, and you are right to flag it.
DHCS's consumer page is written broadly; CANHR reads the underlying policy letters and states the narrower rule. The narrow reading is better supported, but if your parent is heading for a board-and-care or an RCFE rather than a skilled nursing facility, do not assume you are outside the rule on the strength of a blog post.
Put that question to your county in writing.
Ava:
This is a complicated matter and I would rather we say 'unsettled' than sound certain and be wrong.
Michael Benavides, Esq.:
Agreed. The third filter is amount. CANHR gives two examples. Someone with $125,000 who transfers $100,000 gets no penalty
— never over the $130,000 limit. And Carmen, with $142,000, transfers $12,000 to get under the limit — no penalty, the transfer is below the Average Private Pay Rate.
Ava:
So small transfers by people near the limit are not the target.
Michael Benavides, Esq.:
Correct. The rule aims at large gifts by people well over the limit entering a nursing home. CANHR's penalty example: David has $150,000, gifts $20,000 in August 2026, applies in September from a nursing home. $20,000 divided by the APPR gives 1.5 months; California does not count partial months, so he is ineligible one month and eligible again September 1.
Ava:
What is the APPR, and can we state it confidently?
Michael Benavides, Esq.:
Not quite.
The figure is $14,440 per month, but CANHR's fact sheet labels it 2025 in one line and 2026 a paragraph later. The dollar amount is consistent; the year label is not. DHCS republishes it annually. Confirm the current APPR with DHCS or your county before relying on it.
Disclaimer
Attorney advertising. General information about California law, not legal advice; reading it creates no attorney-client relationship. Medi-Cal eligibility is highly fact-specific, published figures are updated periodically, and some points in this series are expressly identified as unsettled. Confirm current rules with DHCS or your county Medi-Cal office before acting. Michael Benavides, Esq. — California State Bar No. 270714. Ava Benavides is an editorial brand voice, not an attorney, and does not provide legal analysis.
