Navigating the Complexities of Medicaid
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Medicaid is the government program that pays for nursing home care for people whose countable, available resources are below $2,000 ($4,000 for the higher-income applicants). The spouse in the community can retain the marital home, the car and up to $115,920 in assets or half the marital assets, whichever is less.
Paying for Nursing Home Care
The extraordinary cost of long-term nursing care can swiftly deplete a person's life savings and create great hardship for the spouse who remains in the community. Inability to pay for care may result in inadequate arrangements patched together by desperate family members. Medicare and most health insurance plans do not pay for this kind of care in either a residence or a nursing home.
Younger retirees may be wise to purchase long-term care insurance for themselves, but those who are already ill, frail or aged may not be able to procure such insurance. The Medicaid Program is available as a payer of last resort for those who have become financially eligible.
A person can apply for Medicaid to pay for nursing home care or care in the home when the countable, available resources have been reduced to $2,000 plus an allowance for the community spouse (if any) which is called the CSRA or Community Spouse Resource Allowance. This process is called the "spend-down".
Transfers of the Home or Other Assets
It is critical to understand that a transfer of any assets for less than fair market consideration, if made within the five years prior to applying for Medicaid, will generally trigger a disqualification period known as a transfer penalty which begins at the time the applicant has completed the spend-down process and is otherwise eligible for Medicaid benefits.
Certain exceptions exist to the basic transfer penalty rules. Assets can be protected with the structure that was created by Congress for this program.
For more information on navigating the minefield of real estate transactions in Elder Law planning, please see Preserving the Primary Residence.
Medicaid Application Process
Our Firm has extensive experience in assembling, evaluating, preparing, presenting and defending Medicaid applications for our clients. We can manage the burdensome details for you and assist you to utilize all opportunities created by federal law to preserve what can be preserved.
The Application process can be complex, requiring up to five years of cancelled checks, receipts and bank statements along with a detailed explanation of all cash withdrawals and movement of funds between accounts. You will need to provide 5 years of documentation to show all your financial transactions.
Fink Rosner Ershow Levenberg Law Firm provides you with the vigorous advocacy that you need in navigating the complexities of Medicaid.