Medicaid Planning

As the quality of health care improves and the lifespan of our loved ones extends, the use of nursing homes is becoming more commonplace.

Moreover, medical care that used to be provided in a hospital setting is now being provided by nursing homes. Even patients with complex medical needs such as dialysis, ventilator care, tracheotomy care, catheterizations, traumatic brain injuries and other medical needs are now being discharged from hospitals to long term care facilities during recovery. Short term rehabilitation has become the number one reason for nursing home admissions.

While everyone wants to provide their loved ones with the best quality of care, the reality is that the cost of a long term care facility is expensive. Even if your parent receives Medicare, this only pays for 100 days in a rehabilitative or nursing home facility. After that, even with supplemental private insurance, long term care can quickly deplete a family’s assets and life’s savings. Medicaid is really the primary source for funding long term care. Therefore, anyone with an elderly parent or a chronic health condition should educate themselves about Medicaid.

Many people think they are not eligible to qualify for Medicaid because their income level is too high. As a result, they often pay out of pocket for their care until their assets are fully depleted. This is not necessary – there are many planning techniques available to shelter your income and assets while still allowing you to qualify for Medicaid.

Some areas that require special attention are listed below:

1. Plan Ahead
The sooner one begins planning the better. There is a five year look back on the transfer of assets. When applying for Medicaid, you must submit up to five years of statements for all assets. Therefore, any transfer should be done with the guidance of a reputable attorney or financial advisor.

2. Document Medical Needs
New York State provides 24 hour home care for individuals who can demonstrate a medical necessity. You should speak to your doctor about completing the necessary paperwork for your Medicaid application.

3. Shelter Your Assets and Save Your Home
There is an income level and an asset threshold for Medicaid eligibility. Large investments, savings, pensions, retirement accounts and even home ownership may lead to a denial of benefits. Many strategies are available such as setting up complex trusts and other beneficiary accounts which will allow you to save your hard earned assets. Since these strategies are quite complex and need to be tailored to each circumstance, this too should be done with the guidance of a professional.

4. Get Your Paperwork in Order
The typical Medicaid application requires you to gather and analyze up to five years of your banking, investment and tax records. In addition, you have to furnish records such as birth and death certificates, marriage licenses, social security cards, insurance cards, deeds, stock certificates, etc. It is a good idea to begin compiling these in a folder.

Since the Medicaid rules are complex and vary with each person’s individual situation, a professional should be consulted.