What is Medicaid?
Medicaid is a federal assistance program that is administered by the states. It is designed to help those who are financially eligible pay for the cost of long-term care and allows access to other medical and healthcare benefits.
Because Medicaid is a needs-based program, there are strict financial requirements in order for someone to be eligible for Medicaid assistance.
Do I need to plan for Medicaid now?
Unfortunately, 2 out of 3 senior citizens will need long-term care at some point. Although no one wants to believe that they will need nursing home care, the reality is that many of us will.
If you or a loved one is a senior citizen, it is important to visit an estate planning or elder law attorney who can help walk you through the estate planning process. Because Medicaid considers gifts and other transfers you make (including those made to trusts) within five years of the date you apply for Medicaid, it is important to begin Medicaid planning early, before you and your spouse are actually in need of long-term care.
Am I eligible for Medicaid?
Although each state has its own set of Medicaid eligibility rules, there are some general guidelines that must be met in order for someone to qualify for Medicaid.
For example, in Virginia, there is a resource limit of $2,000 for each Medicaid applicant. Although some things such as one motor vehicle and most personal property are exempt from this limit, most people will need to rearrange some assets before they will be eligible for Medicaid assistance.
What does Medicaid cover?
Many of our clients believe that Medicaid will cover any long-term care they receive. However, Medicaid only covers nursing home care and some in-home care under specific waiver programs.
If you or a loved one is in an independent living facility or an assisted living facility, their care is not covered by Medicaid.
What does Medicaid not cover?
Another common misconception is that once a loved one is in a nursing home and receiving Medicaid assistance, all of their needs are being paid for.
However, Medicaid does not cover many basic needs, including a private room, telephone, television or radio, personal clothing, social activities or entertainment, dentistry, and eye care.
Because Medicaid does not cover all of these items, it is important to have a plan in place rather than spending down all of your assets until you are financially eligible for Medicaid assistance. If you are unable to pay for the items not covered by Medicaid, then your family and friends may be burdened with paying for these items for you.
Will a general practice attorney be able to do my Medicaid planning?
Medicaid and long-term care planning can be a complex and confusing area of the law. Although most attorneys are aware of the basics of Medicaid planning and elder law, it is important that you hire an attorney who is experienced in this area of the law.
If a Medicaid application is submitted without all of the correct transfers and planning strategies having been completed first, this misstep can result in thousands of dollars being lost to out-of-pocket nursing home payments.
I am a veteran. How does this impact Medicaid?
Elder law attorneys also help veterans plan for and become eligible for the VA Aid & Attendance pension. Although this pension is similar to Medicaid in that it helps pay for the cost of long-term care, it is also a very different benefit.
Unfortunately, for most people, this VA pension will not cover the entire cost of long-term care. The maximum benefit for a married couple in 2017 is $2,127 per month.
However, because the VA pension covers all types of long-term care, not just nursing home care, this benefit can help prevent people from going on Medicaid prematurely because they cannot afford to pay out-of-pocket for assisted living care.
If you already receive the VA Aid & Attendance pension and need to go on Medicaid instead, then your VA pension benefits will be reduced to $90 per month upon the approval of your Medicaid application.
Can I qualify for Medicaid by giving my assets to my children?
When considering whether an applicant is eligible for Medicaid assistance, Medicaid looks at the assets that you have transferred or given away within five years of the date of your application.
For every $5,993 that the applicant transfers, they will be placed on a “penalty period” for one month. For that reason, it is very important that you not transfer assets to your children in order to get them out of your name.
Instead, we recommend meeting with an experienced elder law attorney who can help you discuss ways of shielding your assets so that you can become eligible for Medicaid.
Do I need a lawyer to apply for Medicaid?
The process of applying for Medicaid can be very confusing and frustrating for someone who is not familiar with how the system works.
Although there is no requirement that an attorney file a Medicaid application on your behalf, it is always helpful to have an advocate on your side who knows how to complete the application and who can communicate with the Medicaid caseworker after your application has been submitted.
Can I afford to privately pay for nursing home costs?
In 2017, the average nursing home in Virginia costs over $113,000 per year – and the average stay is three to five years.
If both you and your spouse had to pay out-of-pocket for nursing home costs for three years each, would you be able to make those payments? For most of us, the answer is “no” – not without depleting hard-earned savings and leaving no inheritance to our children and grandchildren.
Implementing a few planning strategies now can avoid your home, savings, and other hard-earned assets from being wiped out in a matter of months from a nursing home stay.
Can I use Medicaid benefits to pay for assisted living?
Medicaid only covers nursing home care and some types of in-home care waiver programs – not assisted living care. If you are interested in assisted living, you will be required to pay out of pocket or, if you are a veteran, you can arrange your assets so that you are eligible for the VA Aid & Attendance pension.
Navigating the Medicaid process – both the financial planning and the application itself – can be a stressful and daunting task. However, at Alperin Law, we are happy to help guide you through each step of the process. Contact us today to schedule your consultation.