As Americans live to be older, they are outliving the assets set aside for long-term care and with the cost of long-term care skyrocketing, Medicaid has become the default payor source for those nursing home care in their later years. Most people understand that Medicaid helps pay for the cost of nursing home care but there is still confusion on when someone becomes qualified to use the Medicaid benefit.
If you are helping to care for a senior chances are you have considered applying for Medicaid benefits. It’s a great benefit but there are some things you need to know before applying.
Qualified Based On Assets Not Age
Unlike Medicare which is automatically given to every American once they turn 65, Medicaid criteria is based on the applicant’s assets and income. Long-term care is expensive and in order for Medicaid to pick up the bill, they want you to use as much of your own money first before using tax dollars. Seems reasonable but Medicaid laws have not changed in sometime and as a result a senior has impoverished before even qualifying.
In general an applicant must have below $2000 in assets in order to qualify for Medicaid.
It is important to note that each state controls how their Medicaid dollars are spent and as a result each state has their own set of Medicaid rules. For example, some states allow exemptions for houses and cars while other states require the senior sell those assets before applying.
The rules can vary so before applying contact your local department of health and human services or an Elder law attorney.
This is the time period in which Medicaid will look back into your finances to check for transfers of funds to family members. In order to make themselves Medicaid eligible, many seniors and their families attempt transactions like gifting and quit claim deeds to preserve assets. If any of these transactions have been done in the last five years the Medicaid could assess a penalty that must be paid before Medicaid benefits begin.
There are great Medicaid planning strategies to preserve assets within the rules but most require the services of an Elder Law or Estate Planning Attorney to accomplish.
Medicaid rules for protecting assets change all of the time. DO NOT ATTEMPT TO PROTECT ASSETS ON YOUR OWN. Unless you have an intimate and clear understanding of the rules, it could have disastrous consequences.
There Is No Going Back
Before applying for Medicaid make sure you do a throughal review of your finances. Make sure you have taken advantage of all the exemptions allowed by Medicaid. Furthermore, make sure that all assets are being accounted for during the application process to avoid disruptions in coverage at a later date. Remember once you apply, Medicaid can start looking back, if missed something you it may cause a penalty or cause a lapse in coverage. If your situation is complicated, it is important to have an expert look over your application before submitting it.
Make Medicaid Planning Part Of A Senior Care Plan
The decision to apply for Medicaid should be part of a long-term senior care plan. Not all services are covered by Medicaid and not all providers can accept Medicaid payment. If becoming Medicaid eligible does not increase a senior’s access to services or fully cover the services they are using now, it might not be the right move.
Our Elder Care Coordinators can help develop a senior care plan designed to meet the unique health care needs of the senior. An important step to ensuring the senior is able to age in place. After we help you develop a plan we can connect you with our community of Sherpa Certified providers to help you execute that plan. Our list includes Elder Law Attorney’s, Home Care companies, Geriatric Care Managers and more. They all have been vetted, checked and certified to be free of fraud and follow the industry best practices. CLICK HERE for more information of starting you own senior care plan.