Medicaid Tag

Friday’s post talked about the new state program being developed for delivery of home and community-based Medicaid services (MLTSS), which will require individuals whose income exceeds the income cap to set up a Miller Trust to receive and handle the excess income. The State has actually published a Notice of Proposal, announcing its intent to ask the federal government to allow it to do...

The State of New Jersey provides part time home health care services to eligible individuals through the Medicaid Managed Long-Term Services and Supports (MLTSS) home and community  program (formerly called Global Options). Applicants are individuals who require an institutional level of care because they require assistance in three or more of their Activities of Daily Living (ADL’s),...

On January 24, 2013, a settlement was reached in a class-action suit called Jimmo v. Sebelius, which was pending in the U.S. District Court for the District of Vermont. As noted in yesterday’s blog, Medicare Part A will pay for up to 100 days of skilled care services in a skilled nursing facility (SNF) following a hospitalization of three days or more, if medically necessary and all...

Many times over the years, as we work on their estate planning, my senior clients have told me that they gave a substantial sum to one of their children to help them with a specific need. Perhaps it was to pay off debt, or buy a house, or start a business, or pay for college expenses for their own children. Whatever the reason, an important legal question comes up: “Was this a gift or a...

As explained yesterday, the NJ State Medicaid Program cannot assert a lien against the Medicaid recipient’s property during his lifetime, unless the individual had wrongfully received benefits and the State sued and obtained a judgment. In all other cases, a lien can only be asserted after the death of a Medicaid beneficiary, and certain conditions must apply: the Medicaid recipient had...

Nursing home care can be necessary when a person who is medically fragile or has severe memory impairment, confusion & dementia is unable to be effectively cared for in a home care setting. It could be that the home has too many stairs, inaccessible bathrooms or other hazards. It could be that the patient needs higher skilled nursing attention. It could also be that there is no family...

When a Medicaid application is denied due to “excess resources,” many procedural tangles can ensue. Individuals who require long-term care in nursing homes, assisted living or at home may apply for Medicaid when their countable available resources have been reduced to a low level, typically $2,000 for an unmarried person plus a protected share for their spouse. (Income is treated...

There may come a time when your beloved aged & infirm family member just cannot take care of their basic needs for daily living any more. They cannot get themselves safely in and out of bed or chair; cannot bathe themselves; are starting to trip and fall; need help getting to the bathroom; can no longer obtain and prepare food; or can no longer remember how to do basic things or how to ask...

Reparations payments received by Holocaust survivors are exempt from consideration under the federal Medicaid and SSI laws. According to the SSI regulations at 20 CFR 416.1236 (a)(18) – “reparations are excluded” from the definitions of “resources.” The SSI POMS SI 01120.610 says that reparations are not includable as either resources or income. There is an...

The term “Special Needs Trust” typically refers to a “first party trust,” funded with assets that belong to a person under 65 who has disabilities. Federal law for the Medicaid and SSI programs  — 42 USC 1396p(d)(4)(a) and 42 USC 1382b(c)(C)(ii) –allows an applicant to transfer their excess resources into a Special Needs Trust without being disqualified for...