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Medicaid Questions and Answers

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Medicaid Questions and Answers

Q. What benefits does Medicaid provide?

A. Medicaid benefits can be divided into two broad categories: acute care and long term care Eligibility for each kind of benefit is different, though they are similar. Eligibility for the long term care benefit is usually much more difficult to establish, and is the focus of most Medicaid planning and advocacy work by elder law attorneys.

Q. My parent is in a nursing home and has spent most of her lifesavings, is it too late to do any Medicaid Planning which will benefit my parent?

A: Not necessarily. If your parent meets all the Medicaid requirements, is in a Medicaid approved facility and has some assets left, it is possible to get them qualified for Medicaid now and may be possible to set aside a portion of their remaining money for their use during the rest of their life.

Q: Will Medicare pay for a nursing home stay?

A: Typically Medicare will only pay for nursing home care on a limited and short-term basis. Medicare coverage is generally limited to rehabilitative services performed in a nursing home of up to 100 days. Ongoing custodial care is not covered.

Q: Will Medicaid pay for a nursing home stay?

A: Typically Medicaid will provide nursing home coverage in Medicare/Medicaid certified nursing homes if its strict financial eligibility requirements are met. A detailed and lengthy application process is used to determine those who qualify for the coverage.

Q. Do I have to spend all my money before I will qualify for Medicaid?

A. While Medicaid is a “spend down” program, you don't have to be destitute, or leave your spouse destitute, to qualify for Medicaid. Certain assets and transfers are exempt from a Medicaid spend down, and by effective planning, you can qualify for Medicaid and still keep, transfer, or gift certain assets to your love ones.

Q. Do you need to plan years in advance to do effective Medicaid Planning?

A. While early planning allows greater flexibility, it is almost never too late to do effective Medicaid planning, even when you have been in a facility and private paying.

Q. Is it true that you can gift up to $13,000.00 a year without affecting your Medicaid eligibility?

A. No, the $13,000.00 gift amount is the amount you can gift to an individual in any year without triggering gift tax consequences, but if you gift this amount without proper planning, you may be ineligible for Medicaid.

Q. Is it true that assets held in joint tenancy with my spouse or child is only half mine, and not considered in determining Medicaid eligibility?

A. Generally, with personal property, such as bank accounts or brokerage accounts, held in joint tenancy with someone else are fully considered assets of the Medicaid applicant, unless you can show that the original source of funds, or a portion thereof, were supplied by someone other than the Medicaid applicant.

Q. Since my assets are in my living trust is it true that they are not considered when I apply for Medicaid?

A. No, assets held in your revocable trust are considered your assets for purposes of Medicaid eligibility.

Q. Does the Medicaid recipient have to pay for any portion of his or her care?

A. The patient's ability to contribute to care will be determined by a formula, and that amount must be turned over to the nursing home each month

Q. What is meant by the "lookback" period for Medicaid benefits?

A. When an application is filed, the applicant caseworker will inquire about any gifts or transfers for less than fair market value made by the applicant, the applicant's spouse or anyone acting on behalf of either of them within the preceding 60 months. These five years before application is known as the "lookback" period, gifts made before that period will not affect eligibility. Gifts made during the "lookback" period will result in a period of ineligibility, and that disqualifying period will not start to run until the applicant has already spent down all of his or her assets and applied for Medicaid.

Q. Can a Medicaid applicant purchase a new home, car, home furnishings or prepaid burial arrangements?

A. Yes. Available resources can easily be made unavailable by purchasing exempt assets. In some cases, however, such purchases can be very effective in establishing Medicaid eligibility.

Q. Is it true that I can only spend down my assets on medical and nursing home bills?

A. Not in most cases. While some nursing homes would have you believe that you have to spend all your savings on the nursing home at the private pay rate before qualifying for Medicaid, this is not true.  If you are seeking Medicaid to apply retroactive to the date of the application, then there will be some limitations on spend down.  

Q. Is it true that all of my spouse's income must be used to pay the nursing home bill prior to my spouse receiving Medicaid?

A. No, depending on the community spouse's income, part or all of the nursing home resident's income may be transferred to the community spouse in order to avoid spousal impoverishment.

 

FOR MORE INFORMATION ON THIS SUBJECT, OR TO SCHEDULE AN APPOINTMENT, PLEASE CALL THE LAW OFFICE OF JAMES C. SIEBERT & ASSOCIATES AT 847-253-7500, E-MAIL INFO@JCSLAW.COM, OR YOU MAY CONTACT THE LAW OFFICE OF JAMES C. SIEBERT & ASSOCIATES THROUGH THIS WEBSITE.

 

 

 

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