Avoiding Medicaid Penalties - Trust and Estate Planning Law Office

Top 5 Strategies for Protecting Your Assets From Medicaid

Medicaid is a means-tested program that conditionally accepts applicants based on their income and current assets. According to Medicaid regulations, individuals must have less than $2,000 to qualify for coverage. Applying for Medicaid is quite a complex process, as the questions being asked within the application have great depth and implications for your future. The foundational system responsible for asking the questions that define your eligibility for Medicaid purposely selects specific diction and word choice which may make it challenging for elderly individuals to effectively answer the questions. Considering that these questions are the main defining factor when it comes to obtaining Medicaid coverage, family members should seek guidance from an experienced Elder Law Attorney to guide them through this imperative process. The attorney is quite familiar with your state’s rules when it comes to long-term care planning and receiving government benefits. An Elder Care Attorney will use her experience in the field to devise the most effective plan in assisting the family by selecting strategies that align with the family’s personal and financial circumstances. Below are the top 5 strategies suggested by an Elder Law Attorney regarding ways of protecting your assets from Medicaid.

1. Income Trusts

Income Trusts serve the purpose of protecting your assets and keeping your monetary income safe. This trust aids in maintaining the income limit set for all Medicaid applicants. Income Trusts are beneficial towards those applicants that exceed the qualifying amount. These trusts give the applicant an opportunity to designate a sub quantity of their income to a specific trust in order to refrain from exceeding the standard acceptable quantity. The Qualified Income Trusts are irrevocable meaning they cannot be changed or revoked. They serve as holding areas for the applicant’s excess income and protect this income from being taken by Medicaid. In states that allow applicants to spend down their excess income, these trusts are less effective, yet can still be utilized based on the applicant’s preference. In order to qualify for Medicaid many married couples must participate in the Spend-Down process, which pertains to the prospects of saving assets when only one spouse needs Medicaid. The purpose of this process is to ensure that the individual in need of long-term care receives the aid they need, while also guaranteeing that their spouse has the financial means of remaining in their home and covering the cost of all their living expenses. An Elder Care Attorney can assist you in establishing an Income Trust and answering any of your questions regarding the trust.

2. Asset Protection Trust

An Asset Protection Trust is a great way to preserve your assets when applying for Medicaid, as it allows you to maintain your wealth while still receiving coverage. This is helpful because a Medicaid applicant is only eligible for convergence if they meet the specified quantity of assets held within their account. Many individuals fall into the assumption that the best way to remove the additional assets that prevent them from getting Medicaid coverage is to transfer the assets to family members. This approach, however, is extremely flawed and risky because it often results in a Medicaid penalty. Incurring a penalty prevents you from receiving coverage for a specified period of time. A trust allows you to disperse these assets to the family members you had in mind at the time of creating a trust. The beneficiaries will not be subject to the payment of capital gains tax based on the increase in quantitative value your assets have accrued over time. It is important to note that transfers to a trust are still subject to the Medicaid Lookback period,which tends to include the last five years of your assets. This strategy is extremely effective when it comes to protecting your assets fromMedicaid, while still receiving the coverage you are in need of. An Elder Care Attorney can guide you through the process of creating an Asset Protection Trust based on your personalized extent of assets.

3. Caregiver Agreement

A caregiver agreement is beneficial to individuals who require additional services that will not be included within the typical Medicaid coverage. This option is great for individuals who would prefer to be cared for by a family member or a trusted close friend. You would not only be cared for by an individual you already know and have a close relationship with, but you would also be benefitting the caregiver for their service. The caregiver will be paid for their duty in caring for you and you will receive the best care possible. In most cases the caregiver would be paid for their services in advance under a contract that defines the services provided and the hours being worked. In the case that the patient passes away all of the unearned funds must be paid to Medicaid in correlation to the amount that Medicaid paid for the patient’s care. A Caregiver Agreement can be the best option for numerous individuals who do not wish to leave home and go into the care of a nursing home, as they would still be able to maintain their full Medicaid coverage. An Elder Care Attorney can help you make the decision in selecting a caregiver you trust to take care of you.

4. Medicaid Compliant Annuities and Promissory Notes

In many cases, individuals require urgent long-term care services, however they have recently conducted a transfer of assets or are still in possession of the assets that limit the income cap they require to qualify for Medicaid coverage. As of now, there is no possible method of removing these assets in time to qualify for coverage because any movement of the assets will result in a Medicaid penalty. The only options left to qualify for coverage under such short notice and with exceeding assets present would be to write an annuity or promissory note. This would serve as an insurance product that would payout the income. First, you would make an investment into the annuity. Then, the insurance provider would return your income by using a constant stream of income approach. The annuity has specific qualifications to ensure that Medicaid will approve of the strategy. The annuity must be fixed with all monthly payments being the same, while also being irrevocable. The annuity is unassignable meaning it cannot be transferred or sold to another individual. The payments on the annuity must be immediate in order to qualify for coverage. An Elder Care Attorney can further explain this strategy in describing the best course of action in selecting an annuity with qualifications that would make it possible for you to still qualify for Medicaid.

5. Spousal Transfers and Spousal Refusal

According to current Medicaid laws, transfers may occur between spouses without being subject to the five year look-back period. The assets who are under the name of the spouse in need of care should be transferred to the name of the spouse who doesn't require care. The spouse who is not in need of care is typically referred to as the community spouse. With the presence of spousal refusal, the community spouse may refuse to provide necessary support to the spouse in need of care. If this is the case, then the spouse who is in need of care will immediately be provided Medicaid services to ensure that they are provided with all the care necessary. Medicaid may then require the community spouse to make contributions even though that spouse initially refused to provide the necessary support. The community spouse will still receive a benefit because the reimbursements to Medicaid will be at specified discounted rates. Spousal refusal is present in New York, however it may not be present in other states. Seeking legal advice from an Elder Care Attorney puts you and your loved ones in a good position to protect your assets from Medicaid.

Reasoning Behind Asset Protection:

Asset protection from Medicaid is extremely important in the long run in regards to receiving long term coverage. Without taking the proper steps now to protect your assets, you may be unable to receive long term coverage, such as nursing home care. Long term care insurance provides coverage for nursing home care and at home coverage for individuals ages 65 and older with chronic conditions. There is nothing worse than running out of money when you need it most, so by taking the necessary steps to protect your assets today, you will avoid this problem when it becomes time to consider long term care. An Elder Care Attorney will guide you through the process of following all of the strategies above to save and protect your assets from Medicaid.

For further Medicaid eligibility information please contact the Law Office of Inna Fershteyn at 718-333-2395 to effectively protect your assets from Medicaid.

How to maintain Medicaid Eligibility when your spouse dies in NYC?

The process of aging is a difficult concept, especially for individuals who lack knowledge of their medical coverage system and management of their financial assets. Prior to reaching old age, individuals should consider applying for Medicaid and creating an Elder Care Plan. Applying for Medicaid is quite a complex process, as the questions being asked within the application have great depth and implications for your future. The foundation system responsible for asking the questions that define your eligibility for Medicaid purposely selects specific diction and word choice which may make it challenging for elderly individuals to effectively answer the questions. Considering that these questions are the main defining factor when it comes to obtaining Medicaid coverage, family members should seek guidance from an experienced Elder Law Attorney to guide them through this imperative process. The attorney is quite familiar with your state’s rules when it comes to long-term care planning and receiving government benefits.The Elder Care Attorney will use her experience in the field to devise the most effective plan in assisting the family by selecting strategies that align with the family’s personal and financial circumstances.Additionally, the esteemed attorney will ensure that you maintain your Medicaid Eligibility even when your spouse dies in NYC.

What if the nursing home spouse outlives the community spouse?

In the case that the spouse enrolled in nursing home care passes away prior to the community spouse, then the living spouse is subject to an exception of 50% of the total countable assets of both of the spouses.The total countable assets may only reach the value of $119,220 in order to remain qualified for Medicaid coverage. However, this exemption does not work if the roles are reversed. This means that if the community spouse passes away prior to the spouse in the nursing home, then the nursing home spouse may not use the 50% exemption.This is due to the fact that the individual inhabiting the nursing home will no longer receive Medicaid coverage and therefore will not obtain the care they require. The maximum quantity of assets an individual on Medicaid may hold is $2,000, thus any value above this would result in a Medicaid penalty. In most cases the surviving spouse will receive the remaining assets based upon the content of the will. To avoid dealing with this complex situation you should hire an Elder Care Attorney to begin Medicaid Planning for married couples.

Medicaid Planning for Married Couples

Upon receiving inheritance the surviving spouse should convert this money into a non-countable form. These forms may include Medicaid-qualified annuity, a new car, new household furniture, etc. An Elder Care Attorney will provide guidance on which non-countable form would be most effective for your specific family circumstances in order to avoid incurring a Medicaid penalty. This penalty will result in a disqualification period that may leave you without coverage, which is certainly not worth the risk. Prior to the death of the community spouse, the couple should change their accounts in order to prevent them from being in joint names. Without taking this step, there may be numerous financial consequences that will jeopardize your Medicaid coverage. In the case that the house or the home was under joint names and the community spouse passes away, then the spouse receiving nursing home care will exceed the $2,000 maximum assets allowed. Therefore, the house should be solely in the name of the community spouse instead of under joint names.

The passing of a Medicaid recipient’s spouse could harm the current Medicaid recipient by making him ineligible for coverage. If the community spouse dies and leaves the estate to the nursing home Medicaid recipient, then the individual will have too many assets to qualify for coverage. Even in the case that the individual chooses not to claim his share of the estate, Medicaid will still assess the situation, which may result in a Medicaid penalty. In this case, a trust could be an effective option to protect the spouse’s medical coverage. The surviving spouse is typically titled to either half or a third of the assets titled under the name of the deceased spouse. The money must be removed and properly disposed of to ensure that the Medicaid recipient continues to be eligible for coverage.

For further Medicaid eligibility information please contact the Law Office of Inna Fershteyn at 718-333-2395 to effectively maintain Medicaid Eligibility when your spouse passes away.

Top 5 Strategies for Protecting Your Assets From A Nursing Home

Coming to terms with the prospects of your loved ones aging is not a simple and enjoyable task, especially when you are the one responsible for making the most efficient medical and financial decisions for them. Not only are you tasked with these complex decisions, but you are also responsible for finding the best ways to protect your loved one’s assets from a nursing home. In order to make this process simpler and give you more time to spend time with loved ones, rather than worrying about legalities, an Elder Care Attorney can assist in the procedure. Around 73 percent of individuals over the age of 65 will need long-term care, thus is it quite logical to make decisions concerning this care prior to the individual reaching the specified age. Participating in the long-term care planning process early will give you the opportunity to consider which facility will best cater to your loved one’s individual needs. This will also give you the opportunity to plan your desired payment method for all of the medical and care expenses. There are various procedural strategies that can be followed to guarantee that your assets are being protected from a nursing home.

Strategy #1: Asset Protection Trusts

An Asset Protection Trust is a great way to preserve your assets when applying for Medicaid, as it allows you to maintain your wealth while still receiving coverage. This is helpful because a Medicaid applicant is only eligible for convergence if they meet the specified quantity of assets held within their account. Many individuals fall into the assumption that the best way to remove the additional assets that prevent them from getting Medicaid coverage is to transfer the assets to family members. This approach, however, is extremely flawed and risky because it often results in a Medicaid penalty. Incurring a penalty prevents you from receiving coverage for a specified period of time. A trust allows you to disperse these assets to the family members you had in mind at the time of creating a trust. The beneficiaries will not be subject to the payment if capital gains tax based on the increase in quantitative value your assets have accrued over time. It is important to note that transfers to a trust are still subject to the Medicaid Lookback period,which tends to include the last five years of your assets. This strategy is extremely effective when it comes to protecting your assets from a nursing home, while still receiving the coverage you are in need of.

Strategy #2: Income Trusts

Similarly to the Asset Protection Trusts, Income Trusts serve the purpose of protecting your assets and keeping your monetary income safe. This trust aids in maintaining the income limit set for all Medicaid applicants. Qualified Income Trusts and Pooled Income Trusts are beneficial towards those applicants that exceed the qualifying amount. These trusts give the applicant an opportunity to designate a sub quantity of their income to a specific trust in order to refrain from exceeding the standard acceptable quantity. The Qualified Income Trusts are irrevocable meaning they cannot be changed or removed. They serve as holding areas for the applicant’s excess income and protect this income from being taken by nursing homes. In states that allow applicants to spend down their excess income, these trusts are less effective, yet can still be utilized based on the applicant’s preference. In order to qualify for Medicaid many married couples must participate in the Spend-Down process, which pertains to the prospects of saving assets when only one spouse needs Medicaid. The purpose of this process is to ensure that the individual in need of long-term care receives the aid they need, while also guaranteeing that their spouse has the financial means of remaining in their home and covering the cost of all their living expenses.Pooled income trusts also happen to be irrevocable, however they specifically aid disabled applicants. The excess income is pooled together and is then cared for by a non-profit organization. This organization takes on the role as the trustee, meaning they are responsible for disbursing the funds.

Strategy #3: Medicaid Compliant Annuities and Promissory Notes

Oftentimes individuals require urgent long-term care services, however they have recently conducted a transfer of assets or are still in possession of the assets that limit the income cap they require to qualify for Medicaid coverage. There is no way to remove these assets in time to qualify for coverage because any movement of the assets will result in a Medicaid penalty.

The only options left to qualify for coverage under such short notice and with exceeding assets present would be to write an annuity or promissory note. This would serve as an insurance product that would payout the income. First, you would make an investment into the annuity. Then, the insurance provider would return your income by using a constant stream of income approach. The annuity has specific qualifications to ensure that Medicaid will approve of the strategy. The annuity must be fixed with all monthly payments being the same, while also being irrevocable. The annuity is unassignable meaning it cannot be transferred or sold to another individual. The payments on the annuity must be immediate in order to qualify for coverage.

Strategy #4: A Caregiver Agreement

A care agreement is beneficial to individuals who require additional services that will not be included within the mMedicaid coverage in a nursing home. This option is great for individuals who would prefer to be cared for by a family member or a trusted close friend. You would not only be cared for by an individual you already know and have a close relationship with, but you would also be benefitting the caregiver for their service. The caregiver will be paid for their duty in caring for you and you will receive the best care possible. In most cases the caregiver would be paid for their services in advance under a contract that defines the services provided and the hours being worked. In the case that the patient passes away all of the unearned funds must be paid to Medicaid in correlation to the amount that Medicaid paid for the patient’s care. A Caregiver Agreement can be the best option for numerous individuals who do not wish to leave home and go into the care of a nursing home.

Strategy #5: Spousal Transfers and Spousal Refusal

According to Medicaid laws transfers may occur between spouses without being subject to the five year look-back period. The assets who are under the name of the spouse in need of care should be transferred to the name of the spouse who doesn't require care. The spouse who is not in need of care is typically referred to as the community spouse. With the presence of spousal refusal, the community spouse may refuse to provide necessary support to the spouse in need of care. If this is the case, then the spouse who is in need of care will immediately be provided Medicaid services to ensure that they are provided with all the care necessary. Medicaid may then require the community spouse to make contributions even though that spouse initially refused to provide the necessary support. The community spouse will still receive a benefit because the reimbursements to Medicaid will be at specified discounted rates. Spousal refusal is present in New York and Florida, however it may not be present in other states.

With the aid of an Elder Care Attorney, nursing homes and other senior housing options become affordable even for individuals who did not allocate money specifically for elder care. Government programs can provide assistance to elderly in financial need of aid. This government aid will come in the form of Social Security, Veteran’s Benefits, Medicaid, and various state programs. Additionally, there are insurance coverage options for those who do not qualify for government aid. These insurance options pertain to Medicare, Medicare Supplement programs,and Short-Term Care Insurance. There are potentially private assistance options, such as certain nonprofits and foundations that aid elderly in need of care. Once you have a senior housing option in mind, it is a great time to start thinking about the medical and financial power of attorney. A durable power of attorney allows an individual to make decisions for the benefit of your loved one in regards to financial and medical concerns over their well-being. This allows documentation to stay in place even if the elderlt loved one becomes incapacitated and is unable to make decisions independently. This individual is in charge of paying your bills, managing your assets and investments, and directing your medical care when you are unable to do so yourself. The medical power of attorney establishes your loved one’s plans for healthcare, such that the agent will work with medical professionals to ensure the individual is cared for in a manner in which they personally prefer. The financial power of an attorney gives an individual the ability to make financial decisions involving real estate and more. The agent can be responsible for depositing Social Security checks, managing tax returns, and other fiscal tasks. An esteemed Elder Care Attorney will assist you in completing these documents, as well as selecting the designated agent and specified senior housing. All the while, the attorney will guarantee that your assets will remain protected from the nursing home.

For further Medicaid eligibility information please contact the Law Office of Inna Fershteyn at 718-333-2395 to effectively protect your assets from nursing homes.

Applying for Medicaid: An Elder Law Attorney Can Help

Applying for Medicaid is quite a complex process, as the questions being asked within the application have great depth and implications for your future. The foundation system responsible for asking the questions that define your eligibility for Medicaid purposely selects specific diction and word choice which may make it challenging for elderly individuals to effectively answer the questions. Considering that these questions are the main defining factor when it comes to obtaining Medicaid coverage, family members should seek guidance from an experienced Elder Law Attorney to guide them through this imperative process. The attorney is quite familiar with your state’s rules when it comes to long-term care planning and receiving government benefits.The Elder Care Attorney will use her experience in the field to devise the most effective plan in assisting the family by selecting strategies that align with the family’s personal and financial circumstances.

What are some of the advantages in hiring an Elder Care Attorney when Applying for Medicaid?

Advantage #1:Avoiding Penalties

There are numerous benefits in hiring an esteemed Elder Care Attorney, as the lawyer has much experience in the field and will be able to answer all of your questions concerning the Medicaid application process. Hiring an attorney guarantees that you will be able to avoid Medicaid penalties, which are very common in individuals who attempt to complete the Medicaid application without the aid of an attorney. There are numerous questions that seek to identify if the applicant has made any disqualifying transfers that would result in a penalty. The most common question that correlates to the Medicaid penalty prospect is the prompt asking if the applicant has made any gifts or transfers for less than fair market value within the last 5 years. If you hire an Elder Care Attorney, the lawyer will ensure that you do not have any penalties that would prevent you from obtaining the Medicaid benefits you deserve. The attorney will be well aware of any of the exceptions that will prevent you from earning a penalty and will therefore assist you in the process of qualifying for Medicaid. Hiring an Elder Care Attorney enhances the probability that your application is approved, therefore increasing your chances of obtaining Medicaid coverage.

Advantage #2: Effective Spend-Down Process Plans

In order to qualify for Medicaid many married couples must participate in the Spend-Down process, which pertains to the prospects of saving assets when only one spouse needs Medicaid. The purpose of this process is to ensure that the individual in need of long-term care receives the aid they need, while also guaranteeing that their spouse has the financial means of remaining in their home and covering the cost of all their living expenses. An Elder Care Attorney may assist in creating a personal care agreement that enables the senior to provide monetary compensation towards their family caregiver, while also participating in the Spend-Down process. Additionally, the attorney can aid in renaming bank accounts and real estate titles in the effort to enhance the applicant’s eligibility for Medicaid. In order to receive Medicaid long-term care benefits the spouse inhabiting the nursing home may have up to $2,000 while the community spouse may have up to $128,640 according to 2020 data.Therefore, hiring an esteemed Elder Care Attorney can assist you in the Medicaid Planning process associated with qualifying for Medicaid coverage.

What is the Medicaid Lookback Period and how does it impact my Eligibility for coverage?

A Medicaid Lookback is imperative in relation to Financial Eligibility for Medicaid. This means that if a lookback is required for a specific service, then the medicaid applicant is required to present all financial records pertaining to the applicant and their spouse during the lookback period. The typical lookback period for nursing homes is estimated to be around 5 years. The Human Resource Administration (HRA) is responsible for reviewing the lookback documents and checking the transfer of assets, especially in identifying transfers for less than the fair market value by the applicant or spouse during this period. Based on current NY State laws, nursing homes are required to do a lookback to admit applicants for care. The lookback will be required for people who are in the Medicaid Buy-In for Working People with Disabilities. Applicants who have an income that is below the income bracket of $895 as a single individual or $1304 for a couple will not be required to partake in the lookback process. It is important that you avoid giving away or selling assets below the fair market price, as this could jeopardize your eligibility for Medicaid coverage. The Elder Care Attorney must be fully aware of all the transactions made during this 5 year period to ensure that you avoid any penalties that would delay the rate at which you would qualify for coverage.

What procedure will the Elder Care Attorney follow when assisting me in the Medicaid eligibility process?

When consulting an Elder Care Attorney for the purpose of Medicaid Planning, the attorney will begin by asking you about your assets and income. In order to effectively decide when is the best moment to apply for Medicaid coverage, the attorney must be aware of your personal financial situation. The attorney will ask you how your home, bank accounts, and other assets are titled. You will be asked to state all of the transfers you have made within the last 5 years in the effort to create a plan that avoids the often lengthy Spend-Down process. Although hiring an Elder Care attorney can be quite costly, it is certainly worth the price. The attorney will provide guidance in the process of filling out all of the paperwork, as well as outline the next steps when filling out the Medicaid eligibility application. It is imperative that you do not wait until Medicaid coverage becomes an urgent matter, for it will be extremely challenging to obtain financial aid in such a short time period. This process is quite lengthy and requires planning to guarantee the best outcome, thus it is encouraged that you initiate the Medicaid Planning process as soon as possible and select an attorney you trust.

For further Medicaid eligibility information please contact the Law Office of Inna Fershteyn at 718-333-2395 to effectively complete the Medicaid Application.