Medicaid is the government program that pays for nursing home care, assisted living, adult day care or home health for people whose countable, available resources are below $2,000. The well spouse, who does not require nursing home level of care, can retain the marital home, the car and up to $130,380 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 for a family member with Alzheimers or other cognitive disorders 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 within the laws 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 LLC, Attorneys at Law, provides you with the vigorous advocacy that you need in navigating the complexities of Medicaid.

Frequently Asked Questions

Q. What Is Medicaid?
A. Medicaid is a federal program administered through the local county Board of Social Services where the applicant resides. Medicaid is funded jointly by federal & state governments.

Q. Do I have to be able to pay for nursing home care for 5 years before applying for Medicaid?
A. Not necessarily. Applications can be filed as soon as you achieve financial eligibility, taking into account the Community Spouse Resource Allowance (CSRA), exempt transfers, and strategic planning involving gifts and highly restrictive annuities.

Q. Does the State take my house?
A. No. To protect the house if you need nursing care, it is critical to understand the five year transfer penalty and the rules that preserve the home under certain circumstances.

Navigating the Complexities of Medicaid

At Fink Rosner Ershow-Levenberg Marinaro, your case is managed by a team comprised of a Senior Attorney, an Associate Attorney and a Legal Assistant.

In the photo above, we have just completed a Medicaid application. We can help you complete your application, too.

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Medicaid News & Insights