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 With laws and regulations constantly changing, there is a possibility that you’ve heard incorrect or outdated information along the way.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 | 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.
by Bill Miller | Jan 18, 2021 | Blog, Medicaid, Medicaid Planning, Medicaid Qualification
With 2020 now receding from view and an end to the Covid-19 pandemic (hopefully) in sight, that sigh of relief so many of us need is finally on the horizon. The New Year brings promise of better times and yet it would be foolish to forget the lessons of the last twelve months. Chief among these is that health cannot be taken for granted and having a plan to ensure access to care is essential. For millions nation-wide, this means organizing assets in order to qualify for Medicaid. After all, despite common misconception, Medicaid is the best way for many folks to gain the long-term care coverage they need.
Five Frequent Medicaid Myths
- Only Low-Income Adults Qualify
This is both the most common and most deeply-flawed misunderstanding on this list. First, nearly half (49.7%) of the 76 million Americans receiving Medicaid are children (which is part of why planning is essential for people of any age) and second, many millions of middle-income individuals may qualify with proper foresight.
- Gaining Coverage Means Hiding Your Assets
Not only is this notion mistaken, it is unethical. An experienced (and honest) attorney can walk you through such common practices as spousal income and asset transfers, annuities, Medicaid asset protection trusts, and qualified income trusts (to name just a few legal instruments). All of these both work to preserve your assets and are reported directly to Medicaid through the application process.
- Medicaid Means You (or Your Parents) Will Lose Their Home
This misconception is related to the above but because of its prevalence (and frightening nature) it deserves individual mention. Contrary to popular belief, Medicaid rules, in fact, aim to preserve the family home. What’s more, a well-organized plan can prevent the home from being lost in what is referred to as estate recovery when the person receiving benefits dies. While too much to get into here, an experienced attorney can walk you through all of the details.
- Medicaid Only Covers Nursing Homes
It is true that traditionally Medicaid has mostly paid for nursing home care costs and yet (because nobody wants to be in a nursing home) some states, including Texas, offer home and community-based services (HCBS) programs. These programs allow beneficiaries to receive care in their own home or community rather than in an isolated setting and strive to make lifestyle decisions in consultation with each individual’s unique needs.
- It Is Too Late to Gain Coverage
Regardless of your age, financial well-being, or medical history, it is never too late (or too early!) to initiate long-term care planning. While it is true that Medicaid employs a five-year look-back period when assessing an applicant’s financial eligibility, you may still gain access and retain significant assets with proper planning even if you need care now.
According to government data, a person turning 65 today has an almost 70% chance of needing some type of long-term care in their remaining years. Such care comes at an overwhelming cost and yet this need not be a burden if you have a plan in place. The simple act of getting started on building such a plan provides immense relief and if there’s one thing most people in the US need right now, it’s just that: relief.
Download our FREE Medicaid Planning in Alabama: What You Need To Know Guide to help you get the ball rolling toward a worry-free 2021! Contact us today to set up a consultation or if you have any questions.
by Bill Miller | Sep 14, 2020 | Blog, Medicaid, Medicaid Planning, Medicaid Qualification
Medical emergencies can strike without warning. Martin’s family learned that when he suffered a major stroke and landed in the emergency room. He needed skilled, 24/7 nursing care. Unfortunately, he had never done any Medicaid planning or even wondered, “Do I qualify for Medicaid.” His family had to scramble to find ways to pay for his care until his Medicaid application was processed. Don’t be like Martin. As you consider whether you might qualify for Medicaid for the Elderly & Disabled or Institutional Medicaid, think about the following questions.
Do I have a physical or mental condition that meets Medicaid requirements?
To receive Medicaid for Institutional Care, you must be in the hospital, a nursing home, or an ICF-IID facility. Medicaid usually needs to see a doctor’s diagnosis for this type of care for it to be covered.
To receive Home and Community-Based Waivers, you must be “elderly, disabled, homebound, mentally disabled, or have certain medical diagnoses…”
As Medicaid caseworkers review your application, they will review your medical records to make sure you meet the medical requirements for the appropriate program.
Do I meet residency requirements?
Since Medicaid is a joint federal-state program, each state has some flexibility in how it manages its own Medicaid program.
To receive Alabama Medicaid benefits, you must be a resident of Alabama. Also, you must be a U.S. citizen or a qualified non-citizen.
Do you meet Medicaid’s income and resource limits?
These limits vary from program to program. However, the income and resource limits for E&D and Institutional Care are:
• Income limit: $2,030 per month
• Resource limit: $2,000 as of the first day of each month.
There are special rules for married individuals. When deciding whether you qualify for Medicaid or not, talk to an experienced Alabama Medicaid lawyer to make sure.
Answer the Question, “Do I Qualify for Medicaid?”
Discuss your circumstances with an experienced Alabama Medicaid lawyer.
Contact us at 256-472-1900 for a free consultation. The attorneys at Miller Estate and Elder Law know how to help you with Medicaid planning and with estate recovery concerns. 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.
Also, receive a free download of Medicaid Planning in Alabama: What You Need to Know by completing the brief form below:
by Bill Miller | Aug 24, 2020 | Blog, Medicaid, Medicaid Qualification, Uncategorized
Almost 90 million American rely on Medicaid for health care benefits. In fact, Medicaid pays for more health care than any company in the United States. So, you may immediately think of Medicaid when you can’t pay for your medical care. You may be wondering, “How do I apply for Medicaid?” This article may provide an answer to this important question.
Choosing the Right Program
Medicaid does not just offer one benefit or one program. Alabama Medicaid offers several benefits, including:
- Medicaid for Children
- Medicaid for Parents and Caretaker Relatives
- Medicaid for Pregnant Women
- Medicaid for the Elderly and Disabled
- Medicaid in the Nursing Home
As you can see, Medicaid has programs to cover Americans from the cradle to the grave. Also, many individual programs consist of more than one element. For example, Medicaid for the Elderly and Disabled (E&D) also offers Home and Community-Based Waivers and SSI-Related Programs.
Once you choose the programs you need, it’s time to apply.
Completing the Paperwork
The Alabama Medicaid website contains several applications and additional forms. Certain programs require or allow online applications. Choose the forms that you need for the program you want.
Another form – Tips for Applying for Institutional (Nursing Home) Medicaid – offers a list of documents needed. The form also offers tips for making the process a little easier.
The most important thing to remember is that your application must be complete, with all supporting documents.
Submitting the Application
The final step is getting your application to the right place:
- Apply online if you are pregnant, applying for a child, or applying for Plan First Family Planning. You may also mail an application to P. O. Box 5624, Montgomery, AL 36103-5624.
- Use a paper application to apply for nursing home care, home and community-based waiver program, or help paying for Medicare. You may also contact the district office or Customer Service Center for your county.
“How Do I Apply for Medicaid?” With Help from Someone Who Understands
Applying for Medicaid is time consuming, frustrating, and difficult. You can ease the process a little by finding an experienced Alabama Medicaid attorney.
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 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 | Aug 17, 2020 | Blog, Medicaid, Medicaid Planning, Medicaid Qualification, Uncategorized
Sometimes the more answers we get, the more questions we have. The same may be true when it comes to Medicaid. Someone who needs help paying for medical care or a nursing home may be relieved to learn that Medicaid offers this type of benefits. Then they learn that the application process is difficult. You have to qualify for Medicaid benefits, and some of the requirements are hard to understand. For example, you may want to learn more about the Medicaid income limit. That’s what we will explore in this blog.
First, what are the basic Medicaid qualifications?
Medicaid offers several programs, each with its own qualifications. For example, Medicaid for Pregnant Women and Medicaid in the Nursing Home target very different groups. That said, Medicaid generally is intended for people with low incomes. Applicants who exceed the Medicaid income limit usually will not qualify for benefits.
What is the current Medicaid income limit?
It varies. The income limit for people who qualify through Supplemental Security Income (SSI) is $791 per month / $1,177 for couples.
However, the Medicaid in the Nursing Home program income limit is $2,313 per month for one person. This limit also applies to:
- Elderly and Disabled Waiver,
- Independent Living Waiver,
- Persons with Intellectual Disabilities Waiver, and
- Technology-Assisted Waiver for Adults.
Effective February 2019, Medicaid uses the Modified Adjusted Gross Income (MAGI) method of determining income for some programs. For example, the Plan First and Pregnant Women & Children programs calculate income after deductions based on family size:
Family of 1 = $1,520
Family of 2 = $2,058
Family of 3 = $2,596
Family of 4 = $3,133
You may be wondering if Medicaid counts all your income when determining if you are qualified for benefits.
What does Medicaid consider to be income?
Generally, Medicaid counts all the following income toward your Medicaid income limit:
- Federal taxable wages;
- Self-employment income;
- Unemployment compensation;
- Social Security benefits, including Social Security Disability Income (SSDI);
- Retirement or pension income;
- Alimony or spousal support for divorces finalized before January 1, 2019;
- Capital gains;
- Investment income;
- Rental and royalty income; and
- Untaxed foreign income.
Income that is not counted toward the limit includes:
- Supplemental Security Income (SSI);
- Veterans’ disability payments,
- Workers’ Compensation,
- Proceeds from loans, including student loans; and
- Child support.
I’m just over Medicaid income limit. Is there anything I can do?
Possibly. Just talk to an experienced Alabama Medicaid lawyer about Medicaid planning and spend-down strategies.
The attorneys at Miller Estate and Elder Law assist their clients with Medicaid and incapacity 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, Medicaid Planning in Alabama: What You Need to Know, by clicking here.
