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Medicaid: Paying For Nursing Home Care.

January 31, 2020/in Asset Preservation, Estate Planning, Medicaid/by KT Williams

Medicaid pays the nursing home costs for people who qualify. To qualify, we must satisfy personal criteria and financial criteria. For the personal criteria, we must be over age 65, blind, or disabled. For the financial criteria, our income must be below the Medicaid income limit and our assets must be below the Medicaid asset limit.

So, it may seem that qualifying for Medicaid is a simple and straightforward process. For a few, it might be. But for most, it is not.

The rules and regulations governing Medicaid eligibility are lengthy and challenging to understand and apply. Those of us who help individuals navigate the Medicaid-qualification process see it regularly. We know the difficulty and roadblocks that people can face if they don’t have the background or motivation to make the system work the way it should. We know how to overcome the difficulty, and we know how to work around the roadblocks.

What If The Nursing Home Says You Won’t Qualify For Medicaid?

Just as you wouldn’t rely on a lawyer to provide health care advice, it may not be wise to rely on a health care professional for legal advice. Perhaps you’ve visited a nursing home to ask about its costs and about Medicaid. And maybe the nursing home told you that you wouldn’t qualify for Medicaid. What do you do now? If the nursing home said you won’t qualify, then there is no use in doing anything more, right? Wrong! You shouldn’t stop there. Talk to a lawyer who is trained to know Medicaid’s rules and regulations and knows what it takes to qualify.

I meet with families regularly who have visited a nursing home and have been told they won’t qualify for Medicaid. That advice is usually wrong. We use a detailed and in-depth evaluation process to determine if someone can qualify for Medicaid. And we typically find that they can qualify after taking some important, well-defined steps based on carefully applying Medicaid’s rules and regulations.

Should You Use A Nursing Home To Apply For Medicaid?

Nursing homes and their staff don’t intend to misdirect people about Medicaid. But working through the Medicaid rules and regulations to help someone qualify is not their training and focus. Instead, they are trained and paid to provide important medical services to our loved ones. Their expertise is in operating a nursing home and providing care, not the law.

What Should You Do When A Loved One Needs Nursing Home Care?

If a loved one needs nursing home care or may need nursing home care in the near future, you should take a few important steps. Meet with an Estate Planning/Elder Law attorney who knows Medicaid’s rules and regulations. Also, visit nursing homes to find the one that will be a good fit. As your attorney, I will work with you to qualify for Medicaid, and the nursing home will help you figure out if their nursing home is a good fit for your loved one. Contact us with questions and for help.

 

https://ktwilliamslaw.com/wp-content/uploads/2020/01/83984594_1375073102670623_239609894662045696_o.jpg 508 800 KT Williams https://ktwilliamslaw.com/wp-content/uploads/2015/12/williams-law-logo-rgb-640px.png KT Williams2020-01-31 10:54:412020-01-31 11:28:01Medicaid: Paying For Nursing Home Care.

VA PENSION RULES AFFECTING VETERANS AND THEIR FAMILIES: AID AND ATTENDANCE BENEFITS

April 11, 2019/in Medicaid, Veterans/by KT Williams

On October 18, 2018, the Department of Veterans Affairs (VA) changed its old pension rules. The changes affect Veterans and Veteran’s families, including Aid and Attendance Benefits. The changes are quite comprehensive and impact net worth, asset transfers, penalty periods, medical expenses, and income deductions.

NET WORTH LIMITS

The new limit on net worth will equal the maximum community spouse resource allowance (CSRA) for Medicaid purposes. This number started at $123,600 in 2018 and increased to $127,061 in 2019.

Annual income is added to a claimant’s assets to come up with a total net worth number. A Veteran’s assets include the assets of the Veteran and the Veteran’s spouse. Assets are defined as “fair market value of all property that an individual owns, including all real and personal property”, unless otherwise excluded under other parts of the rule. Mortgages and liens reduce the value.

EXCLUDED “ASSETS”

The primary residence, whether lived in or not, remains excluded from the definition of assets, and if sold, the proceeds will not count if used to purchase another residence within the same calendar year as the sale. Personal mortgages on the primary residence will not reduce the value for the net worth calculation because the residence is excluded anyway. If the residential lot area exceeds 2 acres, then the value of the additional land in excess of 2 acres will be included in the asset calculation. Personal effects such as appliances and automobiles are excluded.

CALCULATING NET WORTH

An example provided in the VA rules states that if the claimant’s assets total $117,000 and annual income is $9,000, the net worth is $126,000. This amount exceeds the net worth limit ($123,600). Unless the net worth is decreased, the claimant wouldn’t qualify.

DECREASING NET WORTH

There are three ways net worth may decrease: (1) the assets decrease; (2) annual income decreases; or (3) both decrease. Assets decrease when they are spent and something of equivalent value is received in return, usually a service or excluded asset.

ASSET TRANSFERS AND PENALTY PERIODS

A “covered asset” is an asset that “was part of the claimant’s net worth, was transferred for less than fair market value, and if not transferred, would have caused or partially caused the claimant’s net worth to exceed the net worth limit…”. Therefore, only the amount transferred in excess of the net worth limit ($123,600) will be subject to a penalty. With regard to transfers to a trust, annuity or other financial instrument or investment, “uncompensated value” means the amount transferred.

LOOKBACK PERIOD

The lookback period for all transfers is 36 months immediately preceding the date the VA receives an original pension claim or a new pension claim after a period of non-entitlement. This definition does not include any transfers prior to October 18, 2018. VA will disregard asset transfers made before October 18, 2018.

ALLOWED TRANSFERS TO TRUST

A claimant may transfer assets to a trust established for the claimant’s disabled child if the child is incapable of self-support AND there is no circumstance where the trust assets can benefit the claimant.

CALCULATION OF THE PENALTY PERIOD

There is a 5-year limit on the penalty period. The penalty begins the first day of the month following the transfer. Entitlement to pension will begin the last day of the last penalty period month, with payment to begin the following month.

MEDICAL EXPENSES THAT MAY BE DEDUCTED FROM INCOME

Medical expenses for VA purposes are those that are “medically necessary; that improve a disabled individual’s functioning; or that prevent, slow, or ease an individual’s functional decline.”

1. Health care provider payments.
2. Medications, medical supplies, medical equipment, medical food, vitamins and supplements. Prescriptions and non-prescription medications.
3. Adaptive equipment. Along with adaptive services, payments for service animals are included under this section, including veterinary care.
4. Transportation expenses, as long as the transportation is for medical purposes.
5. Health insurance premiums. Payments for long-term care insurance premiums are included, as well as health insurance and Medicare premiums for parts B and D.
6. Smoking cessation products.
7. Institutional forms of care and in-home care. Hospital charges, nursing home charges, medical foster home charges and inpatient treatment centers are allowable expenses, including the cost of meals and lodging. Payment for in-home care to assist with ADLs (activities of daily living) and IADLs (instrumental activities of daily living) will be considered valid medical expenses as long as health care or custodial care is provided.

The major changes to VA’s pension rules will impact Veterans and their families for years to come. If special care isn’t taken to comply with the new requirements, the benefits will be in jeopardy. Contact us for sound legal guidance to understand what should be done to qualify for these important benefits.

https://ktwilliamslaw.com/wp-content/uploads/2018/09/Veterans.jpg 460 800 KT Williams https://ktwilliamslaw.com/wp-content/uploads/2015/12/williams-law-logo-rgb-640px.png KT Williams2019-04-11 09:05:042019-04-12 09:04:17VA PENSION RULES AFFECTING VETERANS AND THEIR FAMILIES: AID AND ATTENDANCE BENEFITS

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