Blog

Medicaid long-term care benefits traditionally pay mainly for nursing home care, but the federal government can grant “waivers” to states allowing them to expand Medicaid to include home and community-based services. The downside is that receiving care in a nursing home is an entitlement, while getting care at home is not.  

In order to be eligible for Medicaid benefits a nursing home resident may have no more than $2,000 in "countable" assets (the figure may be somewhat higher in some states). Note that Medicaid is a state-run program, so the rules are somewhat different in each state (especially California), although there are federal guidelines.

The U.S. Supreme Court has agreed to hear a case disputing how much states can recoup from Medicaid recipients’ settlements in personal injury cases. The decision has the potential to affect anyone who receives government assistance with their medical care following a disabling injury that results in a lawsuit.  

For better and for worse, Medicaid is the primary method of paying for nursing home care in the United States. But navigating the Medicaid system is complicated and confusing. Here are the basics. 

Long-term care involves not only a loss of personal autonomy; it also comes at a tremendous financial price. Proper planning can help your family prepare for the financial toll and protect assets for future generations.

Medicare and Medicaid are two different government programs for healthcare.  It is important to understand the difference between them.  Here, we will discuss how the program benefits differ, how eligibility for each program is established, and discuss some recent news pertaining to each program.

Medicaid planning can be a difficult and confusing process. The following are some common mistakes people make when planning to apply for Medicaid.

The one-year deadline for nursing home residents on Medicaid to spend down their first round of stimulus checks is here, but they may have a little extra time. 

As the second (and maybe third) round of stimulus checks go out, it is important to know that nursing home residents are not required to turn their checks over to their nursing home.

Entering into a caregiver contract (also called personal service or personal care agreement) with a family member can have many benefits. It rewards the family member doing the work. It can help alleviate tension between family members by making sure the work is fairly compensated. In addition, it can be a be a key part of Medicaid planning, helping to spend down savings so that the elder might more easily be able to qualify for Medicaid long-term care coverage, if necessary.

Transferring assets to qualify for Medicaid can make you ineligible for benefits for a period of time. Before making any transfers, you need to be aware of the consequences.

Stimulus payments will NOT be treated as income but rather as a tax refund which is exempt (not countable as a resource) for 12 months. For recipients whose countable resources are already below $800, such that the stimulus payment plus the existing countable resources will not exceed the typical $2,000 resource limit, no spend down will be required. Recipients whose existing countable resources are greater than $800 will have 12 months to spend their resources down to below the resourse limit.

I am often contacted by someone whose elderly spouse or parent is being discharged from the hospital with a doctor's certification that the patient has fewer than six months to live. The discharge staff at the hospital is recommending that the patient enroll in hospice care. The spouse or adult child is concerned about how he or she is going to pay for hospice care. While the patient was in the hospital, Medicare was paying the bills.

Medicaid Pre-Planning is a process of using legal techniques to transfer assets to your spouse or children or other beneficiaries, or to otherwise cause the assets to be exempt from consideration in qualifying for Medicaid. These techniques (1) preserve these assets for your heirs, (2) while allowing you to maintain a certain degree of control while you are still living, and (3) allow you to qualify for Medicaid coverage much sooner than if your assets were just spent down.

Many people are vaguely aware that Medicaid (not to be confused with Medicare) can collect from decedent's estates for amounts paid for the decedent's care during lifetime. What they do not know is that state laws on this vary widely. This is because Medicaid is a federal-state partnership program, and the federal laws governing the Medicaid program give states some latitude in designing their estate recovery programs. Some states are "standard recovery" states and some states are "expanded recovery" states, in the parlance used by elder law attorneys.

If your spouse has assets, it is likely that Medicare will take them into consideration. Medicaid is likely to ignore any spousal agreements and consider the assets of each spouse when determining eligibility, according to My San Antonio in "Protecting separate assets from Medicaid."

If you end up needing Medicaid, the government will look closely at your assets. There are some ways around the problem of having assets and needing Medicaid. A trust is one of the answers, according to the Times Herald-Record in "Benefits of Medicaid Asset Protection Trust."

Medicaid is a possibility, if retirement money runs out.  However, the program is aimed at helping the poor. When many Americans consider the possibility of long-term care in a nursing home and look to insurance, they find that insurance is often difficult to obtain and afford. Medicaid is a...