Getting benefits from Medicaid for nursing home costs may be something that is easy and straightforward for some. For others, those who want to protect assets from nursing home costs, the Medicaid planning process and the application for Medicaid benefits to pay for nursing home costs is a potential minefield that practically requires the assistance of an elder law attorney experienced with Medicaid and nursing home care planning.
Many courts have commented on the complex nature of the Medicaid laws and rules, and generally find the Medicaid process to be second in complexity only to the Internal Revenue Code. If your objective is to preserve as many assets as possible to provide financial support for the nursing home resident’s spouse or other family members, it is imperative that you work with a Florida elder law attorney who is experienced with Medicaid for nursing home costs. The costs of nursing home care and financing nursing home care, as well as the increasing cost and decreasing availability of long term care insurance, are forcing more and more people to rely on Medicaid for nursing home costs.
The process for determining one’s eligibility for Medicaid for nursing home costs begins with a “snapshot” of the income and financial resources of the individual applying for Medicaid benefits, and the spouse if there is one, on the date the application is submitted. If the applicant for Medicaid benefits, and the spouse, qualify on the date of the application, then benefits to pay the nursing home costs begin retroactively to the first day of the month in which the application is submitted. However, if the individual does not qualify on that date, there may be a substantial delay in obtaining Medicaid for nursing home costs while the individual’s or spouse’s, or both, “spend down” any assets above the level that is allowed for Medicaid eligibility. Currently, the amount of countable assets allowed to be owned by the person applying for Medicaid benefits is $2,000.
If the applicant for Medicaid benefits has more than $2,000 when the application is filed, benefits to pay for nursing home costs will be denied. It will be necessary for the applicant to spenddown the assets, often by paying the nursing home, until the countable assets are less than the allowed $2,000. However, with proper planning before the application is filed, it may be possible through various legally allowed actions to protect a substantial amount, or all, of the assets owned by the applicant before the application is filed. The protected assets can be available to family members to provide financial support for the spouse or others, and to provide the nursing home resident with services and products that would otherwise be unavailable to the resident because of the low $105 per month “personal needs allowance” allowed by Medicaid after obtaining Medicaid for nursing home costs. (After a person has qualified for Medicaid for nursing home costs, the person must pay all of their income to the nursing home except $105 which is allowed to be retained for the resident’s personal needs.)
Another potentially negative consequence of filing an application for Medicaid for nursing home costs can occur if the applicant for the Medicaid benefits, or that person’s spouse, has transferred any assets to other family members, charities, churches or others, within the five years prior to filing the application. The Florida Department of Children and Families is required by the Medicaid law to “look back” for 60 months prior to the filing of the application for Medicaid benefits to pay for nursing home costs, to determine whether there are any such “uncompensated” transfers, or gifts. If there are any such gifts or transfers, the applicant, even if otherwise approved for Medicaid benefits to pay for nursing home costs, will not be eligible to actually receive the benefits to pay for the nursing home care for a “penalty period.” The length of the penalty period is determined by the value of the uncompensated transfers that were made. Even though the gift may have been made just a year or two ago, or as many as four or five years ago, the penalty period could be for a longer period of time than the five year look back.
By properly analyzing the uncompensated transfers, an elder law attorney experienced with Medicaid and nursing home planning may be able to develop a strategy that would result in the legal avoidance of the penalty period, or at least ensure that the application is not filed until the appropriate look back period has passed so that there would be no penalty period imposed because the transfer took place more than five years before the application was filed. Otherwise, the penalty period will be unavoidable if such an uncompensated transfer, or gift, was made in the five years prior to the filing of the application for Medicaid for nursing home costs.
If you, your spouse or your parent, or other family member presently need or will soon need nursing home care, you can help protect assets from nursing home costs by consulting with an elder law lawyer who is experienced in Medicaid and nursing home care planning. Your Jacksonville elder law attorney at the Coleman Law Firm has more than 20 years experience working with Medicaid planning, nursing home care planning, preparing asset protection Medicaid spend down plans, and filing applications for Medicaid for nursing home costs. You can schedule an appointment to determine whether you or your family member can benefit from Medicaid planning to pay for nursing home costs by calling 904-448-1969, or toll free 866-510-9099, or you can email us at Info@TheColemanLawFirm.com.
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