Some time back, feels like about a year, I got mass mailings from Medi-Cal, inviting people to sign up, saying that many more people would be eligible than know they are. Which struck me as uncharacteristic of Medi-Cal, which (I had heard, maybe wrongly) had a reputation of obstructing applicants and being generally miserly or tardy with payments, to the point that many health providers refuse to take Medi-Cal patients. And now they want to hand out coverage?
Recently I received another mailing from Medi-Cal, which may explain this anomaly. This one comes from the Estate Reimbursement division, addressed to me because I am the executor of a will of someone who received Medi-Cal benefits. It turns out that if, after the age of 55, you received any treatment that Medi-Cal paid for, then at your death, your estate is liable for reimbursement to the state for whatever that treatment cost. There are certain exemptions — for example, if your spouse survives you, they won't take anything until the spouse dies, at which time they will come back again. They won't go after the inheritance of minor children. They won't try to get any reimbursement if they think it will cause severe hardship.
I think I would have remembered if the solicitation mailing had mentioned that very salient fact. I've asked around, and nobody I know realized that Medi-Cal did this. Most people refused to believe it. But here it is, from the California Department of Health Services web site's "Estate Recovery Program."
The Medi-Cal program pays for medical services and premiums, including payments to managed care plans, for people who are unable to pay for their own care. Upon death, the decedent’s estate or any recipient of the decedent’s estate may have to pay the costs of care back under federal and state law. Repayment will come from the assets of the deceased Medi-Cal member and will not exceed the asset value.
Now this, it seems to me, is extremely deceptive, if not consciously deceitful, if most people over 55 don't realize that whenever they use Medi-Cal, they are shifting the burden of the entire medical cost to their children or other heirs — and no one ever told them about this hidden take-back.