Medicaid Applications and Planning
The cost of nursing home care in Upstate New York maybe $9,000 per month or more. The cost of home health care can be even higher depending on the number of hours and the level of care that a person needs at home. The loss of life savings and the family residence can have a devastating financial and emotional impact on the entire family. The money saved from a lifetime of hard work may be spent in a matter of months when a family member is faced with long-term nursing home care or home health care.
Medicare will not pay for ongoing long-term care in a nursing home. The only government program that will pay for long-term health care is a program called Medicaid. Medicaid was enacted in 1965 by the United States Congress and is a federal-state program. Today, a major part of the Medicaid program involves paying for the cost of nursing home and home health care. The Medicaid program in New York provides an illustration of the complexities of this dual federal and state program. The New York State Legislature enacted Medicaid laws for New York State. New York State then delegated the administration of the Medicaid program to each county. Many counties have improperly created their own policies that vary from county to county. As a result, Medicaid applicants may be deprived of their legal rights and lose assets unnecessarily. Eligibility for Medicaid must be established before coverage will be provided. Without proper legal advice, the Medicaid Agency will require you privately pay for your own health care until your life savings is depleted. However, with proper legal advice, there are many options available to protect your life savings.
If you or a loved one is facing a catastrophic illness, please aconsultation. I am available for home and hospital visits.
You should never assume that it is too late. There is something you can do.
Single Person Eligibility Rules in New York State
The Medicaid resource limit for a single person in New York State for 2010 is $13,800. You will be forced to sell your investments, cash in your CD's, cash in your life insurance policies, sell your summer cottage, and sometimes even sell your home. If you are in a Nursing Home, you will only be entitled to keep $50 of your monthly income. If you are receiving home care, you will be entitled to keep $787 of your monthly income (2010 figures).
Married Couple Eligibility Rules in New York State
The assets of both spouses are treated as being available to the spouse who is applying for Medicaid. The ill spouse is treated as a single person and is entitled to keep the same income and resources as a single person. The healthy spouse is entitled to keep a minimum spousal allowance of $74,820 up to a maximum of $109,560 of the couple's combined life savings. The healthy spouse is also entitled to keep at least $2,739 of the couple's combined income. If the healthy spouse has income of his/her own above $2,739, then the Medicaid Agency will "request" a contribution of 25% of all income above $2,739.
For certain types of Home Care, the healthy spouse is not entitled to the spousal income and resource allowances, but instead the couple is entitled to keep a total of $20,100 of life savings and $1,137 of combined income. In this situation, the healthy spouse would be able to retain more life savings and income if the ill spouse were placed into a nursing home.
Medicaid Transfer Rules
As a general rule, you cannot transfer assets for the purpose of qualifying for Medicaid. However, there are many exceptions to this rule. These exceptions can be important for preserving your life savings in a time of immediate crisis. The transfer of assets can result in a penalty period of ineligibility for Medicaid coverage. The Medicaid Agency is entitled to look at all your financial transactions for the 60 months immediately preceding your Medicaid application. Medicaid can review your bank statements and question each of your deposits and withdrawals for the past 60 months. In the event you apply for Medicaid before the expiration of the 60 month penalty period, the government has a formula that could extend your period of ineligibility beyond the 60 month period. If you decide to make transfers, you should then review whether it would be better to make giftsto other people or to an Irrevocable Trust. As part of making gifts, you may also want to consider transferring your home with a retained life Estate.
In New York State, there are some types of home health care coverage where there is no transfer penalty.
Medicare will not pay for ongoing long-term care in a nursing home. The only government program that will pay for long-term health care is a program called Medicaid. Medicaid was enacted in 1965 by the United States Congress and is a federal-state program. Today, a major part of the Medicaid program involves paying for the cost of nursing home and home health care. The Medicaid program in New York provides an illustration of the complexities of this dual federal and state program. The New York State Legislature enacted Medicaid laws for New York State. New York State then delegated the administration of the Medicaid program to each county. Many counties have improperly created their own policies that vary from county to county. As a result, Medicaid applicants may be deprived of their legal rights and lose assets unnecessarily. Eligibility for Medicaid must be established before coverage will be provided. Without proper legal advice, the Medicaid Agency will require you privately pay for your own health care until your life savings is depleted. However, with proper legal advice, there are many options available to protect your life savings.
If you or a loved one is facing a catastrophic illness, please aconsultation. I am available for home and hospital visits.
You should never assume that it is too late. There is something you can do.
Single Person Eligibility Rules in New York State
The Medicaid resource limit for a single person in New York State for 2010 is $13,800. You will be forced to sell your investments, cash in your CD's, cash in your life insurance policies, sell your summer cottage, and sometimes even sell your home. If you are in a Nursing Home, you will only be entitled to keep $50 of your monthly income. If you are receiving home care, you will be entitled to keep $787 of your monthly income (2010 figures).
Married Couple Eligibility Rules in New York State
The assets of both spouses are treated as being available to the spouse who is applying for Medicaid. The ill spouse is treated as a single person and is entitled to keep the same income and resources as a single person. The healthy spouse is entitled to keep a minimum spousal allowance of $74,820 up to a maximum of $109,560 of the couple's combined life savings. The healthy spouse is also entitled to keep at least $2,739 of the couple's combined income. If the healthy spouse has income of his/her own above $2,739, then the Medicaid Agency will "request" a contribution of 25% of all income above $2,739.
For certain types of Home Care, the healthy spouse is not entitled to the spousal income and resource allowances, but instead the couple is entitled to keep a total of $20,100 of life savings and $1,137 of combined income. In this situation, the healthy spouse would be able to retain more life savings and income if the ill spouse were placed into a nursing home.
Medicaid Transfer Rules
As a general rule, you cannot transfer assets for the purpose of qualifying for Medicaid. However, there are many exceptions to this rule. These exceptions can be important for preserving your life savings in a time of immediate crisis. The transfer of assets can result in a penalty period of ineligibility for Medicaid coverage. The Medicaid Agency is entitled to look at all your financial transactions for the 60 months immediately preceding your Medicaid application. Medicaid can review your bank statements and question each of your deposits and withdrawals for the past 60 months. In the event you apply for Medicaid before the expiration of the 60 month penalty period, the government has a formula that could extend your period of ineligibility beyond the 60 month period. If you decide to make transfers, you should then review whether it would be better to make giftsto other people or to an Irrevocable Trust. As part of making gifts, you may also want to consider transferring your home with a retained life Estate.
In New York State, there are some types of home health care coverage where there is no transfer penalty.
Randall S. Lewis, Esq.
Attorney and Counselor at Law
1 Falconer Street, P.O. Box 517
Frewsburg, New York 14738
C: 716-720-8269
randall@rlewislaw.net
Attorney and Counselor at Law
1 Falconer Street, P.O. Box 517
Frewsburg, New York 14738
C: 716-720-8269
randall@rlewislaw.net