by Bill Miller | Jun 6, 2018 | Elder Law, Medicaid, Medicaid Planning
Applying for Medicaid is tricky, and timing is important. In fact, Medicaid planning is best started years before you actually need to apply for benefits. How your property is owned, and when it was titled, makes a big difference. One way to plan ahead for Medicaid is by using a life estate deed.
What is a Life Estate Deed?
A deed is a legal document used to transfer property interests. Just as there are different types of real estate transfers, there are different types of deeds: general warranty deeds, statutory warranty deeds, quitclaim deeds, and life estate deeds.
A life estate deed is often used in estate planning. It’s also useful for Medicaid planning. Some of the benefits offered when using a life estate deed include:
- As life tenant, the property owner continues living at the property until death or incapacity.
- At the death of the life tenant, the property immediately passes to the other owners, known as remaindermen or remainder beneficiaries.
- Property passed by life estate deed is not included in probate estate. (However, it is still included in taxable estate.)
Medicaid Eligibility and Your Life Estate Deed
The Medicaid application process involves determining eligibility based, in part, on available income and resources. If an applicant owns property outright, it typically will be considered a resource. In some cases, people are denied Medicaid eligibility because their income or resources exceed the limits.
However, Alabama Medicaid guidelines do not consider property held under a life estate deed to be a resource – unless the property was transferred within the five year review period going back from the date of the application.
How might this play out? Well, if Maggie applies for Medicaid. She does not own her home outright, but has signed a life estate deed naming her children as the remainder beneficiaries. Her other resources put her well below the resource limit. Medicaid ignores the property that’s held under the life estate deed and approves her application. Several years later, Maggie passes away and the remainder beneficiaries take possession of the property. There are tax consequences of using a life estate deed that need to be considered before proceeding.
Learn More About Life Estate Deeds and Medicaid.
Even if you haven’t started Medicaid planning before you need to apply, you can still benefit from the advice you’ll receive from the attorneys at Adams & Miller, P.C.
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. Contact Miller 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 2, 2018 | Medicaid
One government program is by far the largest payer of nursing home costs in the U. S. – Medicaid. Although the funds come from the federal government, the states administer Medicaid. For example, Alabama Medicaid processes applications and distributes benefits for eligible Alabama residents. Although Medicaid covers many medical services, however, there are some services not covered by Medicaid. Before expecting Medicaid to defray your medical costs, it’s important to know what is not covered.
Services Not Covered by Medicaid:
- Routine or annual physical checkups
- Over-the-counter drugs or health supplements
- Custodial care and assistance with activities of daily living (ADLs)
- Charges for missed appointments
- Dental care
- Cosmetic surgery
- Medical services provided outside of the United States
- TV rentals and VCRs in hospital rooms, as well as meal trays and cots for guests
- Respiratory therapy, speech therapy, and occupational therapy
- Services provided to people in prison or jail
Example: Jessie qualified for Medicaid and thought all her medical needs would be covered. However, her claims for her yearly physical and her over-the-counter allergy pills were denied. She also missed several doctor’s appointments. She was charged because she did not cancel in advance. Jessie had to pay for the missed appointments. She learned the hard way about services not covered by Medicaid.
Medicaid may pay for optional medical services like:
- Eye examinations, glasses, contact lenses
- Hearing exams and aids
- Preventive screenings
- Physical therapy
- Nonemergency transportation to and from medical appointments and treatments
- Some non prescription drugs and nonprescription drugs not covered by Medicare
- Chiropractic care
Fred needed physical therapy and chiropractic care to build his strength and help him get around a little easier. Medicaid typically does not pay for these services. However, Fred should talk to a Medicaid caseworker because some assistance may be available.
In addition, Medicaid does not pay for services provided by any health care provider who does not participate in Medicaid. Make sure your doctor accepts Medicaid patients before making an appointment.
Medicaid must consider Medical treatment and supplies medically necessary. For example, Randall feels he needs to move to a nursing home, but his doctor does not. Medicaid will probably deny Randall’s request unless his request is supported by documentation showing nursing care is medically necessary.
To receive Medicaid, you must be eligible.
The Medicaid application process is long, complex, and frustrating. In addition to the application, individuals must present many documents supporting their request for benefits. Applicants who are denied coverage can appeal the denial.
Act Now.
People should plan for long-term care and Medicaid eligibility well before incapacity strikes. In doing so, you should also know about services not covered by Medicaid.
The attorneys at Miller Estate and Elder Law help their clients prepare estate plans that address future potential incapacity issues. For a free consultation, contact us at 256-251-2137 or use our convenient Contact Form. Although we’re located in Anniston, we also help clients in the Birmingham, Gadsden, Hoover, Talladega, Vestavia Hills, and surrounding areas.
by Bill Miller | May 21, 2018 | Asset Protection, Medicaid
The American dream is to work hard, build your life savings and purchase a home. But what happens when that dream is threatened? What if you want your family members to benefit from your hard work? There are ways to protect your savings from the ravages of long-term care, future creditors and civil judgments.
Protect Your Savings from Medicaid Recovery
In some cases, Medicaid programs must at least attempt to recover money paid to Medicaid recipients. Typically, Medicaid will file a claim against the deceased recipient’s estate. However, there are ways to protect your savings from Medicaid recovery:
- Alabama’s Partnership for Long-Term Care helps people buy long-term care insurance that will cover costs that otherwise might be paid by Medicaid. Although not everyone who applies will qualify, it’s certainly worth looking into.
- Irrevocable trusts are a great way to protect your savings from Medicaid recovery because the assets transferred to the trust are no longer considered your property. Medicaid’s 60-month look back period still applies, however.
Other alternatives to Medicaid:
- You can ask family and friends to agree to care for you in exchange for some type of compensation.
- You may also consider transferring assets to spouses or family members. However, this method could adversely affect your eligibility for public benefits. Another potential problem is taxes. Additionally, once you transfer your assets to someone else, you lose all control over those assets. Those assets are also subject to the creditors and predators of the person you gave them to including divorce, tax liens, bankruptcy filings and lawsuits.
Protection from Creditors and Predators
Some people need to protect their life savings from unscrupulous creditors or dishonest persons. Sadly, sometimes family members take advantage of elderly or disabled individuals by cleaning out their bank accounts with no remorse.
You can establish an asset protection trusts then fund it with your assets. In some cases, you may still receive benefits from the trust though it is protected.
Another option is to give money to family members or friends. However, you lose control of the assets, your beneficiary’s share may be taken by their creditors, and such transfers may hurt your Medicaid eligibility.
There’s one important thing to remember: you have to make sure you don’t violate fraudulent transfer laws when setting up an asset protection trust. If creditors are already filing claims against you, it may be too late to establish and fund an asset protection trust.
It’s best to consult an attorney before taking any steps toward asset protection.
Take Steps to Protect Your Hard-Earned Money.
Are you concerned about protecting your assets? Start planning now. 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.
The following might be helpful, too:
Protecting Your Estate from Medicaid Recovery
How Do I Protect My Assets from Nursing Home Costs?
by Bill Miller | May 14, 2018 | Medicaid
Many think they are not eligible for Medicaid because that’s only for elderly people. Nothing could be further from the truth. The Alabama Medicaid program offers Medicaid benefits to qualified children, parents, and caregivers. It’s important to understand the application process and what services may be covered.
Benefits for Children
Some of the services available to kids who qualify for full Medicaid benefits are:
- Dental services until age 19 unless they qualify for this service under another category.
- Up to 14 doctor visits each year and up to 16 days of doctor’s care while admitted to a hospital.
- Eye exams and eyeglasses at least once a year, depending on medical need.
- Hearing screening once a year and hearing aids.
- Certain home health
- Hospital stays, including psychiatric services for people under age 21, x-rays, and lab tests.
- Maternity
- Some prescription drugs.
- Renal dialysis.
- Some transplants.
- Ambulances and non-emergency transportation.
- Services covered by the Well Child Checkup Program.
To receive Medicaid benefits, children must meet some requirements:
- Must be an Alabama resident under the age of 19;
- Living in either a one or two parent family;
- Family income must be below the current level;
- Must be a U. S. citizen or have an approved immigration status.
Children who are not eligible for full Medicaid benefits may qualify under the All Kids Program. Through Blue Cross Blue Shield of Alabama, children can receive health care under low-cost, yet comprehensive, health care coverage.
Benefits for Parents and Caregivers
Some parents and caretaker relatives can receive full Medicaid benefits if they meet the following requirements:
- Have a child under age 19 who is a close relative living at the parent/caretaker’s home. Caretakers not related to the child are not qualified for Medicaid, but the children may be.
- Be an Alabama resident.
- Be a U.S. citizen or an immigrant in good standing.
- Must assign all medical insurance or medical support benefits to the State,
- Must report all household changes like birth, pregnancy, someone moving, address changes, or income changes.
The income of every person listed as part of the house is totaled to see if the family meets Medicaid income requirements.
Applying for Medicaid
Applications can be submitted online or as a hard copy. Qualifying may be difficult and the whole process can be complicated. A sliding scale is used to determine the income limits for the applicant. For example, a child whose monthly family income is $2,003 for a family of 2 may be eligible.
We Can Help with Medicaid Eligibility Concerns.
The attorneys at Miller Estate and Elder Law know how to help you with Medicaid eligibility. For a free consultation, contact us at 256-251-2137 or use our convenient Contact Form. Although we’re located in Anniston, we also help clients in the Birmingham, Gadsden, Hoover, Talladega, Vestavia Hills, and surrounding areas.
For more information:
Applying for Emergency Medicaid
Estate Planning for All Ages
by Bill Miller | Apr 20, 2018 | Medicaid
Incapacity is tough. Medicaid eligibility rules are tougher. It seems like a never ending stream of rules and regulations. Even the jargon they use is hard to understand. For example, the Snapshot Date, Look Back Period, and Penalty Period all seem very important. But how do they relate to my Medicaid eligibility?
As many of you know, Medicaid is a program that pays certain types of health care costs for qualified individuals. Though federally-funded, the program is run by individual state agencies. Not everyone qualifies for Medicaid. The application process with its requirements and limitations can be confusing. Most people are especially confused by the Snapshot Date, the Look-Back Period, and the Penalty Period. We’ll summarize those in this blog to help you understand what they mean for you.
The Snapshot Date
Medicaid “takes a picture” (or snapshot) of a couple’s countable resources on the snapshot date. The amount of countable resources helps the caseworker determine how much the healthy spouse will be allowed to retain as the community spouse resource allowance.
What does Medicaid consider to be the snapshot date? Medicaid looks at 12:01 am on the first day of the month in which the applicant begins a period of 30 days of continuous institutional care, a nursing home for example.
The Look-Back Period
When Medicaid receives an application, they at the applicant’s financial history for the five years prior to the application date. This is the “look-back” period. During this time, the applicant’s financial transfers, including gifts, will be analyzed. The amount of the gifts and transfers may be combined to determine the applicant’s penalty period.
For example, perhaps an applicant gave his four children a total of $200,000 four years ago. Medicaid will review the transaction and decide whether the money should have been used to care for the applicant. If it’s determined the money should have been used for the applicant, the amount of the gift may make the applicant ineligible for Medicaid until $200,000 has been paid toward his care.
The Penalty Period
During the penalty period, the applicant is not eligible for Medicaid. This usually because of financial transactions and gifts within the look-back period. The length of the penalty period is determined by dividing the amount the applicant transferred by the amount Medicaid says is the average cost of a nursing home in the applicant’s state (Medicaid Divisor).
Still Have Questions About Medicaid Eligibility?
We’re not surprised. The Medicaid application process is exhausting. You need someone in your corner who understands how the system works. We are more than happy to go over any questions you may have about your medicaid snapshot date, lookback or penalty period.
Schedule a free consultation with the attorneys at Miller Estate and Elder Law Our attorneys know how to help people like you. Just give us a call at 256-251-2137 or use our Contact Form to set up an appointment. Serving clients in the greater Anniston area, including Birmingham, Talladega, and Gadsden.
by Bill Miller | Apr 10, 2018 | Medicaid
Nursing homes are expensive, even if Medicaid benefits are available. It’s especially difficult when a married couple is split up. The emotional toll is great, but there’s also the problem of providing for expensive residential care for one person while maintaining quality of life for the other. Medicaid offers a way that may prevent the spouse from becoming impoverished.
What is a Community Spouse Resource Allowance?
This is an allowance of resources for the husband or wife of a Medicaid recipient (the community spouse). Resources includes money and other assets. The allowance means the community spouse gets to keep a certain amount of resources instead of spending them down to qualify.
Though based on the value of the couple’s resources at the time of admission, the community spouse resource allowance is usually applied after admission. The community spouse resource allowance in Alabama is equal to ½ of the total non-exempt assets with a maximum of $123,600. So, if a couple has $500,000 in non-exempt assets, they will have to spend those assets down until there are is only $123,600 left for the community spouse!
According to Medicaid rules, the community spouse is the spouse who is not entering a nursing facility. The community spouse is allowed to retain the following exempt assets:
- The family home if the community spouse is still living there,
- Furnishings and other personal belongings,
- One automobile,
- Pre-paid burial plans,
- Life insurance policies, as long as the face value is below the allowed limit.
- The community spouse’s retirements accounts, and
- The Community Spouse Resource Allowance that is ½ of the total assets up to $123,600. Of non-exempt countable resources.
What does “spending down” have to do with my Community Spouse Resource Allowance?
Sometimes the value of an applicant’s income and resources exceeds Medicaid’s limits.
Medicaid will first add together the couple’s countable resources. Then the amount the community spouse is allowed to keep, generally 50% of the assets up to $123,600, is subtracted from the total, along with a small sum for use by the Medicaid applicant ($2,000). Sometimes the remaining amount is more than Medicaid’s limit. In this situation, the applicant will have to spend down their resources to get down to the level where they are eligible for Medicaid benefits.
Have questions or concerns about Medicaid?
Talk to people who know the Medicaid system. We have worked with many families just like yours to help them navigate the Medicaid maze and saved them thousands of dollars. The attorneys at Miller Estate and Elder Law can help you with eligibility planning, 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 Gadsden, Leeds, Hoover, Talladega, Vestavia Hills, and surrounding areas.
