I. Medicaid General
How does the Medicaid process work?
Medicaid is a federal program, administered by the state you live in, which provides help paying for long term care. In order to receive Medicaid, you must meet specific health and financial qualifications. FamilyAssets can support you throughout the Medicaid application process, help you to understand your options, and connect you with qualified professionals who can help you plan for the care you need.
How do I know if I qualify for Medicaid?
You must meet both financial and health requirements in order to qualify for Medicaid. The financial requirements vary by state, but both your income and the amount of assets you own must fall below certain maximums. You also must require health care services of the type that are provided by nursing homes.
Does Medicaid cover the cost of a nursing home?
Yes, if you qualify for Medicaid, Medicaid will pay for your nursing home. In most cases, you will also have to pay a copay to the nursing home based on your income.
Can Medicaid pay for assisted living?
Yes, in many cases, Medicaid will pay for the cost of assisted living if your health care needs require services that would typically be provided in a nursing home or a skilled nursing facility and you meet specific financial criteria. Financial criteria will vary by state, but will usually follow the criteria required to receive Medicaid for nursing home care.
Can Medicaid pay for in home care?
Yes, in many cases, Medicaid will pay for the cost of in home care if your health care needs require services that would typically be provided in a nursing home or a skilled nursing facility and you meet specific financial criteria. Financial criteria will vary by state, but will usually follow the criteria required to receive Medicaid for nursing home care.
How long does the Medicaid application take to get approved?
A Medicaid application will typically take 1-3 months to get approved. In many cases, you will not have to pay the nursing home while your Medicaid application is pending.
When should we apply for Medicaid?
You should apply for Medicaid when you qualify for Medicaid. This will vary by state, but it means that you meet all asset and income requirements and you are in a Medicaid-qualified nursing home.
How is the Medicaid penalty period calculated?
A penalty period is the amount of time you are disqualified from receiving Medicaid because of gifts or transfers made during Medicaid’s lookback period. The penalty period is calculated by dividing the amount of the total amount of gifts or transfers by the penalty divisor in your state. The result is the number of months the penalty period will last.
How does a Miller Trust work?
In some states it may be possible for you to lower your income, thereby meeting Medicaid’s income requirement, by depositing your income into a Miller Trust. A Miller Trust must be irrevocable and meet certain other requirements in order to qualify as Medicaid-compliant. Any income deposited in the trust will be paid to your nursing home as a copay.
Do I need to work with a lawyer?
According to federal regulations, you do not need to work with a lawyer in order to apply for Medicaid. Depending on your situation, a lawyer may be able to help you with some of the steps along the way, and in most states, a Medicaid planner or a lawyer may provide you with guidance and advice about your specific circumstances.
How do Medicaid asset limits work in my state?
The asset limit in most states is $2,000 (though some states have higher and lower limits), which means that a care recipient will not qualify to receive Medicaid if he or she has more than $2,000 in total assets. However, there are numerous exclusions to the Medicaid asset test that can protect significant amounts of your family’s assets. For example, in many states if you are married and receiving nursing home care through Medicaid, your spouse is allowed to keep $119,000 as a community spouse benefit. Additional asset exclusions exist, which means that the $2,000 limit can be very misleading for families. Medicaid Planning specialists like FamilyAssets can help your understand opportunities to access Medicaid nursing home benefits by utilizing the exceptions and exclusions to the Medicaid asset limit rules in your state.
Am I allowed to keep my house if my spouse goes on Medicaid?
The rules differ by state, but if the house is a primary residence and you intend to return to it, you can often keep your house. Additionally if your spouse is living in the house it is likely to be viewed as an excluded or non countable asset. It is important to be aware that Medicaid may seek repayment from the estate of the care recipient, so it is crucial to understand your family’s options for protecting that asset.
My mom gave me a gift under the IRS ($14,000 in 2016) gift amount for the past 5 years, does that count against the Medicaid look back period?
The Medicaid limits for gifts are stricter than the IRS gift limits. Gifts that are not transferred according to the Medicaid rules are subject to a penalty period. If you have made or received a gift that is not allowable under Medicaid rules, Medicaid planning assistance can help you minimize or avoid penalty periods. Penalty periods last for months, even years, during which your family will be unable to access Medicaid funding and will be responsible for paying nursing homes costs out of pocket. The average cost of a nursing month is $6,000 per month, so the cost of penalties can quickly turn into an enormous financial burden for your family. FamilyAssets can identify and implement allowable asset conversion approaches that follow Medicaid rules, which can spare your family costly penalties from the Medicaid office.
II. Medicaid Financial Benefits
Can Medicaid pay ME to be a caregiver?
In some cases, Medicaid can pay you to care for your relative. Several states allow you to provide caregiver services to your relative in your own home and to receive payment from Medicaid for those services.
How do I protect our home from Medicaid?
If Medicaid pays for part of your care during your lifetime, the state can recover some of those expenses from your estate after your death. Typically, the largest asset in a person’s estate is their home. There are a few ways to protect your home from estate recovery. Depending on what state you live in, you may be able to use a Ladybird Deed, convey a fractional interest in your home to a child, or transfer your entire house to a child while retaining a life estate in the home. Some of these methods may incur a penalty period for Medicaid eligibility but they will also remove your home from your estate for the purposes of estate recovery.
Can my relative keep any of his/her income while on Medicaid?
The Medicaid recipient is allowed to keep a small personal needs allowance from their income to pay for personal expenses such as haircuts or cable television. The amount of the allowance is set by the state, but is typically between $50-$100 per month.
III. Medicaid Application Process
What do I do if my relative’s bank (or other institution) won’t take my power of attorney?
If this happens, please reach out to your FamilyAssets contact person.
How do I fill out the spouse/child section of the intake form if my relative’s spouse/child is dead (or if the relative had more than one spouse)?
Please only list the most recent spouse as your relative’s spouse. If he or she is deceased, please only include his or her name and status as a veteran. If a child is deceased, please only include his or her name.
What do I put in the bank account section of the intake form if my relative’s money is being depleted as we speak?
Please list an approximate current value. There will be space to include expenses as well.
What do I list as my relative’s address if he/she is in a facility but also owns his/her own home?
List the person’s home address, but include the facility as the mailing address if that’s where the relative received his or her mail.
What documents do you need me to send you copies of?
Please see our document checklist for a list of the documents we might need from you.
How do I get 5 years of bank records and [if it costs money to get them] how do I pay for all of them?
In order to get 5 years of bank records, you will need to contact your bank to request them. If the bank asks that you pay for the bank records, please reach out to your FamilyAssets contact person.
IV. Nursing Home Medicaid
How do I find a nursing home that takes Medicaid?
You can find a list of nursing homes that take Medicaid by clicking the following link.
When do I have to move my relative into a nursing home?
You should move your relative into a nursing home before you apply for Medicaid.