by Bill Miller | Apr 9, 2019 | Long-Term Care, Medicaid
What Does Medicaid Pay For if You Need Long Term Care?
One question people always ask when it come to long term care expenses, what does Medicaid Pay For? Long-term care is expensive care – but also very necessary for some people. However, planning for Medicaid to cover all your long-term care needs may lead to some unpleasant surprises! Not everyone qualifies for Medicaid. Those who do qualify may find that some services are restricted or not even covered at all. Let’s look at what Medicaid will – and will not – pay for when it comes to long-term care.
General Services Covered by Medicaid
Some services may be restricted to certain patients or in limited quantities. However, the following services might be available to Medicaid recipients, including people who need long-term care:
- Outpatient hospital visits for lab work, x-ray services, radiation treatment, or chemotherapy.
- Chiropractic care in some situations.
- Eye exams and glasses, once every three calendar years.
- Psychiatrists that are Medicaid providers.
- Emergency visits for serious problems. Otherwise, ER visits are limited to three non-emergency visits per year.
For a full list of available services, see the Alabama Medicaid website.
Services Related to Long-Term Care
Most people think of nursing homes when they think of long-term care. However, it is actually a “variety of services designed to meet a person’s health or personal care needs during a short or long period of time.”
In general, Medicaid will pay for medically-necessary care. For people who with long-term needs, Medicaid may cover the following:
- Home health services,
- Hospice care,
- Private duty nursing,
- Targeted case management,
- Residence at long-term care facilities like nursing homes.
Special programs may be available for people who need some form of long-term care.
What Does Medicaid Pay For – Waiver Programs
Medicaid offers home and community-based waiver programs for certain Medicaid recipients. An applicant or recipient who meets the medical and financial eligibility requirements and need long-term care may be qualified.
Services That May Not Be Covered by Medicaid
Generally, Medicaid generally refuses to pay for the following procedures unless they are considered to be medically necessary:
Cosmetic surgery, breast lifts, tummy tucks, and liposuction.
In addition, Medicaid does not pay for medical services provided to people incarcerated in jail or prison.
Learn More About Paying for Long-Term Care
For a free consultation with an experienced Alabama estate planning attorney, contact us at 256-251-2137. Miller Estate and Elder Law is located at 818 Leighton Avenue in Anniston, but we serve clients in Gadsden, Hoover, Talladega, Vestavia Hills, and surrounding areas.
Additionally, you may want to read Don’t Go Broke Paying for Long-Term Care, a free e-book available for download at your convenience.
by Bill Miller | Feb 25, 2019 | Estate Planning, Probate
When doing your estate planning, one question to ask is “will your estate go through probate?” It is said that nothing is certain except for death and taxes. Should probate be added to that list? There may be ways to avoid probate altogether.
Basic Information About Probate
Probate is a process through which a deceased person’s property is distributed to their heirs. Valid claims against the person’s estate are also paid during probate. An estate may have to go through probate whether the decedent left a Will or not. However, there are some exceptions.
The Alabama Small Estate Act allows personal property only to go through a summary distribution process without requiring full blown probate administration of the estate. There are rules and restrictions to dealing with a small estate, though. For one thing, if the estate own real estate, there cannot be a small estate administration. Additionally, the value of the estate must be minimal (nor more than $25,000 or so).
Also, not every asset
will become part of the probate estate. Some of the exceptions are listed
below.
Answering the Question Requires More Questions
To answer, “Will your estate go through probate?” ask
yourself the following:
- Do you own real estate? If the property is jointly owned with a survivorhip provision, it may pass directly to the other owner(s).
- Are you the sole owner of any property? If you are the sole owner of property, it will pass to your heirs through probate.
- Do you have any financial accounts or insurance policies? If so, have you named beneficiaries for these account? Since beneficiary designations bypass your Will, these accounts and your insurance policy do not become probate assets.
- Have you created and funded any trusts? Many people use a revocable living trust to pass property to heirs without the need for probate. Assets funded into the trust during the lifetime of the decedent will avoid probate. If the trust is created through a Will, (a testamentary trust) then the Will does go through probate and then the trust is created.
- Do you own other asset that will not pass through probate? It’s complicated. Some assets may pass to your spouse as their elective share of your estate.
The Best Way to Deal with Probate
Leave a complete, up-to-date estate plan behind for your family. The guidance you offer through your Will and revocable living trust is priceless. By doing proper planning, you can decide “will your estate go through probate” yourself.
At Miller Estate and Elder Law, we work with families everyday who are dealing with the probate process. We also work with people as they set up their estate plans. Contact us at 256-472-1900 and let us help you. We also do free workshops and offer free resources on our website.
Miller Estate and Elder Law is now located at 818 Leighton
Avenue in Anniston, but we serve clients in Leeds, Gadsden, Hoover, Talladega,
Vestavia Hills, and surrounding areas.
by Bill Miller | Feb 4, 2019 | Medicaid Planning
Steve realized his father, Hank, needed help. Still, he was surprised when a doctor told him that Hank needed 24/7 nursing care. As he looked for a nursing home, he was surprised at the cost and unsure of how his father would pay for it. Someone suggested he check into Medicaid. Steve checked the Alabama Medicaid website, but was dismayed to learn his father’s income was just a little too high. Fortunately, someone suggested he see a Medicaid planning attorney to ask about Miller Trusts.
Medicaid Eligibility
When someone applies for Medicaid benefits, a caseworker reviews their application and supporting documents to make sure they are eligible. In particular, they look at income and resources.
To qualify for Medicaid, an individual’s monthly income must be no more than $2,205. The individual’s resource limit must be $2,000 or less on the first day of each month.
These limitations are important to know. For example, if Hank’s income is $2,500 a month, he may be denied Medicaid benefits. Fortunately, there may be a solution to Hank’s problem with excess income.
Where a Miller Trust Might Help
Medicaid applicant’s, or their families, may need to find a legal way to reduce the applicant’s monthly income. This often is accomplished through a Miller trust.
All trusts have a grantor, trustee, and at least one beneficiary. Trusts are also funded with money or other assets.
With a Miller Trust, a Medicaid applicant or recipient deposits their monthly income in excess of Medicaid limits into the trust. The amount deposited no longer counts against the benefit recipient.
With Hank, he makes almost $300 a month more than the Medicaid income limit. He may be able to open a Miller trust, then deposit $300 a month into the trust.
The trustee can use funds from the Miller trust to pay the recipient’s expenses.
Setting a Trust Is Tricky
The attorneys at Miller Estate and Elder Law use their experience and knowledge of trusts to help clients make informed decisions. For a free consultation, contact us at 256-251-2137 or use our convenient Contact Form. Although we’re located in Anniston and Birmingham, we also help clients in the Gadsden, Hoover, Talladega, Vestavia Hills, and surrounding areas.
by Bill Miller | Feb 4, 2019 | Medicaid, Medicaid Qualification
Everything seemed to happen in a split second. One minute, 88-year old Mary Elizabeth was living at home and appeared able to care for herself. Then her son, Jason, received a call from the emergency room. Mary Elizabeth had suffered a devastating stroke and needed the kind of 24/7 nursing care best offered in a nursing home. She moved immediately from the hospital to a nursing facility, but financing her stay was a problem. Jason quickly learned about Nursing Home Medicaid Qualification and how quickly he could get her eligible.
The Basics of Nursing Home Medicaid Qualification
We’ve all heard of Medicaid, but may not understand the finer points of applying, qualifying, and finding the services we need.
Medicaid is federally funded, but state managed. Programs and eligibility requirements may vary from state to state. Alabama Medicaid offers a program for Institutional Medicaid – or Medicaid for nursing home residents.
Qualifying as a Nursing Home Resident
For Jason to get Medicaid for Mary Elizabeth, she has to meet the following criteria:
- Mary Elizabeth must be a U.S. citizen residing in Alabama.
- She must prove that her nursing care is needed for a medical condition.
- Mary Elizabeth must live in the nursing facility for at least 30 continuous days.
- She must have a monthly income below the current limit of $2,205 per month, although this amount may be adjusted in January of each year.
- Mary Elizabeth’s resources must be worth less than the limit Medicaid sets. At this time, the limit for an individual is $2,000. However, there are exceptions to this, particularly if the applicant is married.
But applying for government benefits can take months. Mary Elizabeth and Jason urgently need Medicaid coverage now.
Emergency Medicaid
It can take 45 to 90 days for a Medicaid application to be approved. However, Medicaid coverage may be granted to cover up to three months before the month in which the application was submitted. This applies if the applicant received medical care and if the applicant meets all other eligibility requirements.
One of the biggest obstacles to getting Medicaid immediately is that most people have more than $2,000 and are therefore “over resourced”. Medicaid requires that an applicant spend down their assets to $2,000 before they can qualify. There are planning strategies to protect some of your assets and still get qualified for Medicaid immediately.
Get a Decision on Medicaid as soon as Possible.
At Miller Estate and Elder Law, we work with families everyday who have loved ones in or going to a nursing home. We know the rules for Nursing Home Medicaid qualification. We can get you qualified quickly. Contact us at 256-251-2137 to schedule an appointment. We have offices in Birmingham and we have a new office located at 818 Leighton Avenue in Anniston. We serve clients in Gadsden, Hoover, Talladega, Oxford, Jacksonville, Vestavia Hills, and surrounding areas.
by Bill Miller | Jan 21, 2019 | Estate Planning, Uncategorized
A Trustworthy Person Standing in Your Shoes Right Now
Michael was having a wonderful time in Florida while he waited for his Alabama house to close. Unfortunately, he took a bad fall and ended up in a Florida hospital. He had his Alabama power of attorney, but the problem was that it was a springing power of attorney. The powers were only effective if Michael lost capacity. Michael’s capacity was fine, it’s just that he wasn’t in Alabama when an offer on the house came through.
Power of Attorney
A power of attorney is a legal document that allows someone else to stand in your shoes. It allows them to speak and act on your behalf. A document that is effective immediately – even if you’re perfectly capable of managing your own affairs at the time – is the better choice in most cases. Michael should have designated an Alabama agent with immediate powers. The document should be comprehensive enough to authorize the agent to conduct real-estate transactions on Michael’s behalf.
A document like Michael’s, however, that “springs” into life only on incapacity, would not serve him as he needed. And even if Michael had lost capacity, a doctor would still have to certify that he could no longer make his own decisions. This would cause delay and uncertainty, when swift action was required instead.
Get a Trustworthy Person to be Your POA
Many are concerned that if they have a power of attorney that is immediately effective, their agent will abuse privileges that aren’t even needed at the time. This is a sign, however, that they don’t trust that person. And after all, it’s better to be alert and aware if such a thing should happen, instead of discovering the problem only when you’ve lost capacity and it’s too late. Making sure to name a trustworthy person to serve as power of attorney is often better that using a spring power of attorney.
An experienced attorney can help you find your way through many such pitfalls. Please give us a call at 256 251-2137 to learn how we can help. You can also learn more about powers of attorney and other estate planning documents by getting a free copy of our book – The Basics of Estate Planning in Alabama by at www.AlabamaEstatePlanningGuide.com.
