Medical Assistance - Medicaid Planning
Elder Law Attorney for Rhode Island, Eastern Connecticut and Southeastern Massachusetts
The high cost of long-term care has made planning a critically important issue for most middle-class seniors and their families. In fact, most seniors will likely require some form of long-term care. Sadly, many of them are unprepared for the significant financial burdens it places on their family’s hard earned savings. Financial devastation looms large for a family facing ongoing care at a rate of $10,000 or more per month.
If you do have long-term care insurance, you should be aware of what your policy covers. Many policies have high deductibles or provide for only a short period of care in the facility. In fact, many who have long-term care insurance still have to resort to Medicaid to pay for their care at some point.
Medicaid is a federal program that provides health coverage for people with limited assets and incomes. It also covers the cost of nursing home care for those who meet the program’s economic requirements for eligibility.
Although it is a federal program, Medicaid is administered by each state. Federal law empowers each state to enforce Medicaid eligibility rules according to its own interpretation meaning that every state may have different rules regarding eligibility.
Here in Southern New England, Rhode Island, Connecticut and Massachusetts have different rules and require different ways of collecting and interpreting documents. At Connelly Law, our Medicaid planning advisors can best help you determine how the rules apply to your specific circumstances in your specific locality.
What We Do
For each client, Connelly Law Offices, Ltd. develops a personalized comprehensive long-term care plan designed to identify and finance quality long-term care, while protecting the family’s assets from catastrophic care expenses and exorbitant nursing home costs.
Asset protection planning strategies often involve the transfer of client resources. Wills, living wills, powers of attorney and trusts are often employed.
It is important that the filing of a Medicaid application is properly timed. Connelly Law’s Medicaid planning advisors prepare a comprehensive evaluation of each client’s unique family and financial situation. Based upon the evaluation, our firm provides planning recommendations that are designed for your needs. Our planning recommendations are designed to meet three goals:
to ensure that the care needs of our client are met;
to make certain that there are sufficient assets available to pay for all needed care; and,
to ensure that the client’s estate is preserved for the client’s loved ones to the maximum extent possible.
About the Process
Federal and state laws regulate the Medicaid application process. The federal law governing Medicaid applications is set forth in the Code of Federal Regulations, 42 C.F.R. §435.900. There are also state regulations for the process as well, with Rhode Island, Connecticut and Massachusetts having different processes and requirements in place. Our firm and our Medicaid planning advisors are well versed in these regulations.
Extensive documentary evidence and information is required by the Medicaid agency. Because the evidence required is so extensive, a face to face meeting is required to review what information is needed and our firm will supply you with a checklist and be available to answer any question you may have along the way.
Unfortunately, Medicaid planning is a complex matter. Most need expert assistance to keep their assets safe given the ever-changing regulations and requirements. Properly completing a Medicaid application and providing all necessary information and documentation to the Medicaid agency is a labor-intensive process and requires an expertise that only comes with experience and knowledge of the system.
By assisting our clients with the process, and by coordinating efforts with the nursing home or other care facilities, Connelly Law's Medicaid advisors help the client avoid being denied Medicaid benefits and work to obtain a quick approval from the Medicaid office once all required information and documents are received.
What About the "60 Month" Look-back?
Those who may be qualified for Medicaid believe that if you give your assets away, you must wait 60 months to qualify for Medicaid. This is not the case. The 60 month requirement only applies to the financial disclosures you must provide, not eligibility.
Look at it like this, when you apply for Medicaid, you are bringing with you a file with every financial transaction you made in the last five years. That's all you need to provide to complete the application. What is in the file, however, has nothing to do with determining your eligibility. It's what Medicaid sees in the file that counts.
There are exceptions to this (including spousal protections and for those with special needs) and ways to plan to provide for those you care for as provided by law within this look back period. By using smart planning and the advice of an elder law attorney with expertise in long term care planning, you give yourself the best opportunity to qualify for Medicaid coverage when you need it.
Will I Lose My Home?
If you’re married, and you or your spouse need long term nursing home care, your home is exempt from Medicaid’s calculation of what your contribution to the cost of care should be. If you are unmarried or widowed, and you go into a nursing home, your house may be exempt if you follow certain procedures that may vary from state to state.
Although your house is safe while you reside in a nursing home, it will likely be lost to Medicaid after your death. Planning is key to preserving your home whether married, single or widowed.
Gifting Away Property
There have been major changes in Medicaid regulations that affect “gifting” away your assets. Such "gifting" can create unforeseen circumstances and can make you ineligible for Medicaid benefits for 5 years or more! Rather than protecting yourself, you end up undermining your own financial security. However, Congress has created a number of provisions for protecting your assets. These provisions exempt certain assets and allow transfers to children or siblings, who meet certain eligibility requirements, as well as putting assets in certain kinds of trusts. Only someone with expertise in this area can provide appropriate guidance in the process.
Filing the Application
After the application is filed, the Medicaid agency will verify the information provided by the applicant by matching the information on the Medicaid application with data obtained from the Internal Revenue Service and contacting financial institutions and other third parties. Although the verification process continues after the application is approved and may take years to complete, applicants must be scrupulously honest on the application and the verifications provided to support the application. This is why our firm will review and re-review the information provided to us. The Medicaid agency will usually take 2 to 3 months to process the application. However, it is not unusual for applications to take much longer to process if the application is complex or the state agency is backlogged at the time the application is submitted. To ensure that the application is processed smoothly, Connelly Law will keep the nursing home advised of the progress of the Medicaid application.
During the time the application is being processed, the applicant is not required to continue paying the nursing home, however, there is a worksheet that figures out an estimated payment called "Applied Income" which must be paid monthly. Connelly Law will supply this number to both the client and the nursing facility. Failure to do so can result in the application being denied by the state.
Emergency Planning - It's Never Too Late
What happens if you haven't made plans for long-term nursing care but suddenly a medical emergency occurs and now you need it. Fortunately, there are emergency strategies that can help to ensure that you get the program benefits you need. Many of the strategies can be extremely complex and difficult for the average layperson to manage on his or her own.
Further complicating matters, the Medicaid program’s strict penalties are something that no applicant wants to face. To avoid this, make sure that you’re relying on the advice and counsel of competent elder law Medicaid planning attorneys to help you better understand which strategies are right for you.
"Remember, Medicaid planning is a complex matter. A mistake in the application process could be devastating. You need expert assistance to keep your assets safe and provide you with the security you want. Be sure to find legal counsel with proven expertise in Medicaid law. Connelly Law has over two decades of experience in Medicaid Planning.
Call us today!"
Rhode Island, Southeastern Massachusetts and Eastern Connecticut Elder Law Attorney
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