by Bill Miller | Jan 11, 2022 | Elder Law, Medicaid, Medicaid Planning, Medicaid Qualification
Medicaid is a government-administered health insurance program that provides coverage to low-income Americans during all stages of life, from birth to age 65+. Given the massive breadth of this program, it should not come as a shock that it’s an incredibly complex system, governed by a confusing set of rules. This article aims to answer the questions, what does Medicaid cover, and what does Medicaid NOT cover?
While Medicaid can support individuals of any age, it’s an especially excellent resource for seniors. Long-term nursing care costs in Alabama average $78,000 per year, and that is for a shared room. However, qualifying for Medicaid can be a challenge. Applicants must meet certain financial and medical eligibility requirements. There are strict income and asset limits, with policies designed to prevent individuals from giving away their assets in order to qualify. A qualified elder law attorney can help you navigate the Medicaid maze, and avoid unsuspecting mistakes that could leave you or a loved one without the coverage they need.
For seniors who qualify, Medicaid is a wonderful program that works in collaboration with Medicare to cover a variety of healthcare needs
What Does Medicaid Cover?
Medicaid covers mandatory healthcare services, including:
- Hospital care
- Skilled nursing
- Home healthcare
- Doctor’s appointments
- Preventative care & wellness screening
- Transportation to and from medical appointments
- Diagnostics
Optional benefits include hospice care, case management, prescription drugs, physical or occupational therapy, rehabilitation, dental, vision, and more.
However, Medicaid does have some limitations…
What Does Medicaid NOT Cover?
In most circumstances, Medicaid will not cover medical care provided outside of the United States, though certain circumstances—such as if a foreign hospital is closer than a domestic hospital—may be covered. Like with private health insurances, Medicaid will also not cover services deemed unnecessary, or services paid for by another insurance provider.
Some other services that Medicaid will not cover include:
- Free health screening or medical devices that are given away
- Cosmetic surgery or complications that result from cosmetic surgery
- Personal comfort items or beauty services
Every state has slightly different Medicaid qualifications and coverage, so the best way to gain comprehensive (and accurate) understanding is to speak with a qualified elder law attorney in your home state.
Miller Estate and Elder Law is happy to offer a number of free resources to help you better understand how Medicaid planning works, and how to avoid going broke paying for long-term care. Gain access to our brief 20-minute webinar about how to get you or a loved one qualified for Medicaid by completing the brief form below, or download one of our free guides.
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by Bill Miller | Oct 18, 2021 | Estate Planning, Medicaid, Medicaid Planning, trust
Studies have shown that almost 70% of adults turning 65 will need long-term care at some point during their lifetimes. While long-term care is an amazing resource to many Americans and their families, it is also extremely expensive and can cost around $266/day in the state of Alabama. However, if you are eligible, Medicaid can help pay for long-term care. While Medicaid’s income and asset restrictions are strict, there are estate planning tools—like the Medicaid Asset Protection Trust—that can help you qualify for Medicaid, while also preserving your life savings.
What is a Medicaid Asset Protection Trust?
A Medicaid Asset Protection Trust (MAPT) serves to protect your assets if you or your spouse needs long-term care. A MAPT is designed to help you avoid draining your assets if you don’t have long-term care insurance, but need to pay for nursing home care.
Medicaid pays for long-term care, but it can be difficult to qualify…which is where the MAPT steps in to play. To qualify for Medicaid, the state will generally look at your income and assets. If you’ve worked hard to obtain a healthy savings account and own your home, you may not qualify, unless you spend down your assets. A MAPT, however, allows you to avoid that potential scenario.
How Does a Medicaid Asset Protection Trust Work?
A MAPT is a type of irrevocable trust, which means that once you place your assets in the trust you cannot take them back out. The type of assets you can include in a MAPT are:
- Savings Account
- CD’s
- Investments accounts
- Cash value life insurance policies
- Your primary home and other real estate
Benefits of a MAPT
The main benefit of a MAPT is that it protects those assets placed into the trust so they are exempt when you attempt to qualify for Medicaid. When a couple has to spend-down their savings and assets, this can shrink the size of the estate that is left to a surviving spouse or family members. Selling off assets can also have certain tax implications if you’re required to pay capital gains on the sale. A MAPT allows you to avoid these situations.
Special Considerations to Keep in Mind
While MAPTs are put in place to help you protect your assets in order to qualify for Medicaid, it’s important to remember the look-back period. The look-back period for Alabama is 60 months prior to your Medicaid application date. So, if you want to use a MAPT to protect your assets, then it’s wise to create one sooner rather than later.
Another important consideration is that this type of trust is irrevocable, which means that once assets are placed in the trust, they cannot be taken back. It is vital to ensure that you are comfortable with the permanent transfer of your assets into this trust.
Talk with an Estate Planning Attorney
Everyone has a unique financial situation and estate planning needs, so it is extremely important to talk to an estate planning attorney who can help you understand all of your options, and which may be best for you, your family, and your assets.
If you have questions about creating a Medicaid Asset Protection Trust—or an estate plan altogether—we encourage you to contact Miller Estate & Elder Law at (256) 251-2137 or register for one of our free estate planning workshops.
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by Bill Miller | Sep 13, 2021 | Blog, Medicaid, Medicaid Planning, Medicaid Qualification
If you or a family member have ever needed long-term care, then you probably understand the importance of Medicaid, especially Medicaid asset protection. While neither Medicare nor health insurance will cover the cost of long-term care, Medicaid will. However, to qualify for this prodigious benefit, one must meet the income and asset restrictions.
Medicaid Asset Protection Trust Defined
A Medicaid asset protection trust is an irrevocable trust that is designed to hold assets so that they are no longer countable if you have to apply for Medicaid. This type of trust allows you to pass assets on to your children and grandchildren because they are not counted for Medicaid purposes and therefore do not have to be “spent down” to qualify for Medicaid. A Medicaid asset protection trust should be established at least 60 months before your application date, so it’s critical that you take advantage of Medicaid planning before the need arises.
Why You Need One
If you ever have to go into long-term nursing home care, the assets in the Medicaid asset protection trust are not considered by Medicaid as long as they’ve been held in the trust for at least 60 months. What this means is that even with your money and assets in this trust, no one can touch or move your assets.
For people who are trying to protect their assets from long-term care costs, a Medicaid asset protection trust is a great option. This is also a much safer option than giving away your assets to your children, because your assets are protected and not at risk to your children’s creditors – such as divorce, tax liens, lawsuits, bankruptcies, etc.
With the Medicaid asset protection trust, you get the benefits of having your children managing your assets without risking your assets to their creditors and predators. If protecting your assets is important to you then we highly recommend medicaid planning as part of your estate plan.
If you would like to explore the option of a Medicaid asset protection trust, then contact Miller Estate & Elder Law at (256) 251-2137 or register for one of our free estate planning workshops.
by Bill Miller | Jul 13, 2021 | Blog, Medicaid, Medicaid Planning, Medicaid Qualification
Medicaid is widely known but often misconstrued. With laws and regulations constantly changing, there is a possibility that you’ve heard incorrect or outdated information along the way. We’re here to help debunk some of the most common misconceptions about Medicaid eligibility, but first let’s cover a few of the basics.
What Is Medicaid?
Medicaid provides health coverage to low income families, disabled adults, and nursing home residents.
Who is Eligible for Medicaid?
Medicaid Eligibility varies from group to group. You can find the full list of eligibility requirements on the Alabama Medicaid website.
Myth #1: You cannot use Medicaid and Medicare simultaneously
False. Medicare is a federal program that provides health coverage primarily for those over the age of 65. Medicaid is a federal and state program that provides health coverage to low income people, and those with disabilities. If you qualify for both Medicaid and Medicare, then you can use both.
Myth #2: Medicaid is a lot like Medicare
While Medicaid and Medicare can be similar, they are also very different. For instance, Medicare will only pay for 100 days of long-term care in a nursing home, while Medicaid will pay indefinitely for long-term care for recipients. Nursing home care in Alabama can cost around $70,000/year, so it’s important to plan ahead.
Myth #3: You can only apply for Medicaid if you are going to long-term care.
Did you learn to dial 9-1-1 after an emergency or before? If you have the proper Medicaid qualifications, then apply ASAP. It’s much easier to have Medicaid and not need it, than to need Medicaid and not have it.
Myth #4: Only lower income individuals are Medicaid qualified.
While it is true that Medicaid qualifications do have income restrictions, including Alabama Medicaid planning as part of your estate plan can be extremely beneficial. By planning ahead, it’s possible to use asset protection strategies to safeguard your estate.
Myth #5: Medicaid only looks at the individual’s income, so you can give away your assets to your spouse or kids.
Medicaid caseworkers will review all income, assets and financial records of both you and your spouse going back 60-months prior to the date on your application. Giving away assets or property in that 60-month period may tie up your application and cause penalties that can prevent you from getting the care you need.
Don’t let long-term care issues give you a sudden and unpleasant surprise. Know where you stand now, and how to plan for the future. At Miller Estate and Elder Law, we have helped many families with both advanced planning and crisis planning. Give us a call at 256-251-2137 or use our convenient contact form below to reach out to our legal team today.
by Bill Miller | May 24, 2021 | Blog, Elder Law, Medicaid, Medicaid Planning
According to the United States Census Bureau, by 2030 one in five residents in the United States will be of retirement age. Many of us will eventually require costly long-term care in our old age. Medicaid planning is one important step that helps individuals prepare for their loved ones’ care needs or for their own future long-term care needs and should be part of every estate plan.
Medicaid planning can help individuals make the most of the financial help available for long-term care in Alabama. Since there are income and asset caps for those hoping to qualify for Medicaid benefits, Medicaid planning can provide options for protecting assets and income while still qualifying for benefits.
What Is Medicaid Planning?
Medicaid planning will depend on an individual’s circumstances and can be as simple as receiving assistance with a Medicaid application. However, ideally, Medicaid planning should commence years in advance of any potential care needs and can involve the restructuring of financial assets to ensure eligibility for benefits.
If an individual’s income or assets exceed the caps set by Medicaid, various options may be available, such as Qualified Income Trusts (QIT) and converting countable assets into non-countable assets. Other challenges that Medicaid planners can help with include asset and income division in the event that one spouse needs long-term care while the other continues to live independently.
Contacting experienced attorneys that are Medicaid planners with the appropriate legal and financial expertise can be an important step for those hoping to qualify for Medicaid. Mistakes with Medicaid planning can lead to costly and irreversible consequences.
Mistakes to Avoid with Medicaid Planning
When making plans for long-term care, consider contacting an estate planning attorney to help you determine if either you or your loved one need residential or long-term care. It can be a substantial mistake to simply ignore planning issues, as Medicaid rules and eligibility criteria for benefits are complex and timely planning is essential. However, it is never too late to get help. Even once a loved one has moved into residential care, an attorney can still help with protecting assets and receiving Medicaid benefits.
Ignoring the Look-Back Period
While it can be tempting to transfer large sums to children or grandchildren in order to qualify for Medicaid benefits, in many instances this can be a detrimental decision. Your financial transactions will be subject to review going back several years. The so-called “look-back period” is currently 60 months in Alabama, according to Medicaid.
Other mistakes to avoid with Medicaid planning can include:
● Applying too early or too late
● Not having a power of attorney
● Not taking advantage of spousal protections
● Taking advice from friends and family rather than seeking professional help
Call Miller Estate and Elder Law Today for Medicaid Planning
Do not procrastinate when it comes to Medicaid planning. If you are reaching retirement age, planning for potential long-term care needs can be essential for your future financial health. An experienced elder law attorney from our firm can help you with all aspects of Medicaid planning, including but not limited to:
● Medicaid applications
● Meeting income and asset limits set by Medicaid
● Protecting your income and assets
● Assisting you with long term planning and immediate crisis situations
● Making sure your spouse’s income and assets are protected
Due to the look-back period, planning well in advance can be important. Contact Miller Estate and Elder Law today to find out how we can help you: 256-472-1900.
by Bill Miller | Mar 1, 2021 | Blog, Medicaid, Medicaid Planning, Medicaid Qualification
A change in government inevitably means changes in legislation and the new administration is no exception. On his first day in office, President Biden signed ten executive orders which address a range of topics including vaccine production, testing, and access to healthcare. One, entitled “Executive Order on Strengthening Medicaid and the Affordable Care Act” is of special relevance to long-term care planning—a subject which concerns everyone, especially as Covid-19 continues to threaten communities.
Medicaid-Specific Changes
The central message of policy introduced by the new administration is that Medicaid will operate as a cornerstone of the Affordable Care Act and, according to Jocelyn Guyer, managing director at Manatt Health, “a primary vehicle for coverage for people, particularly during the pandemic.” This will be achieved in two principle ways.
First, states given ten-year expansion waivers which exempt them from certain provisions of federal law in state Medicaid programs may see those revoked. In turn, these states could receive increased federal funding aimed at expanding the program. Areas where significant gaps in low-income coverage exist are the most likely to be affected by such shifts in policy.
Second, the new administration is likely to act against block grants approved by the previous administration. These grants, which permit states to transform their Medicaid programs into demonstration projects that seek to develop alternative coverage options stand in the way of Medicaid’s expansion.
What Does This Mean for Individuals?
None of the changes mentioned have yet become policy and yet the Biden administration’s priorities are clear. Access to Medicaid looks set to expand and policies that undermine protections for patients with pre-existing conditions, create barriers to coverage, or reduce affordability will likely be eliminated. This means that even more so than before, Medicaid is the best way for most US families to gain protection from the crippling costs of long-term care.
The sooner you begin planning, the easier it is to ensure you qualify for Medicaid when you need it. After all, one aspect of the program that is sure not to change regardless of who sits in the Oval Office is the five-year lookback period employed to dissuade applicants from making inappropriate gifts or transfers for the purpose of meeting Medicaid’s asset and income limitations. This rule means that individuals who strategically shuffle around finances within the five-year period preceding their need for Medicaid are subject to a penalty period inhibiting their access to the program. If planning begins more than five years prior, however, access can be assured.
There is nothing wrong with arranging assets to make sure you are covered in your golden years. As a rule of thumb, in 2021 an individual must have income less than $2,382 per month and no more than $2,000 in in assets to qualify for nursing home Medicaid. While these limitations do not count an individual’s house, they are nonetheless stringent enough to exclude most middle-income families. Nonetheless, most middle-income families will struggle to pay the average $8,700 monthly cost of nursing home care and so planning to ensure you aren’t stuck with such a bill is crucial.
At Miller Estate and Elder Law we offer free estate planning and asset protection workshops designed to educate clients about how best to plan for their individual long-term care needs. We also bring years of experience to the planning process, itself, and so whether you are looking to get started or simply learn more about how Medicaid is changing in 2021, don’t hesitate to give our office a call at 256 251-2137 or contact us through our website.
