MEDICAID PLANNING

For instance, a penalty period will usually be imposed for transfers of assets made to anyone other than a spouse during the five (5) years preceding an application for nursing home Medicaid.  Generally, this means that Medicaid will not pay for a period of time, which based on the value of the assets transferred. If transfers were made, it is imperative that an elder law attorney be consulted to explore whether the transfers may be addressed before a penalty period is imposed.  There is no penalty for transfers between spouses.

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Second, Medicaid planning does not stop with the filing of a Medicaid application.  It is important to understand the implications of the planning and to make sure a holistic approach was taken to preserve all possible assets. This is especially important where there is a spouse or where there is a home.  Often, we recommend preparing trusts and revising Wills for the community spouse to complete the planning. Our highly experienced elder law attorneys will help guide and educate you through this process.

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Where there is a spouse in the community and not in a nursing home, we can use a planning technique called spousal refusal so that the spouse’s income and resources are not counted towards the institutionalized spouse’s care. With this kind of planning it is very important to work with an elder law attorney to make sure you understand the implications of this strategy and to do estate planning to make sure the planning is as effective as possible.

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The best time to plan is when you are healthy and do not anticipate requiring nursing home services for at least five (5) years, but acknowledge that at some point you may require care.

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A Medicaid Trust is one of the most common advance planning techniques, but in many cases no planning has been done and care is imminent.  This does not necessarily mean all is lost.  Very often, assets can still be saved through the use of a sophisticated planning technique.

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In-Home Care and Medicaid Planning

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Most people feel more comfortable at home and wish to receive all the care they need at home.  Many people worry, however, that they do not -- or will not -- have the funds to pay for the care. After all, home health aides can cost as must as $35/hour, and paying completely out of one's pocket can quickly deplete savings, leaving insufficient funds to run the household.

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One option that you can use to preserve your assets and receive home health care services is to have Medicaid pay for at least some of your home health aides. The Medicaid home health care application process is very complicated, and there are two components to a successful Medicaid in-home care application:

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• Financial Eligibility – It must be determined whether one is financially eligible for Medicaid.  If not already eligible, creating financial eligibility must be explored.  While there is currently no penalty for asset transfers, it is important to speak with an elder law attorney regarding your assets and formulate a plan that makes sense, especially from a tax perspective.  Not all asset transfers are treated equally.

• Medical Eligibility – One must need assistance with activities of daily living to be deemed medically eligible for Medicaid at home.  Medicaid will then determine how many hours of in-home care Medicaid will provide.  We will work with you to receive the maximum number of hours to which you or your loved one are entitled.

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Financial eligibility for Medicaid home care is just the first step in an increasingly complex process that involves many people from different places including the Department of Social Services, a Managed Long Term Care Company, a Pooled Trust Company and the Home Health Care Agency. ​