Avoiding A Medicaid Disaster

The Problem

Medicare is an insurance program providing payment for medical needs for potential recipients 65 and over and recipients with disabilities. All recipients 65 and over, regardless of financial resources or income, are eligible for Medicare. However, Medicare provides minimal coverage applicable to long-term care costs. Medicaid pays the costs of care provided in a nursing home, including room and board, physicians' care, hospital care, adult care homes, hospices, and provides services that can allow a recipient to stay in their home. Most people who need long term must eventually rely on Medicaid.

Medicaid program eligibility standards are based on the recipient's assets and income. Those standards require you to be destitute to receive Medicaid. Further, when a recipient applying for Medicaid is married, both spouses' assets and income count in the eligibility decision. Before qualifying for Medicaid, a potential recipient often pays for long-term care out of their pocket costs exceeding $8,000 per month until their assets are 'spent down.'

What You Need to Know

• Elder Law attorneys carefully study the Medicaid statutes and regulations and help clients with assets and income exceeding Medicaid eligibility limits.
• Most people who need care for extended periods will are forced to deplete their life savings to pay their care costs before qualifying for Medicaid.
• In determining eligibility for Medicaid payment for long-term care expenses, the Medicaid will review the potential recipient's actual need for care, the recipient's available resources (including life insurance and retirement plans), and income received from any source.
• If a potential recipient's income exceeds the limit, then the potential recipient is ineligible for Medicaid, even though the potential recipient's long–term care expenses exceed her income.
• Transfers or Gifts made by a potential recipient within the past five years may disqualify a potential recipient for Medicaid.
• In determining eligibility for one spouse, both spouses' assets and income are considered, regardless of premarital agreements, community property laws, or the nature of the asset's ownership.
• Assets of married couples receive special treatment allowing the couple who act swiftly to protect significant assets. 

What you Should Know

• While a residence of a potential recipient is non-countable for eligibility purposes, it must be protected. Medicaid will attach the spousal home to recover any payments Medicaid has made on the recipient's behalf after the death of the second spouse. 
• Family support groups and organizations such as the Alzheimer's Association and AARP assist and often have literature. Local Area Agencies on Aging (according to the Older Americans Act) also have comprehensive advice and literature available concerning Medicaid. 
• The state Medicaid Eligibility Office is a good source for information about the program, its services, and the requirements for eligibility.
• A qualified Elder Law attorney will advise and help you and your family avoid or minimize these issues. To find a NAELA member attorney in your area, please visit:

www.NAELA.org/findlawyer, or contact Meyerson Law Firm at contact@meyerson-law.com, or 678-892-8910. 

The Bottom Line

There are proactive strategies that an Elder Lawyer Attorney can implement that require five years to be effective. These strategies can completely protect assets from a Medicaid Disaster. 

In the shorter term, once you realize that you or a loved one with a home or other assets needs or anticipates the need for long-term care, immediately seek the assistance of an Elder Law Attorney. An Elder Law Attorney can help you minimize the damage of a Medicaid Disaster, saving the family home, and potentially tens or even hundreds of thousands of dollars.