Category: Medicaid

Medicaid Myths & Misconceptions: Separating Fact from Fiction

Understanding Medicaid and its benefits is crucial, particularly for seniors who require long-term care. However, several myths and misconceptions often cloud this complex healthcare program, leading to confusion and missed opportunities. This comprehensive guide will dispel some common Medicaid myths and bring the facts to light.

Myth 1: You Must Be Impoverished to Qualify for Medicaid

One prevalent misconception is that only those with no income or assets qualify for Medicaid. In reality, eligibility is based on a combination of income, assets, and medical need. The specific thresholds vary by state and individual circumstances. It’s crucial to consult with an elder law attorney to understand your eligibility fully and explore planning strategies that protect your assets while allowing you to qualify for needed benefits.

Myth 2: You Must Spend Down All Your Assets on Healthcare Costs Before Medicaid Steps In

The “spend-down” myth often discourages many from applying for Medicaid. While there are asset limits, that doesn’t mean you need to exhaust all your resources before receiving assistance. Sound Medicaid planning can help you preserve many of your assets. Various strategies, such as creating irrevocable trusts or making specific types of transfers, may help you meet Medicaid’s asset limit without depleting your estate.

Myth 3: You Will Lose Your Home If You Apply for Medicaid

The fear of losing their homes keeps many seniors from applying for Medicaid. However, the truth is that Medicaid does not force you to sell your primary residence to qualify for benefits. Federal law protects a certain amount of home equity from being considered as part of the asset test. However, Medicaid may seek reimbursement from your estate after your death, potentially involving your home. Proper Medicaid planning can provide strategies to protect your home.

Myth 4: All Assets Transferred Within the Five-Year Look-Back Period Will Incur a Penalty

Many people understand that Medicaid imposes penalties for assets transferred within five years of applying for benefits. However, the misconception lies in believing that all transfers will incur a penalty. Certain transfers, such as those between spouses or to a disabled child, are exempt from penalties. It’s essential to understand these exemptions to avoid unnecessary penalties and delays in coverage.

Myth 5: Once You’re in a Nursing Home, It’s Too Late for Medicaid Planning

Some people believe that once they or a loved one has entered a nursing home, it’s too late to plan for Medicaid. This is not true. While proactive planning is always beneficial, strategies can still be employed to protect assets and qualify for benefits even after nursing home admission.

The Importance of Qualified Legal Guidance

Given the complexity of Medicaid rules and the high stakes involved, it’s critical to get accurate information and advice. A skilled elder law attorney can help you separate Medicaid facts from fiction and guide you through the planning process.

Contact Beasley & Ferber for Expert Medicaid Planning

If you’re struggling with the intricacies of Medicaid or have fallen prey to common misconceptions, Beasley & Ferber can help. Our team has decades of experience in elder law, guiding clients through Medicaid planning and helping them protect their hard-earned assets.

Don’t let myths and misconceptions about Medicaid prevent you from getting the healthcare you need. Reach out to Beasley & Ferber today for a consultation, and let us help you navigate the complex world of Medicaid effectively. To learn more about our services or to schedule a consultation, contact us today. We look forward to providing the guidance and support you need.

Long-term Care Planning: Medicare, Medicaid, and Insurance

Long-term care is something that people generally aren’t eager to think about. However, roughly 7 out of 10 people will require long-term care at some point during their lifetime. When the national average cost of a private room in a nursing facility is $9,034, older adults and families need to address long-term care in their financial and legal planning.

Long-term care is a general term that describes various care services that regular health insurance does not cover. It might include things like:

  • In-home assistance with routine daily activities (activities of daily living or ADLs)
  • Living in a nursing home or assisted living facility
  • Nursing care
  • Physical, occupational, or speech therapy

Because long-term care is not covered by health insurance, you need to make other plans to pay for it.

Does Medicare Cover Long-Term Care?

Medicare is a government-provided health insurance program for adults who are over the age of 65. It also covers some individuals with disabilities as well. Unlike Medicaid, Medicare does not depend on your income, assets, or disability status.

Adults who qualify pay for Medicare just as they would a private health insurance company. The main difference is that Medicare provides more extensive services and lower fees compared to the average private insurance company. In many cases, those receiving Medicare do not pay any insurance premiums at all for Medicare Part A, which provides hospital services.

Medicare Part A covers things like:

  • Care in a skilled nursing facility
  • Hospital stays
  • Hospice care
  • Some home healthcare

It does not cover more basic things that medical insurance might cover, such as doctors’ services, medical supplies, and preventive services.

Medicare also does not cover long-term care, including living in an assisted living facility or nursing home.

As a result, individuals and families cannot rely on Medicare to pay for the full cost of a nursing home or assisted living care. Instead, they need to make other arrangements to pay for long-term care.

Does Medicaid Cover Long-Term Care?

Medicaid might be an option to pay for long-term care in some situations. However, using it appropriately might require some long-term planning. In most circumstances, you will need at least five years to appropriately plan to use Medicaid for long-term care. Learn more about Medicaid planning by downloading our free e-book.

Long-Term Care Insurance

Neither regular health insurance nor Medicare addresses long-term care. So, how can individuals and families pay for long-term care? Long-term care insurance might be a good option.

Long-term care insurance is available from many private insurance companies. It generally covers expenses that Medicare will not cover. If you buy a policy under the age of 55, it is often more affordable than waiting until you are older.

Get Help with Long-Term Care Planning

You might also be able to tap into other resources to pay for long-term care, such as using investments or Veterans’ benefits. However, you need to have a full understanding of your options to plan appropriately.

Get help with long-term planning from the experienced elder law attorneys at Beasley & Ferber. We can help you review your options and make recommendations for your unique situation. Contact us today for more information.

How Will Selling My House Affect My Medicaid?

Medicaid is a federally funded program that each state administers and offers assistance to the elderly, those with disabilities, and low-income people. If you or an elderly loved one are on Medicaid, there are certain regulations that must be adhered to. One of them has to do with income and assets. At the same time, you may be in a situation where you need to start looking at the possibility of selling your home in order to pay bills. Many people who are on Medicaid are forced to sell their homes in order to pay their costs. This is permitted as long as the money is used to pay off debts such as a mortgage, auto payments, or medical expenditures. You should get the help of an elder law attorney in New Hampshire before acting, however. In the meantime, here is what you should know about how selling your house may affect your Medicaid benefits.

Pay Attention to Your Assets

If the proceeds from the sale raise your assets beyond your state’s Medicaid asset level, you may be disqualified from receiving Medicaid. “Assets” refers to any liquid assets, such as cash or equities, for the purposes of the asset threshold.

In most jurisdictions, the barrier is a mere $2,000, thus selling a home will almost always put you well over the limit.

You can still qualify for Medicaid provided your total countable assets stay below your state’s criteria, which in most cases is merely $2,000 in most cases. Primary houses are deemed exempt assets, therefore purchasing a new home may be a viable alternative. However, if the purpose of selling the house is to free up cash, then buying another house may not serve your needs.

Consider Spending Down Assets

If your assets surpass the asset restriction, you can “spend down” your assets to go back below the limit and re-qualify. There is no penalty period that prevents you from getting Medicaid coverage if you spend down your assets utilizing approved spending. Simply reduce your countable assets down below the threshold and resubmit. Paying down credit cards, your remaining mortgage balance, medical expenses, auto payments, and other debts are all eligible spend-down choices. If you or your loved one are moving into a care facility, you could use the assets from the sale of the home and spend down the assets by paying your care facility fees ahead of time.

Rules For Selling a House While on Medicaid

Medicaid is designed to separate “countable” from “non-countable” assets.  Because the value of your principal house does not count against your asset limit, it is called a non-countable asset. If you leave the house and it is no longer your primary abode, however, it becomes a taxable asset.  As a result, you may be ruled ineligible for Medicaid before ever selling your property.

As you can see, the rules for selling a home while receiving Medicaid are complicated. That’s why it’s highly recommended that you enlist the services of an elder law attorney, such as Beasley & Ferber. Contact us today for help.

How to Navigate Medicaid Crisis Planning

Medicaid is a program for people with a low income and few resources to help them pay for the cost of obtaining healthcare. Although the federal government oversees Medicaid, each state determines who qualifies for coverage and the types of treatment it will cover. Medicaid crisis planning is sometimes necessary when a family member needs to move into a long-term care facility with little notice. A stroke that leaves a loved one cognitively impaired and unable to care for themselves is just one example.

Medicaid Crisis Planning Can Help Clients Retain a Lifetime of Savings

Your spouse or parent worked hard all their life, paying their bills on time and putting money aside to leave for the next generation. Unfortunately, the high cost of long-term care means that it could be gone within weeks after moving into a nursing home. The elder law firm of Beasley & Ferber works with clients and their families to determine the best strategies to use to prevent them from losing their life savings.

Here are just some of the factors we consider before providing the family with legal advice:

  • Age and life expectancy of the person needing long-term care
  • The health condition that necessitates long-term care
  • Types of assets in their estate
  • Unique family circumstances, such as a person who needs care having gone through a divorce previously but has since remarried. The new spouse may have a conflict with the adult children over the best course of action for their loved one.

People who apply for Medicaid based on sudden health needs often receive a denial because their income, assets, or both are too high. If you transfer assets suddenly on behalf of your loved one, the government will learn about it during its five-year look-back period. However, certain types of transfers are legal and will not invite government scrutiny. These include:

  • Transferring to a spouse or another adult who manages the financial affairs of the spouse.
  • Establishing a trust for the benefit of a disabled individual under the age of 65.
  • A trust for the benefit of a blind or disabled biological or adopted child, regardless of age. These funds can also go to the benefactor directly.

Persons applying for emergency Medicaid can also transfer their home to someone else if the transaction meets each of the following criteria:

  • The person receiving the title to the home is a son or daughter who is at least 21 years old.
  • An adult child lived with a parent for at least two years before the parent needed nursing home care and provided direct care up to that point.
  • A sibling of the Medicaid applicant with equity in the home lived there for at least one year before the other sibling needed long-term care.

Although you can transfer assets in any of these situations to have your loved one qualify for emergency Medicaid, we recommend that you seek advice from our elder care law firm first. We will ensure the transaction you are considering is legal and offer additional recommendations to help your family at this challenging time. Contact us to schedule an appointment today.

What Should You Know Before Applying for Medicaid

You may qualify for Medicaid if your income falls below a certain level, and you meet certain other eligibility criteria. Medicaid is a federal program operated independently by each state. According to Medicaid.gov, approximately 72.5 million Americans have health insurance coverage through Medicaid. The program provides insurance for more people than any others, including the age-based Medicare program. Read on for some important things to know before applying for Medicaid.

Understanding What Federal Law Requires

Federal law requires each state to provide coverage to low-income families and individuals, people who receive Supplemental Security Income (SSI), pregnant women, and children who meet all eligibility requirements. These groups of people fall into mandatory eligibility groups. Governments of each state have the option to add additional groups or cover certain individuals. Common examples are children living in foster care not eligible for other healthcare programs and people who receive community-based services because of a disability.

2010 Medicaid Expansion

Congress passed the Affordable Care Act (ACA) 11 years ago that expanded access to Medicaid for millions more Americans who had not yet reached their 65th birthday. Under ACA, all children whose families earned a minimum of 133 percent of the federal poverty rate automatically qualify for Medicaid. Several states chose to extend the same eligibility requirements to adults. If you feel your annual income is low enough to qualify for Medicaid, your next step is to check the eligibility requirements in your state.

Main Eligibility Criteria for Medicaid

States use both financial criteria and non-financial criteria when deciding whether to approve a Medicaid application. Employees who process applications use the Modified Adjusted Gross Income (MAGI) model to determine the financial eligibility aspect. Several other federal healthcare programs use MAGI, including the Children’s Health Insurance Program (CHIP) and the health insurance marketplace operated by individual states.

MAGI considers the applicant’s taxable income, eligible deductions, and tax filing status. The formula replaces a previous program used to determine Medicaid eligibility associated with the now-defunct Aid to Families with Dependent Children (AFDC). MAGI does not require applicants to disclose assets or apply a resource test.

People who are blind, have other significant disabilities, or are over age 65 do not have MAGI applied to their Medicaid application. State governments typically use the formula for determining social security disability income (SSDI) eligibility for Medicaid applicants who fall into one of these three groups.

Non-Financial Qualifications for Medicaid

Federal and state governments also require Medicaid applicants to meet the following non-financial criteria:

  • Be a permanent resident of the state where they applied for Medicaid.
  • Be born in the United States or a naturalized citizen, although certain lawful permanent residents also qualify.
  • Meet age, parenting, and pregnancy status qualifications imposed by individual states.

Contact the Elder Disability Law Firm of Beasley & Ferber

Applying for Medicaid can be frustrating and confusing, especially when eligibility requirements can vary significantly between states. Beasley & Ferber invites you to request a consultation with our elder disability law firm today to receive guidance as you go through the process.


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