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.

Maintaining Medicaid Eligibility 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 718-333-2394 to effectively maintain Medicaid Eligibility when your spouse passes away. 

Medicaid versus Medicare: Who covers nursing home costs?

There comes a point in time when you may begin to consider placing your loved one into a nursing home to ensure that they receive the best care possible. When making such a decision it is important to be well informed and aware of all of the aspects that attribute towards nursing home care. One such attribute pertains to the cost of care and how it will be covered. Usually the cost will either be covered using Medicare or Medicaid. However, there are specific qualifications that outline which coverage plan may be utilized based on your personal situation. Additionally, it is important that you are able to differentiate between the types of care offered, such as skilled care and custodial care. In order to best be informed of all the details concerning enrolling your loved one in the care of a nursing home, you should contact an Elder Care Attorney to guide you in your decision making process. With proper counsel you will be sure to place your loved one in the hands of the best nursing home possible, while still being able to cover all of the costs such care will require.

Medicaid vs Medicare Nursing Home Coverage

Qualifications for Medicare Coverage of Nursing Homes

There are specific statements that discuss if an individual qualifies for Medicare coverage when it comes to nursing home care. The first statement pertains to the period of time the individual stayed at the hospital out of medical necessity. In order to qualify for Medicare coverage an individual must have spent at least three consecutive days in inpatient care for a medical necessity. After being discharged from the hospital the individual must then be admitted to a nursing home within the 30 day period that begins the moment the patient is discharged. The individual must be in need of skilled nursing or rehab care on a daily basis for the specific condition they endured while hospitalized in inpatient care. Lastly, in order to receive Medicare coverage for nursing home care, an individual must have a letter from a physician ordering and proving the necessity of this care. If the individual falls within the category that aligns with all of these statements, then they may be eligible for receiving Medicare coverage when it comes to nursing home care. 

Skilled Care vs Custodial Care

The greatest difference between skilled care and custodial care pertains to the manner in which the care is provided and who is responsible for providing such care. Skilled care refers to care that is specifically administered by a professional who is responsible for ensuring that the individual does not further deteriorate from the condition they are currently in. This care is administered when direct medical care becomes a necessity as a result of a short-term medical condition that they will recover from. On the contrary, custodial care can be performed within the home setting, meaning the one administering this care does not have to be a medical professional. This type of care provides aid for activities related to daily living. These activities usually pertain to eating, bathing, and similar skills. In most cases, patients that receive custodial care have a chronic condition, meaning they are not expected to improve in the manner that those who receive skilled care are. If custodial care is the only type of care necessary, then it is possible that Medicare will not cover the costs. However, Medicaid will cover the costs of custodial care, so you will be able to provide your loved ones with the care they require to continue thriving.

Medicaid Rules for Skilled Nursing Payments

Receiving Medicaid coverage can be quite complex, as there is a very specific list of qualifications necessary to obtain coverage. Medicaid is based on “needs only” policies, meaning there are strict regulations pertaining to the amounts of assets you are allowed to hold.  Medicaid is income based, while Medicare does not depend on your assets or income. An esteemed Elder Care attorney will assist you in qualifying for the type of coverage you need, as the attorney has much experience in the field and knows the specific rules of state pertaining to the amount of money an individual can have while still qualifying for Medicaid coverage. A Medicaid applicant over the age of 65 can possess up to $2,000 in NY in order to qualify for coverage. Asset limits for married couples vary in relation to whether both spouses require Medicaid coverage or only one spouse. One automobile regardless of the quantitative value is referred to as a “non-countable” asset as long as the car is used to transport the Medicaid applicant or other members of the family. The attorney will assist you in preparing for the five year Medicaid lookback period and will provide guidance on the Medicaid spend-down process. 

Is Dual-Eligibility a Possibility?

Dual-Eligibility refers to an individual who is qualified to receive both Medicaid and Medicare coverage. In this case, Medicaid will cover all of the costs that Medicare did not cover. Usually, individuals qualify for Medicare based on their age and qualify for Medicaid based on the income bracket they fall into. Additionally, Medicare beneficiaries below the age of 65 who live on Social Security Disability Insurance may be eligible to receive Medicaid benefits. The benefits of being dual-eligible is that you may receive greater medical coverage and lower out-of-pocket costs. For medical issues Medicare is the primary payer, Medicaid will serve as the secondary payer to cover any Medicaid costs leftover. Medicaid assists in covering the cost of the Medicare premiums, deductibles, and copays. An Elder Care Attorney can assist you in becoming dual-eligible and receiving the benefits that result from this eligibility. 

For further Medicaid eligibility information please contact the Law Office of Inna Fershteyn at 718-333-2394 to obtain aid in receiving medical coverage to cover the cost of nursing home care.

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.

Enhancing Medicaid Eligibility by hiring an Elder Care Attorney

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 718-333-2394 to effectively complete the Medicaid Application.