• What is Medicaid Planning?
• What is Medicaid Eligibility?
• Must I give the Nursing Home a Guarantee of Payment?
• We feel in crisis because we need help now. Can we still do any planning?
• What will happen if my mother has to go to a nursing home?
• What can I do to give my mother help even in the nursing home?

What is Medicaid Planning?

Planning for Aging includes Medicaid Planning, which involves protecting assets from having to be spent down in connection with entry into a nursing home and during residency there. Planning for Aging is an overall, intergenerational planning process, involving a review of your planning needs now and as you age.

What is Medicaid Eligibility?

• In 2010, the maximum amount of assets (also called “resources”) that an individual applicant may have to qualify for Medicaid is $13,800. There are certain assets that are exempt from the total, and so will not disqualify the applicant.
• If the applicant is married, then the applicant’s spouse is permitted to retain the “Community Spouse Resource Allowance”, which in 2010 ranges from $74,820 to $109,560. Assets of the applicant’s spouse that exceed the CSRA may result in disqualification of the applicant.
• It is very important to understand which assets are “countable resources” and which are exempt. It is best to have a good understanding long before care is actually necessary so that you have some time to plan ahead.
• All of the income of the individual applicant must be used for his or her care, with certain exceptions. If the applicant is married, then some of the applicant’s income may be used to support the spouse at home if that spouse’s own income is not at least $2739 (in 2010), which is the “minimum monthly maintenance needs allowance”. If the spouse at home has income in excess of that amount, it must be used to help pay for the care of the applicant spouse.
• Medicaid “planning” and qualification require a good understanding of the complex rules.
• For Community Medicaid, there is a maximum income level, and it depends on whether the applicant lives alone, or with a spouse or disabled child or children, for example.

Must I give the Nursing Home a Guarantee of Payment?

No, not only should you not do that, but the Nursing Home is prohibited by law from asking for a guarantee. Only the applicant (or legally responsible person) is obligated to pay the Nursing Home. A guarantee cannot be demanded to secure admission.

We feel in crisis because we need help now. Can we still do any planning?

Crisis Planning is really just Medicaid Planning that does not begin until a person begins to need assistance with Activities of Daily Living (eating, dressing, bathing, toileting, transferring, and walking) or personal management issues such as cooking, cleaning, caring for pets, paying bills and managing finances. , We can help you plan even if you are already in a nursing home or receiving other long-term care assistance. However, if you have the opportunity to avoid a crisis, this type of planning should be started while you are still able to make legal and financial decisions, or can be initiated by an adult child acting as agent under a properly-drafted Power of Attorney.

What will happen if my Mother has to go to a Nursing Home?

Some parents have saved and sacrificed their entire lives and have a strong desire to leave a financial legacy for their children. With proper planning, this goal can be achieved while still qualifying for Medicaid.

With proper planning, a spouse who is able to stay at home can keep all or most of the couple’s assets and all or most of the couple’s income while Medicaid pays for the nursing home care. While Medicaid rules do try to protect the spouse from “impoverishment”, few of us would like to come even close to the risk of impoverishment. That’s why planning is so important.

For those who are single or widowed, asset protection means that not all of the assets will be assigned to provided minimum care that Mediciad would otherwise cover. Instead, with planning, there will be assets available to provide for certain quality of life matters that would otherwise not be enjoyed on the $50 personal monthly allowance permitted by Medicaid.

What can I do to give my Mother help even in the Nursing Home?

For instance, money that we protect for you in the process of getting you qualified for Medicaid can be used, once you are receiving Medicaid benefits, to provide you with an enhanced level of care and a better quality of life while you are in a nursing home. For instance, we will often encourage the families of our clients to use the protected assets to hire a private “sitter” or “helper” – someone to keep you company, help you with meals, etc., somewhat like a “surrogate daughter.” Money that we protect for you in the process of getting you qualified for Medicaid can also be used to purchase services or items for you that are not covered by Medicaid, such as dental work, vision aids, hearing aids, incontinence supplies, personal clothing and toiletries, and haircuts.