by Bill Miller | Jun 22, 2020 | Blog, Medicaid, Medicaid Planning, Medicaid Qualification
Benefit programs like Medicaid often include strict requirements and rules. To qualify for Medicaid, for example, an applicant must show a financial need by staying below Medicaid’s income and resource limits. However, some people need Medicaid benefits but exceed the amounts Medicaid allows. In this article, we will look at those limits, and, more importantly, how to spend-down your assets and monthly income to meet them.
Medicaid Limits on Income and Resources
A nursing home resident typically can possess no more than $2,000 in resources as of the first day of the month.
However, Medicaid does not count all of your assets and income. Some resources might be considered as countable, including cash, real estate, and one automobile per household. The status of some assets may change in certain situations. For example, real estate held as a life estate or that is on the market may not be counted.
It’s to your benefit to consult with an experienced attorney before applying for Medicaid or attempting any sort of spend-down activities.
Planning a Spend-Down
After learning you may not qualify for Medicaid because of income and asset limits, you may want to plan a spend-down of your assets. But how exactly do you go about doing this? Here are some important considerations:
- Where are you living?
- Are you married or single?
- What is the source of your income?
- What type of assets do you have?
The answers to these questions may make a difference in how you spend proceed. Make sure your lawyer has all the information needed to advise you about spending down your assets.
Actions That Spend-Down Your Assets and Monthly Income
After carefully assessing your resources compared to Medicaid’s requirements, you may start taking some of the following steps:
- Pay your medical bills. Certain medical bills can be paid to reduce your countable cash assets. In addition to your own, you may be able to pay medical bills for your spouse and your children. You can pay past and current medical expenses, which may include transportation costs, therapists, personal care attendants, home health aides, rehabilitation programs, prescription drugs, and medical equipment ordered by a doctor.
- Pay off other debts. You may be eligible to use excess income to reduce mortgage, auto loan, and credit card balances.
- Sell certain assets. In some situations, countable assets may be sold to pay off medical bills and debts to reduce a recipient’s resources.
- Set up a Miller Trust. Excess monthly income can be diverted to a Miller Trust to stay below Medicaid’s monthly income and resource limits. Funds in the Miller Trust can be used for eligible expenses.
Keep in mind that transferring, selling, or spending assets may result in reductions or delays in benefits.
Spend-Down Your Assets and Monthly Income Wisely
The rules are complicated. Always speak with an experienced attorney before trying any kind of spend-down strategies.
The attorneys at Miller Estate and Elder Law help clients like you with Medicaid planning and applying for benefits. Contact Bill Miller at 256-251-2137 to schedule an appointment.
by Bill Miller | Jun 15, 2020 | Blog
It’s true. There’s no place like home, especially for people who have lived in a family home for years. Louisa, for example, created many happy memories in the house she had shared with her husband and three children. However, there came a time when Louisa’s health was declining. She needed someone to help with her activities of daily life, including taking her medication and tracking several health conditions. Her family looked for a residential long-term care facility, but then they learned about the Alabama Elderly and Disabled Waiver provided by Medicaid. This may be the answer Louisa needs.
Paying for Long-Term Care
Many people to turn Medicaid when they need help paying for nursing home or institutional care. For those who qualify, Medicaid provides important benefits to meet their healthcare needs. In fact, Medicaid programs are available for children, caretakers, pregnant women, elderly people, and people with disabilities.
Staying Home May Be an Option
Some people like Louisa need assistance but at a level that still allows them to remain at home. The Alabama Elderly and Disabled Waiver does just that for qualified seniors.
Two groups manage this home and community-based waiver program: the Alabama Medicaid Agency and the Alabama Department of Senior Services. The following services may be offered:
- Case Management. A case manager analyzes the benefit recipient needs, then works to line up services that meet those need.
- Homemaker Services. A trained aide may assist the elderly or disabled person with meals, grocery shopping, cleaning, and personal needs.
- Personal Care Services. In conjunction with a doctor’s plan of treatment, an aide may assist with bathing, dressing, walking, eating, taking medication, and more.
- Adult Day Health Services. Recipients participate in social and health care activities, like health education and health screening.
- Respite Care. A personal care attendant, home health aide, homemaker, LP, or RN providers short-term assistance.
- Companion Services. This type of assistance is non-medical. Paid Companions may supervise or assist with activities of daily living and housekeeping as needed.
- Home Delivered Meals. A registered dietician approves menus for food delivered to individuals age 21 or older.
These services not only make life better for an elderly or disabled person but typically cost less than institutional care.
Will the Alabama Elderly and Disabled Waiver Work for You?
Talk to an experience Alabama attorney to find out.
The attorneys at Miller Estate and Elder Law have years of experience working within the Medicaid system. They help clients like you with Medicaid applications as well as advanced Medicaid planning.
Schedule a consultation with one of the attorneys at Miller Estate and Elder Law. Our phone number is 256-472-1900. We are now located at 818 Leighton Avenue in Anniston, but we serve clients in communities like Hoover, Vestavia Hills, Irondale, and Calera.
Also, take a look at some of the free guides offered on our website.
by Bill Miller | Jun 2, 2020 | Blog, Nursing Home
Social distancing and restrictions on entering skilled nursing facilities continue to be in place across the nation. We know, as elder law attorneys, this can make it more challenging to be able to interact with your loved ones who may currently reside inside of them. We also know that this inability to interact personally may also cause you additional stress since you may not be able to physically “see” your aging loved one.
The first step to alleviate this concern and to also help your loved one, starts with making a plan. What should you plan for?
- Plan to communicate with your loved one and the care team.
- Plan to be involved, and stay involved.
- Plan to be available to answer any questions for your aging loved one.
- Plan to be available to advocate for your aging loved one.
We know you may have questions on how to best tackle this responsibility, especially in light of the ongoing issues from the pandemic.
1. Be in frequent communication. Communication is critical right now. Whether it is with your loved one or not, the nursing home needs to know that you are involved. Of course, you want to participate with your loved one who is in the facility but it is equally important to speak with his or her care team. The care team may involve doctors, nurses, and therapists, as well as other specialists. Make contact and ask to be provided with an update at least weekly, if not more frequently.
2. Participate in meaningful conversations. If you are able to communicate with your aging loved one, try to make your interactions as meaningful as possible. Social distancing and visitation restrictions can make this more challenging, but there are ways to stay connected. In addition to phone calls, consider video chats like FaceTime or Facebook Messenger so your loved one can see you and your family. Also, during this time you can share photos and scrapbooks as well.
3. Advocate from anywhere. Remember that your aging loved one may need you more than ever right now. The lack of being able to go into a facility in person should not prevent you from speaking with him or her. Discuss with your loved one, if possible, and the facility what are the best ways for you to be involved.
We know this blog may raise more questions than it answers. Do not hesitate to contact us at any time to help you answer them. We are here to help you and your loved ones as you face these challenges.
by Bill Miller | May 28, 2020 | Blog, Medicaid, Nursing Home
Tom knew his dad, Frank, was having a little trouble taking care of himself at home. He dreaded the idea of putting his father in a nursing home, even though he knew of several wonderful homes nearby. Frank wanted to remain independent at home for as long as possible. One day, however, Frank’s doctor told Tom that Frank should have supportive devices, special transportation, assistance with taking medication, and help with his daily activities. As Tom helped his dad deal with the changes in his life, he learned that Medicaid can help every step of the way. The first step was finding out that nursing care was needed.
Step two is finding out how Medicaid can help your loved one stay at home. Keep in mind that some Medicaid programs cover home health and institutional care.
Home-Based Long-Term Care
Medicaid is a federally-funded, state-run program that provides healthcare to qualified individuals. However, Medicaid is not just one program. Instead, various programs are offered to help different segments of our society. People like Frank need advanced care but may be eligible for Medicaid programs that meet their medical, nursing, and social needs without leaving home. Medicaid home health programs include:
- Home Health Care. Eligible people of any age, including elderly, may be qualified to receive Medicaid home care
- Home and Community-Based Waivers. Eligible Medicaid recipients must be at risk for moving to institutional care, yet willing to receive that care at home.
At some point, people may be ready for step three.
Transitioning to Institutional Care
Moving from home to nursing home can be difficult. Medicaid programs offer services and financial aid to make the move a little easier.
- Medicaid for the Elderly and Disabled (E&D). The services offered through E&D assist people who live at home and in nursing homes, hospital, and other residential facilities.
- Medicaid in the Nursing Home (Institutional Medicaid). This program provides coverage of institutional care for people who qualify.
Medicaid For the Various Phases of Life.
In addition to programs that help people move to an institutional setting, Medicaid also offers a program to help people move out of nursing homes. Gateway to Community Living offers services and support for qualified individuals who wish to move from an institution to a home setting.
Contact Bill Miller at 256-251-2137 to schedule an appointment. The attorneys at Miller Estate and Elder Law can help with applying for Medicaid. Even better, we can help you with Medicaid planning to increase your chance of getting Medicaid and keeping as much property as possible. Though our office is now located at 818 Leighton Avenue in Anniston, we serve clients in Gadsden, Hoover, Talladega, Vestavia Hills, and surrounding areas.
by Bill Miller | May 15, 2020 | Blog, Long-Term Care, trust
According to LongTermCare.gov, almost 70% of people who are 65 years of age at this time will need long-term care at some point in their lives. Such care is expensive and could deplete a lifetime of savings in just a few years. People may be able to both pay for their long-term care and leave money for their heirs by establishing trusts for long-term care planning.
Medicaid Requirements
Many people hope that Medicaid will pay for their long-term care. However, Medicaid only pays for people with limited income and few resources. Applying can be difficult as applicants are required to submit numerous supporting documents.
Another important thing to remember is the Medicaid 60-month look back period. Medicaid reviews an applicant’s financial records for the 60 months before the date of application. Financial transactions made during that time, including transfers to a trust, may cause a delay or reduction in benefits. That’s one reason it’s important to start planning now. A trust may be in your future.
Irrevocable Trusts for Long-Term Care Planning
Please note that there are two general types of trusts: revocable and irrevocable. Revocable living trusts are common. However, they typically do not provide any kind of asset protection and are not helpful for long-term care planning.
Instead, consider establishing an irrevocable trust. This type of trust transfers control of the grantor’s assets to a trustee. In effect, the grantor no longer owns the trust assets. Medicaid generally does not count the funds in an applicant’s irrevocable trust toward the applicant’s resource or income requirements.
Plan Ahead to Pay for Long-Term Care
We don’t know what the future holds or how long it will be until we need long-term care. To prepare for your future, talk to an attorney about trusts for long-term care planning today.
The attorneys at Miller Estate and Elder Law assist their clients with Medicaid and long-term care planning, as well as general estate planning. Contact Bill Miller at 256-251-2137 to schedule an appointment. Though our office is now located at 818 Leighton Avenue in Anniston, we serve clients in Gadsden, Hoover, Talladega, Vestavia Hills, and surrounding areas.
Also, download a copy of our free e-book, Don’t Go Broke Paying for Long-Term Care, by clicking here.
