Are you afraid that you cannot afford the costs of nursing home care without losing your own assets?
There are few areas of the law that are quite as challenging as Medicaid, with its constantly evolving set of laws and regulations. That’s why planning for Medicaid is best when done well in advance. A Medicaid attorney can help you develop a comprehensive asset protection plan. At The Law Office of Antony M. Eminowicz, Esq we help to devise strategies that conform to federal and state law and help protect a significant bulk of assets belonging to a couple or individual, should Medicaid assistance ever be required at some future date.
A fixed fee consultation at The Law Office of Antony M. Eminowicz, Esq typically involves a thorough examination of assets for Medicaid qualification and estate planning purposes, as well as an explanation of Medicaid planning strategies and estate planning options. There will always be a follow up letter or email detailing what was discussed in the meeting and recommended.
Frequently Asked Medicaid
- Although the names look confusingly similar, the programs are quite different. The most significant difference is that Medicaid covers nursing home care, while Medicare, for the most part, does not. Medicare Part A covers only up to 100 days of care in a “skilled nursing” facility per spell of illness. This must follow a stay of at least three days in a hospital. And for days 21 through 100, you must pay a co-payment of $157.50 a day (in 2015). This is generally covered by Medi-gap Insurance.
The rules for obtaining payment of up to 100 days coverage Medicare are strict, and very few patients actually manage to obtain this. As a result, Medicare pays for less than a quarter of long term care costs in the United States.
- There are two different kinds of Medicaid: Community Care Medicaid and Chronic Care Medicaid.
Community Care Medicaid is a program that will pay for the cost of a home health aide, enabling the individual to remain in the comfort of their own home. In order to qualify for such program an individual must not have more than $825 in income and $14,850 in countable assets. Eligibility for this type of program is less stringent than for the Chronic Care program. For example, any excess income can be ‘spent down’ on legitimate medical expenses, or placed in a pooled trust. In addition to this, there is no ‘look back’ period over transfers of assets. This means that eligibility can be obtained overnight by transferring excess assets. Advice from a knowledgeable elder law attorney should be sought, as planning for Community Care will often result in unintended consequence should Chronic Care Medicaid be sought in the future.
A Community Based application includes proof of income, the past year’s tax return, general documentation proving identification and a correctly completed application.
Chronic Care Medicaid is a program that covers the balance of the cost for an individual’s stay in a skilled nursing facility. Generally, the individual will pay over all but $50 of their monthly income, and Medicaid will assume the balance of monthly costs. A spouse will be expected to pay up to 25% of their income in excess of $2,980.50 unless undue hardship can be proven. The spouse is able to keep up to $2,980.50, and any shortfall can be made up from the Medicaid applicant’s own income. Unlike Community Care Medicaid, the Department of Social Services will look at any transfers or gifts of assets for the prior five years, which will often result in a denial of Medicaid benefits to the extent of the value transferred or given away.
A Chronic Care application requires showing all open and closed accounts for the prior five years as well as documentation including three years of tax returns, proof of income, identification and the application itself.
- An individual may retain countable resources of up to $14,850 as well as $50 in monthly income. An individual’s automobile or homestead is not included within the countable resources. Other assets such as retirement accounts may not be included provided certain steps are taken.
If the individual is married then the individual may retain countable resources of up to $14,850 and the spouse can keep between $74,820 and $119,220 in countable resources.
- Your attorney should be familiar with the constantly changing landscape of Medicaid rules and regulations, and how these rules can be applied to your own assets and estate planning. By not consulting an elder law attorney, you not only run the risk of disqualification from Medicaid but can also face an unnecessary depletion of assets.
Take, for example, this common scenario. An individual has made a gift because of the mistaken belief that this is the correct course of action (since an individual is allowed to give away a sum of money for estate tax purposes). New York Medicaid rules and regulations disallow the gifting of certain assets to qualify for the program. Without proper counsel, an individual could do something to disqualify themself from the program without even knowing it.
An individual does not have to be destitute in order to qualify for the New York Medicaid program. It is important to talk to a skilled and knowledgeable elder law attorney so that an evaluation can be made and an appropriate estate plan be implemented to ensure qualification for Medicaid while protecting assets.
- There is nothing to prevent an individual from filing their own Medicaid application. That being said, the application itself and the process involved can be a daunting and complicated affair. Those processing the application will scrutinize everything that is reported and this will often result in a denial of Medicaid benefits. Given that the stakes are usually high for those making the application (the average nursing cost in Ulster County is approximately $11,455) it is always better to hire a professional who knows how to navigate the system. This gives you every chance to get the best possible result: approval of Medicaid benefits. With professional help, you will likely avoid potential loss or delay of benefits, and save on the stresses involved in making a Medicaid application.
Long Term Care Planning Questionnaire
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Long Term Care Planning Consultation
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