What You Need To Know About Medicaid Planning

In this article, you can learn about…

• How to prepare for the cost of long-term care.
• Different Medicaid planning tools that you can use to save thousands of dollars.
• The role an attorney plays in helping you save your money – while still having access to the care you need.

How Much Is Long-Term Nursing Home Care? Can The Average Person Afford To Pay Out Of Pocket?

While the cost of long-term nursing home care ultimately depends on the level of care received, it is generally safe to say that the average person cannot afford to pay for it out of pocket. A highly skilled nursing facility can cost over $9,000 a month and an assisted living facility over $4,000 a month.

Does Going To A Nursing Home Require My Spouse To Lose Our Home & Other Assets?

The spouse staying in their own home does not need to lose all of their assets in order for the other to go to a nursing home. The state has laws outlining community spouse resource allowance guidelines and standards in order to protect couples from experiencing this type of financial hardship.

What Is Medicare? What Is The Difference Between Medicare And Medicaid?

Medicare is a federal health insurance program that is available to adults aged 65 or over and for those with certain disabilities.

Medicaid is a wide-ranging, jointly funded federal and state health care program for low-income individuals of any age. There are various eligibility groups, including, but not limited to children, disabled individuals, and long-term care for seniors. The primary difference between Medicare and Medicaid is that Medicaid is a needs-based insurance program while Medicare is not.

Is Applying For Medicaid Confusing? Can I Do It Myself?

Most people find applying for Medicaid confusing. However, you don’t have to go through this process alone.

By working with a Medicaid planning attorney, you can find the support you need, help protect your savings, and access Medicaid benefits.

Can An Individual Whose Income Exceeds The Medicaid Limit Still Qualify For Medicaid?

It is possible for an individual to qualify for Medicaid if their income exceeds the limit. If planned properly, excess income can be sheltered.

What Is Spending Down As It Relates To Medicaid Planning?

Spending down describes the strategy wherein assets are used in order for an individual to meet Medicaid’s countable asset limit. Spending down should always be done with caution and only in the context of executing a larger strategy that has been carefully planned.

We do not recommend that people spend down as an excuse to spend money. There are specific, relevant rules that should be followed. If they are not, the applicant is at risk of being ineligible.

Can I Sell My Home To A Family Member For Less Than Its Full Value And Still Qualify For Medicaid?

As a general rule, if someone sells their home for less than its fair market value, there will be an aspect of the transaction that is considered an uncompensated transfer and could result in disqualification from Medicaid benefits for a period of time.

As such, we generally advise against selling homes for less than its fair market value to family members.

What Is The Look-Back Period For Medicaid? What Does That Mean Exactly?

The “look-back period” refers to the five-year period prior to the applicant applying for Medicaid benefits. The purpose of the Medicaid penalty periods is to discourage Medicaid applicants from giving away their assets for the sole purpose of qualifying for Medicaid.

The Medicaid case worker reviews all transactions for the five years prior to the Medicaid application in order to determine whether any assets were given to any individual or entity for less than fair-market value (also called a “gift”). If the caseworker finds transfers without value/gifts within that five-year period, a penalty period is assessed. The penalty period is calculated pursuant to a state formula. During the penalty period, Medicaid will not pay for long-term care.

The most common example of a non-exempt transfer is a gift of an asset to a friend or family member within the prior 60 months of applying for Medicaid benefits.

How Do Medicaid Rules Differ For A Single Person And Married Couples Where A Spouse Is Living Outside Of The Nursing Home?

If there is a spouse living outside of a nursing home, Medicaid does not take their income into consideration when it comes to evaluating the eligibility of the spouse who is going to be living in a facility.

In terms of assets, there is a limit on the amount of assets that the spouse living outside a facility can have. This is referred to as the community spouse resource allowance. So if you are going into a nursing home, your spouse does not have to lose everything.

Are Assets Within A Trust Considered Toward Eligibility For Medicaid For An Individual?

Assets in a revocable living trust are considered towards eligibility for Medicaid. Assets inside irrevocable trusts are not considered towards eligibility as long as they meet certain guidelines.

Are Some Assets Exempt From Counting Toward Medicaid Eligibility?

There are certain assets that are considered exempt or non-countable assets that may be exempt. They include but are not limited to an irrevocable prepaid funeral contract, a vehicle, and the person’s primary residence.

For more information about Medicaid Law in Florida, a free initial consultation is your next best step. Get the information and legal answers you are seeking by calling (813) 686-7175 today.