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 | Nov 19, 2018 | Medicaid, Medicaid Planning, Medicaid Qualification
If you have ever spent any time in an emergency room, you know how stressful it is. You may find yourself sitting beside a loved one anxiously awaiting a diagnosis. Or maybe you will be the one in need of emergency care. Either way, you may find yourself wondering how to pay for future medical treatments and long-term care. Medicaid may be an option, but first you need to find out if you or your loved one is eligible for Medicaid. Understanding Medicaid and its eligibility requirements might help.
First, Medicaid is funded by the federal government, but administered by individual state agencies. The program supplies health care for people in need. However, not everyone can receive Medicaid. Applicants to the program must meet strict requirements to qualify.
Understanding Medicaid Medical Eligibility
Some people think Medicaid is only for elderly people. However, there are several programs within Medicaid that aid other groups, like pregnant women and children.
Eligibility requirements vary depending on the program you apply for. No matter which program you choose, however, you must show a medical need, be disabled, or be blind. For example, to qualify for the Medicaid for Elderly and Disabled program, you may need to prove that long-term nursing care is needed.
Applicants also must meet income and resource limits to qualify for Medicaid coverage.
Understanding Medicaid Financial Eligibility
Income is only one test used to determine Medicaid eligibility. Applicants must also prove their assets and resources are within limits in most Medicaid programs. Also, income, asset, and resource limits may vary. For example, Medicaid limits for 2018 are:
- Qualifying Through SSI: Aged, blind, or disabled individuals may earn $770 per month for one person, $1,145 for a couple. Resources cannot exceed $2,000 (single) or $3,000 (couple) per month.
- Nursing Home Medicaid: Individuals eligible for institutional care have an income limit of $2,250 per month and a $2,000 resource limit as of the first day of the month.
- Home and Community Based Waivers: The limit is $2,250 per month for income and $2,000 per month for resources.
This list does not include other programs, such as those for children, parents and caretaker relatives, pregnant women, among others.
Applying for Medicaid Is Hard. We Can Help.
The attorneys at Miller Estate and Elder Law understand the estate planning needs of their clients. 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.
by Bill Miller | Oct 4, 2018 | Medicaid, Medicaid Planning, Medicaid Qualification
Failing to qualify for benefits you desperately need is distressing. Yet benefit programs have to have limits and requirements. Take Medicaid. It provides much-needed benefits to eligible persons. Eligibility is based, in part, on income and resources, or property owned by the person applying for Medicaid. When someone needs help, but their income exceeds the Medicaid monthly income limit, what options do they have?
Medicaid, Generally
This federally-funded, state-administered program provides services for a wide range of people and needs:
- Children,
- Parents and other caretaker relatives,
- Pregnant women,
- People in need of family planning,
- Nursing home residents,
- Elderly and disabled persons,
- Medicare recipients who need help making their payments, and
- Women suffering from breast or cervical cancer.
However, people in need also must have income and resources below Medicaid’s limits.
Medicaid Monthly Income Limits
Different programs have different monthly income limits:
- Aged, blind or disabled people qualifying through SSI: $770 (single) or $1,145 (married).
- Nursing home residents: $2,250
- Pregnant women, children, and those who need family planning: $1,478 (family of 1) to $3,054 (family of 4)
- Parent and Caretaker Relatives: $183 (family of 1) to $377 (family of 4).
These income limits may change from time to time. You or your attorney should check the limits before applying for Medicaid.
When Income Exceeds the Medicaid Monthly Income Limit
Some people, especially those who need long-term care, may benefit from a qualified income trust. When this trust is used, the person who established the trust can move extra income into the trust, where it is no longer counted toward the Medicaid monthly income limit. The trustee may use the trust funds to pay for personal needs, a portion of the person’s nursing home bills, and monthly support for the benefit recipient’s spouse.
Does Your Income Exceed the Medicaid Monthly Income Limit?
At Miller Estate and Elder Law, we help our clients qualify for and keep their Medicaid benefits. For a free consultation, contact us at 256-251-2137 or use our convenient Contact Form. We have offices in Anniston and Birmingham and we assist clients in the Leeds, Gadsden, Hoover, Talladega, Vestavia Hills, and surrounding areas.
by Bill Miller | Sep 19, 2018 | Medicaid, Medicaid Planning, Medicaid Qualification
Laura breathed a sigh of relief when her father, Gene, became eligible for Medicaid. He did not have any savings or a long-term care insurance policy. She wasn’t sure how long she could keep paying nursing home bills. However, Laura learned that her job was not over when it came to Gene’s Medicaid. Every month, she needed to make sure to keep his income within Medicaid’s resource limits.
What are Medicaid’s resource limits?
Applicants must meet certain requirements, or resource limits, before becoming eligible for Medicaid. For example, an applicant cannot receive monthly income exceeding a set amount. In 2018, the income level is $2,025 although that may be adjusted annually for inflation.
Medicaid recipients must not have more than $2,000 in resources on the first day of the month. “Resources” may be:
- Cash,
- Bank Accounts,
- Cash value of life insurance, and
- investment income.
Every month, Laura worries that her dad’s Social Security check will be deposited in his bank account before the first of the month. This might put his resources over the limit. Also, he has some small investments that pay quarterly dividends. These may also cause problems with his Medicaid eligibility.
What steps can I take to stay within Medicaid’s resource limits?
First, learn what those limits are, because not every asset counts toward resource limits. We’ve listed some of the assets that are considered resources. The following assets are generally not included as resources:
- Household goods and personal effects,
- Burial plans,
- One car if used by the recipient’s family member, and
- Certain real property.
Please note that resource limits differ for married Medicaid recipients.
In Gene’s case, he is single. He has a checking account, a car, his Social Security benefits, and a small retirement account. Gene does not own any real property or any cash value life insurance policies. Laura is using his car now that he is no longer able to drive.
Every month, Laura watches Gene’s bank account. She knows that an unexpected quarterly dividend or interest payment could jeopardize Gene’s Medicaid benefits. As the first of the month approaches, she can pay the nursing home in advance or other bills to reduce his checking account balance.
Another option is for Laura to have an attorney set up a Qualified Income Trust, also known as a Miller Trust. Gene’s excess income, anything over the resource limit, could be deposited directly into his Miller Trust. The trustee could then use the funds for Gene’s nursing home bills and personal items.
Don’t Lose Your Medicaid Benefits.
The attorneys at Miller Estate and Elder Law use their experience and skills to assist their clients with Medicaid questions and concerns. For a free consultation, contact us at 256-251-2137 or use our convenient Contact Form to let us know you are ready to get started. You can also check out the free resources on our website. Although we’re located in Anniston, we also help clients in the Birmingham, Gadsden, Hoover, Talladega, Vestavia Hills, and surrounding areas.
by Bill Miller | Sep 3, 2018 | Elder Law, Medicaid, Medicaid Planning, Medicaid Qualification
Joe recently learned that his mother, Lillian, is applying for Medicaid. She lacks the funds and insurance to cover the cost of her 24/7 nursing care. Lillian was suddenly thrown into a world of procedures and terms that she did not understand. Joe felt a little helpless himself. His mother needs Medicaid and he does not what he can do to help her.
Help with the Medicaid Application Process
The Medicaid application process is complicated, complex, and frustrating. It’s also necessary. Medicaid is the largest payer of nursing home costs in the United States. In addition, a majority of people age 65 plus will need long-term care.
Joe can help Lillian find the right Medicaid program. For example, she probably needs either Medicaid for the Elderly and Disabled or Medicaid in the Nursing Home. He can read over the eligibility requirements and find the right application. They can apply online or using a paper application. Then, he can help her with one of the most difficult parts of the application process: finding the documents that go with the application.
Help Gather Supporting Documents
Medicaid requires a long list of supporting documents some spanning the 60 months prior to application, including:
Bank statements, annuities, life insurance policies, promissory notes, loans, property deeds, Social Security card, power of attorney, Will, trusts, long-term care insurance policy, Medicare card and Part D policies, just to name a few.
As Joe started helping Lillian gather documents, he was grateful that his mother was so organized. Many of the documents they needed were filed at her home. Other records required them to contact banks, financial institutions, and so on. Lillian signed a durable power of attorney that allowed Joe to get some records for her.
Help Find an Alabama Medicaid Attorney
It helps to have someone on your side who knows how the Medicaid system works. If an application is denied, naturally the applicant’s benefits are delayed. And, if they have an immediate need for Medicaid funds to cover their care, well, someone has to pay for it. The applicant or family members may be forced to pay substantial amounts for long-term care that could have been covered by Medicaid. That’s why it is so important to get the application right the first time.
Joe found a good elder law attorney for Lillian. In addition to helping get Lillian’s Medicaid application together, they were able to handle other estate planning issues:
- They set up a Miller Trust to handle monthly income in excess of Medicaid resource limits,
- Prepared and signed a durable power of attorney and health care power of attorney, and
- Helped Joe get his own estate planning and incapacity planning in place.
Sometimes You Just Need a Helping Hand
The application process for Medicaid is a difficult path for most people to navigate. The attorneys atMiller Estate and Elder Law use their skills and experience to make the experience a little less difficult.
For a free consultation with an experienced Alabama attorney, contact us at 256-251-2137 or use our convenient Contact Form. We have offices in Anniston and Birmingham and serve clients in Gadsden, Hoover, Talladega, Vestavia Hills, and surrounding areas.
by Bill Miller | Aug 31, 2018 | Elder Law, Medicaid, Medicaid Planning, Medicaid Qualification, Nursing Home
It’s a cold, hard fact. Many people in the United States need long-term care at some point in their lives. It’s also true that this care is expensive.
How many people really need long-term care?
As our population ages, the number of people in need of skilled nursing care will skyrocket. Today, roughly 70% of people who are age 65 will need some form of long-term care in their lifetimes.
Also, age is not the only reason people need long-term care. About 8% of people age 40-50 year age group need long-term care due to a disability. And 69% of people age 90 and up are likely to suffer from one or more disabilities.
Long-term care is expensive. How do people pay for it?
There are basically three ways to pay for this type of care:
- Self-pay, which may use up all your savings and resources.
- Long-term care insurance, which can be difficult to get as you get older.
- Public benefit programs like Medicaid.
So, it’s important that you be able to qualify for Medicaid.
That requires planning.
And Medicaid planning should take place years before you need care.
If I won’t need long-term care until I’m 65 or older, why plan now?
Medicaid programs pay more long-term care expenses than any other group. This means it’s critical that you be able to qualify for Medicaid. The whole application process is complicated and frustrating. Not everyone qualifies for Medicaid, leaving their families struggling to find other ways to pay.
The reason to start planning now is because Medicaid doesn’t just look at your current financial picture when considering your application. They actually look at financial records starting from 60 months prior to the application date. During that time, you may have transferred money or property to family as an early inheritance or just a gift. That kind gesture could reduce or eliminate your eligibility for Medicaid.
The Good News.
There are ways to prepare for Medicaid, well in advance of the time you need it. It’s complicated, but we can help.
The attorneys at Miller Estate and Elder Law assist clients just like you apply for Medicaid benefits. We also help with Medicaid planning and estate planning. For a free consultation with an experienced Alabama attorney, contact us at 256-251-2137 or use our convenient Contact Form.
We also offer free guides, videos, and workshops.
We have offices in Anniston and Birmingham and serve clients in Gadsden, Hoover, Talladega, Vestavia Hills, and surrounding areas.
