Medicaid for Individuals

Medicaid for Individuals

When an individual has income and assets that exceed the Medicaid threshold, The Certified Elder Law Attorneys (CELA) at Hurley Elder Care Law Elder Law have devised a series of strategies for these circumstances. This allows an individual to qualify for Georgia Nursing Home Medicaid while preserving a substantive amount of their assets.

Income and Asset Requirements

Eligibility for nursing home Medicaid is based on both your income and assets. In 2019 the income cap for Medicaid eligibility is $2,313 per month. If your monthly income exceeds $2,313 you can still qualify for Medicaid by utilizing a Qualified Income Trust (also know as a Miller trust. Contact us to learn more about the Miller Trust.

For a single person to qualify for Medicaid their total assets must be less than $2,000. Medicaid does consider certain assets “exempt.” (For a discussion on exempt and countable assets, please click here).

Case Study

Mrs. Johnson is a 91 year old widow who fell and broke her hip. After surgery and rehabilitation, she has limited mobility requiring skilled nursing care. She has a savings and checking account with a combined balance of $92k and a small IRA of $32k. Her monthly pension and social security combined are $1723 per month

Working with Hurley Elder Care Law her family will be able to preserve between 50 -65% of her assets.

 

Medicaid FAQ

1| Will I have to spend down all my money before I can receive Medicaid?

 

 

No, this is simply not true and even though some families do spend virtually all of their savings on nursing home care, Medicaid does not require it. There are a number of strategies that can be used to protect your family’s financial security. In addition, there are also many assets that are considered exempt for Medicaid eligibility purposes.

2| Is Medicaid is going to take my home?

In most cases your home is an exempt asset for eligibility purposes. You can own your home and receive Medicaid benefits! However, the State of Georgia has a Medicaid Estate Recovery Program. Fortunately, there are ways to protect your property and minimize your exposure to Estate Recovery.

3| Can I transfer all of my cash and assets right away to be sure I am eligible for Medicaid?

The law has severe penalties for people who simply give away their assets to create Medicaid eligibility. There is a look-back period of five years. Gifting may be possible; however, it is critically important that you have the advice of an elder law a orney well versed in Medicaid rules.

4| Isn’t Medicaid is only for extremely poor people?

No! As life expectancies and long-term care costs continue to rise, the challenge quickly becomes how to pay for these services. Many people cannot afford to pay $5,000–9,000 per month or more for the cost of a nursing home. Even those who can pay for a while may find their life savings wiped out in a ma er of months, rather than years. Fortunately, the Medicaid Program is there to help. In fact, in our lifetime, Medicaid has become the long-term care insurance of the middle class.

5| Help! My spouse is in a Nursing Home and our combined income seems too high for Medicaid. What do I do?

 

 

Only the income of the Medicaid recipient is considered when determining eligibility criteria. The income of the well spouse is not considered and will never increase the amount a Medicaid recipient is responsible for paying the facility.
In cases where a potential Medicaid recipient’s income exceeds the income cap ($2,313.00 for 2019) funding a Qualified Income Trust is necessary.

 

 

6| If my spouse is living in the Nursing Home and on Medicaid, will I no longer will have the money to pay my bills?

 

 

Not necessarily. You may be eligible to receive a portion or all of your spouse’s income even if Medicaid is paying for the cost of their care. This can avoid the necessity for the community spouse to dip into savings each month, which would result in gradual impoverishment.

7| If I receive Medicaid assistance, will I be able to put money aside to pay for my final expenses?

Good News! Medicaid recipients are allowed to set money aside to take care of their final arrangements. Currently, you can set aside up to $10,000 in a burial fund and still qualify for Medicaid.

8| Won’t the Nursing Home apply for Medicaid for me and make sure that my insurance covers everything?

It is your responsibility to be sure you plan to pay for your Nursing Home expenses. If you find yourself or a loved one in a situation where long-term care is imminent, it is wise to be sure you seek the advice of a professional to be sure you have a plan in place right away. While many Nursing Homes process Medicaid applications as a courtesy for their residents, the responsibility of supplying the State Agency with the application, the required documentation, and the information ultimately falls on the resident and their families.


Medicaid Denials

Receiving a denial after enduring the long and tedious Medicaid Application process can be scary and frustrating. Depending on the situation, there are many different strategies for overturning an initial denial. Our attorneys will review your specific situation and can not only assist with handling the appeal but may also be able to protect your original application date. Timing is of the essence in this situation so don’t delay. Contact us so that we can review your specific situation and find ways we can help!

When dealing with a Medicaid denial knowledge is power. For more information on Medicaid Eligibility please click here.

Medicaid has truly become the long-term care insurance of the middle class. As we live longer and as care costs continue to rise, more and more families will look to Medicaid to pay the cost of Nursing Home care. Consult a Certified Elder Law Attorney (CELA) to determine if Medicaid qualification is an option for your loved one.