by Bill Miller | Jun 19, 2018 | Estate Planning, Medicaid, Medicaid Planning
Many people have never heard of Medicaid Estate Recovery. Medicaid recipients may not realize that benefits received for long-term care may have to be repaid. After certain recipients pass away, Medicaid may attempt to recovery some or all of the funds paid for their care. You may need Medicaid benefits in the future, so it’s important to know how to go about protecting your estate from Medicaid recovery.
What is Medicaid Estate Recovery?
Medicaid is a federally funded, state administered program that pays health-care benefits to qualified individuals.
Due to federal law, individual state Medicaid programs must attempt to recover some of the money paid to certain recipients age 55 or older. As with most government programs, there are restrictions to Medicaid Estate Recovery.
And there are ways to protect against it.
Protection from Medicaid Estate Recovery.
Advance planning is key. It may be too late if Medicaid files a claim against an estate.
Alabama’s Partnership for Long-Term Care program allows people to buy long-term care insurance. Restrictions apply, and you may need to qualify to purchase this insurance.
Some use trusts as a part of their estate planning with an eye toward asset protection. Currently, only an irrevocable trust provides protection from Medicaid Estate Recovery. Even then, an irrevocable trust is still subject to Medicaid’s 60-month look back period.
Simply giving your assets to your family may create more problems than it solves. Your estate may be protected from Medicaid Recovery, but there’s no guarantee your family will do the right thing.
Your best course of action is to talk to an attorney who has extensive Medicaid experience.
A Final Note.
Some states have what are called filial responsibility laws. In these states, children can be held accountable for their parents’ nursing home bills. Fortunately, Alabama does not have this type of law.
Learn More About Protecting Your Estate.
The attorneys at Miller Estate and Elder Law can help you with Medicaid eligibility, applications, and asset protection. 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 | Jun 17, 2018 | Elder Law, Estate Planning, Medicaid
Elderly people often want to remain in their homes as long as practical. But their caregivers and loved ones face some tough decisions. How can they keep Grandma Ruth safe while respecting her rights? Sometimes, Medicaid home and community-based waivers provide the best solution to a difficult situation.
Avoiding the Move to a Nursing Facility
Long-term nursing care doesn’t have to mean you have to pack up and move to a nursing home. When it’s appropriate for a patient, in-home care is preferred over residential care. For one thing, it’s less expensive. Depending on the level of care needed and the location, costs may be as follows:
Nursing home care – between about $200-$235 per day, or approximately $6,000 – $7,000 per month.
Assisted living care – about $2,930 per month. Care for patients with severe Alzheimer’s or dementia may cost $830 more per month.
Adult day care – averages around $47 a day. Again, it’s more expensive in some areas than others.
In-Home Care – typically costs $17 to $22 per hour. Monthly cost, of course, varies depending on the number of hours the paid caregiver works. At 4 hours a day, 20 days a month, the cost would range from $1,360 to $1760.
So, How Can Medicaid Help?
Home- and community-based services are available to qualified Medicaid applicants. The Alabama Elderly and Disabled (E & D) Medicaid Waiver program offers waivers to people age 65 or older, or disabled. Those who qualify may have the state manage their care or may choose their care providers through a program called Personal Choices. This is sometimes called self-directed, participant direction, or cash and counseling.
The waivers are used to pay for in-home or community-based care. The program will not pay for 24/7 in-home care, though.
Use of Medicaid waivers for in-home care helps individuals while also reducing costs for Medicaid. However, participants in the program must first be qualified to receive Medicaid benefits.
Eligibility Is the Issue.
The attorneys at Miller Estate and Elder Law assist clients with applying for the right public benefits, like the Alabama Elderly and Disabled (E & D) Medicaid Waiver program.
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 | Jun 15, 2018 | Medicaid, Medicaid Planning
Max was going about his daily life when suddenly he got a call he’d been dreading. His Great Aunt Maude was critically ill, and Max soon learned that she would need 24/7 nursing care. She doesn’t have any insurance or savings accounts, and public benefits will have to pay – if she’s eligible. In addition to comforting his great aunt, Max had to scramble to apply for emergency Medicaid.
Alabama Nursing Home Medicaid Eligibility
This government-funded benefit offers assistance if applicants meet the following conditions:
- Applicant must prove nursing home care is due to a medical condition.
- Most applicants must live in a nursing home for at least 30 continuous days.
- The applicant’s monthly income must be below limit, which is set in January each year. The current limit is $2,205 per month.
- The value of applicant’s resources must be below a limit set by Medicaid. The limit for an individual is $2,000, but there are special exceptions if the applicant’s spouse will continue to live in their home.
- The applicant must be a S. citizen living in Alabama.
While this may sound simple, regulations also contain exceptions and special situations. It’s best to consult with an attorney who understands the Medicaid application process.
The Application Process
Completing an application, either online or in paper format, is just the first step.
Applicants are required to include a lot of information and documentation. A Medicaid caseworker will review the application. By law, they must review income and expense documents starting 5 years before the date of the application.
The application, along with all supporting documentation, is then submitted to Medicaid for review. It’s important to send the application to the right office, which can be found by calling Medicaid or searching online. Mailing the application to the office that handles Medicaid for Pregnant Women or Children, for example, could delay approval of the application.
Medicaid mails a decision letter to applicants at the address shown on the application. Sometimes applicants will be asked for more information or for clarification before Medicaid can approve or deny the application.
Don’t let Medicaid eligibility issues creep up on you.
Finding out that you need emergency Medicaid during a medical crisis is tougher than you can imagine. Know where you stand now, and how to plan for Medicaid eligibility before illness strikes.
Talk to an Alabama attorney with experience and training to handle your concerns. Contact Miller Estate and Elder Law at 256-251-2137 to schedule an appointment. Though our offices are located in Anniston and Birmingham, we assist clients in surrounding communities like Talladega, Gadsden and Vestavia Hills.
by Bill Miller | Jun 14, 2018 | Elder Law, Estate Planning, Medicaid
A job transfer took Harriet from Michigan to Alabama. The move was stressful, as most moves are. However, Harriet’s relocation was more complex than most. As an only child, Harriet was the only source of reliable help for her mother, who lived in a nursing home in Michigan. Harriet began making plans to move her Mother, but was concerned about her Medicaid benefits.
Medicaid Benefits
Although the funds for Medicaid flow from the federal government, individual states act as administrators of those funds. However, states are allowed to customize some rules and regulations. This flexibility means the rules for receiving Medicaid differ depending on your state of residence.
Fortunately, there are processes in place to move a Medicaid recipient from one state to another. Unfortunately, that process is not as easy as it could be.
Not Exactly a Transfer
First, the Medicaid coverage in the former state cannot just be transferred to the new state. Each state has different eligibility rules, and the recipient must meet the requirements of the new state. Also, Medicaid recipients are not allowed to have coverage in more than one state. So, establishing residency in the new state is the first step. The recipient then can cancel coverage from their former state and apply for Medicaid in their new state.
Requirements Related to Moving
The good news is that it’s probably not impossible to qualify for Medicaid in a new state. Although requirements vary, most states eligibility requirements are similar. A person who is already qualified for Medicaid in one state stands a good chance of qualifying in another state.
No length of residency requirement. States are not allowed to place length of residency requirements on applicants. An applicant can establish residency simply by moving to the new state.
Coverage can be retroactive. Naturally, it takes some time to get approval from the new state’s Medicaid agency. Fortunately, there should be no gap in coverage because Medicaid can be granted retroactively.
Maintain Medicaid Coverage During a Move.
Harriet was able to safely move her mother to a nursing home in Alabama. She cancelled the Michigan Medicaid benefits and immediately applied for Alabama Medicaid. Her mother’s application was approved, and her coverage continued.
Do you or a loved one need Medicaid assistance? Schedule an appointment with one of the qualified elder law attorneys at Miller Estate and Elder Law Our phone number 256-251-2137. Or you may choose to use our Contact Form to get started on your path to peace of mind.
by Bill Miller | Jun 12, 2018 | Medicaid, Medicaid Planning
You may be wondering, “What are the chances I will ever need Medicaid.” Well, about 72 million people received Medicaid benefits in 2017, including younger disabled people, pregnant women, children, and older adults. About 52 percent of people currently age 65 will need long-term care in the future. Many of these people will need help paying for that care. Even people who are currently in good health should start thinking about their five year plan for Medicaid eligibility.
Who is eligible for Medicaid benefits?
Caseworkers review several factors to determine an individual’s eligibility for Medicaid. Each Medicaid program has different requirements. We’ll just be considering two programs: Medicaid for Elderly & Disabled and Medicaid in the Nursing Home.
To receive Alabama Medicaid benefits, applicants have to meet medical, income, and citizenship requirements. An individual might meet those requirements if they:
- Are medically proven to need nursing home care;
- Have lived in the facility for more than 30 continuous days;
- Have a monthly income less than the limit, which is currently $2,205;
- Own resources valued below the current limit; and
- Are citizens of the U.S. and Alabama.
What might block Medicaid eligibility?
Sometimes eligibility is denied for preventable reasons.
For example, Medicaid reviews income and expenses for the 60 months prior to the application date. Large transfers of property or income during that 5-year time frame – the “look back” period – could make the applicant ineligible for months or years – the penalty period. The length of the penalty period varies depending on the amount of money given away.
Proper estate planning before the Medicaid benefits are needed could transfer an individual’s assets in a way that is acceptable to Medicaid. Creating and funding an irrevocable trust may protect the assets for your heirs without affecting your Medicaid eligibility.
It’s great to start Medicaid planning five years out … but we have no way of knowing when or even if we will be incapacitated.
Start your Medicaid planning today.
Even if you haven’t started planning five years in advance, you can still benefit from the advice you’ll receive from the attorneys at Adams Miller.
Don’t let Medicaid eligibility issues give you an unpleasant surprise. Know where you stand now, and how to plan for the future. Talk to an Alabama attorney with experience and training to handle your concerns. ContactMiller Estate and Elder Law, at 256-251-2137 to schedule an appointment. We help clients in Anniston, Talladega, Birmingham, Gadsden and surrounding communities.
by Bill Miller | Jun 8, 2018 | Elder Care Planning, Medicaid
Phil M. lived in a rehabilitation center after suffering a stroke last year. Fortunately, he qualified for Medicaid benefits that covered the high cost of treatment. However, after six months, he and his family felt he was ready to move back to the community and live the independent life he desired. A wise friend pointed them in the direction of Gateway to Community Living.
What is Gateway to Community Living?
It’s a program administered by the Alabama Medicaid Agency. Through this program, elderly people or those with disabilities may be able to live at home with community assistance.
Phil seemed like an excellent candidate for this program. His rehabilitation left him able to care for his daily needs. More importantly, he had a strong desire to live independently for as long as possible.
What services are provided?
Home and community-based programs offer a spectrum of services to meet the population’s diverse needs.
Transition coordinators work with applicants to work out eligibility. In addition, they help applicants work out a custom transition plan.
Specific benefits include:
- Financial assistance with moving costs, and deposits for rent and utilities.
- Help people find affordable, accessible housing.
- Job search assistants for applicants who are returning to the work force.
Phil was able to work with his transition coordinator to find a comfortable apartment in an independent living facility. Gateway also helped him apply for part-time jobs that fit his physical abilities.
Who can receive Gateway to Community Living assistance?
Applicants must meet the following requirements:
- Has lived in a nursing home or qualified facility for at least 90 consecutive days.
- Received Medicaid for at least one day before transitioning to community living.
- Expect to complete their transition within 180 days.
- Be physically and mentally capable of living in the community with assistance.
People who feel they might benefit from Gateway to Community Living can ask the staff at their residential facility to refer them. Patients or their legal guardians and family members may also “self-refer” either online, by email, fax, or regular mail.
The social worker at Phil’s rehab facility referred him for Gateway benefits and helped him complete the required paperwork.
Learn More About Incapacity Planning.
Maybe you have an older parent facing elder law issues. Maybe you are looking ahead to your own future. Either way, it’s important to know what rights and protections are available for senior citizens. Schedule a consultation with one of our attorneys and find out where you stand. Our phone number is 256-251-2137, or you may want to use the Contact Form on our website. We have office in in Anniston and Birmingham and assist clients in communities like Hoover, Vestavia Hills, Irondale, and Calera.
