Medi-Cal Estate Recovery Program in California

My parents are almost 60 and have been using Medi-Cal for years. They also own a house and I wonder if they don’t go to a nursing home in the future. Should we worry about the state will take away their estate without passing it to me because of that recovery program? does the cost include medical services they use on a regular basis(Isn’t that for people who die before 2017? or still?)

Repayment will be limited to payments made, including managed care premiums paid, for nursing facility services, home and community based services, and related hospital and prescription drug services received when the member was an inpatient in a nursing facility or received home and community based services.

Not sure what that managed care premium consist of. does it mean anything not from nursing facility(if my parents are still able to take care of themselves at home with me), then I don’t have to worry the state will come after the house?

What about the hospital bill on their final day in the hospital? could it consist of part of the repayment since I don’t know which category of that bill is belong to.

Not sure how much a living trust would cost or the best way to do it. Do I have to pay it monthly to maintain that trust?