Wednesday, January 24, 2018

When It Comes To Medicaid, the Question Is - Is It Covered?

“To be or not to be? That is the question,” Shakespeare’s Hamlet mused.  When it comes to Medicaid eligibility, however, there’s a whole ‘nuther question to ask: “Is it counted?”
Medicaid is a joint federal-state government program which helps make medical coverage more affordable. For eligible residents of Indiana, Medicaid helps pay for services such as:
  • hospital care
  • clinical services
  • visits to physicians and nurse practitioners
  • lab tests
  • x-rays
  • nursing home care
  • prescription drug coverage
For our Geyer Law estate planning and elder care clients, the big concern is whether an individual must spend down all of his or her assets in order to qualify to receive Medicaid benefits. Will I lose my home? Will our life savings disappear?

Enter Medicaid planning. With careful, knowledgeable advanced planning, it is possible to obtain Medicaid eligibility and still preserve assets. As elder law attorneys, we choose from an arsenal of planning tools to qualify an individual for Medicaid while yet protecting assets for a healthy spouse or for children. Special Medicaid planning tactics may include:
  • gifting
  • trusts
  • long term care insurance
  • annuities
  • promissory notes
  • reverse mortgage
In practice, the National Care Planning Council explains, Medicaid comes into play for seniors when there is a need for nursing home care. “Most older people do not have the income necessary to cover nursing home costs, especially if there is a healthy spouse living at home.”

In fact, many of the features of Medicaid are designed to protect the spouse of a Medicaid applicant or beneficiary who needs coverage for long-term services and supports in either an institution or a home or other community-based setting, from becoming impoverished.

On the other hand, in order to make sure there are enough resources to help those who are truly in need of assistance, there are some very strict Medicaid rules.  For example:

1.   Medicaid beneficiaries will be denied coverage if they have transferred assets for less than fair market value during the five-year period preceding their Medicaid application. 
2...State Medicaid programs must recover from a Medicaid enrollee's estate the cost of certain benefits paid.

In determining eligibility for Medicaid benefits, Medicaid measures two things: income and “resources” (assets). Income includes: pensions, social security, income from annuities, rental income, interest, dividends, capital gains distributions. Income eligibility for Medicaid is determined on a monthly basis (income that is not periodic is counted in the month it becomes available).

The rules are too complicated to cover in one blog post.  The point to remember is   When it comes to Medicaid eligibility, “Will it be counted?” The attorneys at Geyer Law can help you answer this important question.


- by Rebecca W. Geyer

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