A nursing home can never take your Social Security check, at least not legally. However, if Medicaid pays for your care, you may be required to pay nearly your entire Social Security check to the facility.
Your Social Security income is also used to determine whether you are eligible for Medicaid. If you are not yet eligible for Medicaid, you may use your Social Security income toward your cost of care as you spend down assets to become eligible. Federal and state laws allow some exceptions, such as when a spouse still resides at home.
Since 2016, Omega Law Group Accident & Injury Attorneys has protected the rights of vulnerable populations. If you believe your loved one is a victim of financial abuse in their nursing home, let our family take care of your family. Call today to schedule your free consultation and find out how our nursing home abuse lawyers in West Hollywood can help.
Medi-Cal’s Share of Cost Rule
Medicaid is a federal benefits program administered by individual states. In California, this program is known as Medi-Cal. It provides need-based health coverage for eligible individuals. That includes nursing home residents who meet income guidelines and asset limits.
When Medi-Cal starts covering the costs of nursing home care, a big part of your income usually goes toward paying for that care. This portion is known as the share of cost, and it’s a common reason why much of your Social Security check may be used to pay the nursing home bills.
The share of cost is calculated by Medi-Cal based on your income and certain deductions. The nursing home can only charge what Medi-Cal determines. If your bill doesn’t match what you believe your share of cost should be, Omega Law Group can help you compare the numbers.
Your Personal Needs Allowance
Even if your care is covered by Medi-Cal, California law allows you to retain a modest monthly sum for your personal expenses. This is referred to as the personal needs allowance. It is meant to pay for necessary items like clothing and small comforts that make daily life enjoyable.
If your personal needs allowance is missing or smaller than expected, there may have been a mistake in the accounting. You can ask for a written breakdown of your account. A facility cannot take your entire Social Security check to pay its bill, leaving you with nothing.
This allowance may sound small, but for many residents it represents the only money they control directly. Omega Law Group treats protecting it as seriously as any larger financial dispute.
Exceptions for a Community Spouse
If you’re married and your spouse remains at home while you receive nursing home care, California law includes protections. These rules exist because Medi-Cal’s share of cost calculation could otherwise leave your spouse at home without enough income to live on.
Under the Minimum Monthly Maintenance Needs Allowance, a portion of your combined income can be set aside for your spouse who isn’t in the facility before the rest goes toward your care costs.
This means your Social Security check doesn’t automatically get swallowed up entirely by the nursing home. Omega Law Group can review your household’s income and assets to make sure your spouse is receiving every protection California law actually provides.
(310) 526-8383When a Facility Becomes Your Representative Payee
Social Security may appoint someone to manage benefits for a person who cannot do it by themselves. Sometimes, a nursing home takes on this role. This arrangement comes with strict duties, including keeping detailed records of every dollar spent.
A facility acting as payee is legally required to use that money for your needs first, not for costs Medi-Cal already covers. Combining the two is a common source of billing errors and, sometimes, deliberate overcharging.
If you’re unsure whether the facility is your representative payee or how that decision was made, you’re allowed to ask questions and request records. Omega Law Group can help if the facility isn’t forthcoming.
What to Do If a Facility Withholds Your Check
If you have concerns about how your money is being managed at a nursing home, start by asking the facility’s business office for a written statement that shows where your funds are going. You are entitled to this information.
If you suspect that financial abuse is happening, you can report it to the California Department of Public Health. Making a report can lead to an independent investigation into the facility’s practices.
A report to a state agency and a legal claim aren’t the same thing. If applicable, Omega Law Group can work to help you prove nursing home abuse or negligence and pursue damages. You don’t have to fight alone.
Get Help from Our Legal Team
A nursing home cannot simply take your Social Security check without your permission, but many facilities find ways to control that money that catch families off guard. Some of this comes down to legitimate rules, like Medi-Cal’s share of cost.
Other times, it crosses into mismanagement or outright financial abuse. Knowing the difference protects both your money and your peace of mind.
Omega Law Group can review what happened to your Social Security check and let you know if the facility followed the law. If they didn’t, we’ll help you pursue legal action. Call today to schedule a free consultation and tell us what happened.
