by Bill Miller | Oct 10, 2018 | Elder Law, Medicaid
Jeanie lived several hours away from her parents, Norah and James. As they entered their 80s, Norah and James started needing a little more assistance, so they could stay in their home as long as possible. Unfortunately, Jeanie was unable to be with them as much as she would have liked. She started asking her friends whether her parents could get Medicaid to help with daily activities.
What is Medicaid?
It’s a needs-based government program. However, while most Medicaid funding comes from the federal government, individual state governments manage their own Medicaid agencies.
What are ‘daily activities?’
Officially, Medicaid calls these “Activities of Daily Living” or ADLs, which include:
Eating, bathing, dressing, caring for personal hygiene, toileting, transferring from bed to chair and vice versa, ambulation, maintaining continence, and medication management.
Health care providers may assess an individual’s ability to perform daily activities before deciding what type of care they need. For example, if Jeanie’s mom, Norah, is having trouble moving around the house, taking a bath, and remembering to eat, her medical providers may suggest she get someone to care for her.
Some people may also need assistance with Independent Activities of Daily Living (IADLs). These activities include meal preparation, using the telephone, doing laundry, making beds, dusting and vacuuming.
What services are offered?
When an individual needs assistance with ADLs or IADLs, Medicaid may pay for in-home and out-of-home assistance, medical supplies that help the individual perform ADLs. The services offered may depend primarily on the level of assistance needed with ADLs, but could include:
- Hiring skilled nurses to provide in-home care.
- Attending an adult day health services center.
- Transferring to an assisted living facility.
- Moving into a nursing home.
Medicaid also offers home and community based waivers. The Elderly and Disabled (E&D) Waiver Program assists people who are elderly and/or disabled. The person in need may get services like house cleaning, personal care, adult day health, adult companion, and home delivered meals.
Can Medicaid Help with Daily Activities?
Jeanie learned that Medicaid did indeed have programs that could provide her parents with the care they needed.
The attorneys at Miller Estate and Elder Law. help their clients get the benefits they deserve. 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 | 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 26, 2018 | Medicaid
Medicaid provides benefits to millions of Americans. When someone with limited income and resources needs help, Medicaid may be the right place to turn. However, figuring out how to apply for Medicaid can be difficult.
Find the Right Medicaid Program
Although the federal government funds Medicaid, each state manages its own Medicaid agency. For example, Medicaid for Alabama residents is offered through Alabama Medicaid.
However, Medicaid is not just one program. Instead, benefits are provided to people in the following categories:
- Children,
- Parents and Caretaker Relatives,
- Pregnant Women,
- Elderly and Disabled,
- Nursing Home Residents,
- Breast and Cervical Cancer Patients,
- People in need of family planning through the Plan First Family Planning Program,
- People who need help paying for Medicare costs.
Once you know which category fits your situation best, it’s time to find the right application and instructions.
Qualifying for Medicaid
Just being a certain age or having a certain medical condition does not mean you are automatically qualified to receive Medicaid. People seeking Medicaid benefits must meet certain requirements first:
- Citizenship – must be an Alabama resident and be living in the United States legally.
- Income – rules vary from program to program, but an applicant’s income must fall within their state’s limit.
- Resources – the same is true for resources: the value of an applicant’s countable resources must be below their state’s limit.
- Medical Condition – programs also have different medical criteria that must be met.
For example, Jane applied for Medicaid for the Elderly and Disabled while living in Alabama so she meets the citizenship requirements for Alabama Medicaid. The income limit for the nursing home program is $2,250 per month or $1,145 for a married couple. Jane is single and makes $2,500 per month. At first glance, she appears to be ineligible for Medicaid. However, a lawyer with Medicaid experience might be able to help her find a way, perhaps by setting up a Miller trust to handle her excess income. As for resources, not all of her property will count toward the resource limit. Still, she seems to be under Medicaid’s monthly $2,000 limit. Since Jane is 83 years old and homebound as ordered by her doctor, she probably meets the medical requirements.
The Medicaid Application Process
Alabama Medicaid’s website contains forms needed to apply for the various Medicaid programs. You may apply online, by mail, or in person. However, send your application to one of Medicaid’s 11 district offices if you are applying for help with your Medicare premium, for nursing home or elderly or disabled benefits.
In addition to the application, you may also submit attachments like Form 204/205, which is used for applications to Elderly & Disabled programs.
Supporting documents may include proof of citizenship and identity, proof of income, information about countable resources, pension statements, benefit award letters, deeds, financial account statements and more. The process can get really complicated really quickly.
You May Need Help When You Apply for Medicaid
The application process for Medicaid is a difficult path for most people to navigate. The attorneys at Miller Estate and Elder Law. help many of their clients every step of the way.
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 | 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 7, 2018 | Medicaid
Most people have heard of Medicaid. Most people know that Medicaid is a massive program funded by the federal government. However, these three little known facts about Medicaid are important to help you understand how Medicaid might help you.
#1 – Medicaid Pays for a Limited Number of Doctor Visits
Becoming eligible for Medicaid benefits does not mean you can go to the doctor any time you want. Well, you can go but Medicaid typically pays for only 14 doctor appointments per year.
However, if you need to see the doctor more than 14 times a year, check with your local public clinics and federal health clinics. Otherwise, additional office visits will be self-pay.
Eye care and dental care appointments are separate from general office visits. Medicaid pays for one exe exam every three years. Most dental services are covered for Medicaid recipients.
#2 – Medicaid Might Pay for Transportation to Doctor Appointments
In general, Medicaid benefits include ambulance transportation when medically necessary. However, many people don’t know that Medicaid’s Non-Emergency Transportation Program may also cover transportation to and from scheduled appointments. There are some limitations, though:
- Visits must be medically necessary;
- The Medicaid recipient must be unable to find or pay for other forms of transportation; and
- The transportation must be approved by Medicaid five (5) days before it is needed.
If you may need this program, check out the FAQs or call 1-800-362-1504.
#3 – Medicaid Is the Nation’s Largest Primary Payer for Long-Term Care
As the baby boomer generation hits retirement age, more people will need some form of long-term care. The cost of that care continues to increase, and many people are just not prepared for it.
In this current climate, Medicaid has become the source of long-term care funds for many people. However, although 72.2 million people qualified for Medicaid in 2016 (including children and caregivers), the application process is long and hard. Many people are denied benefits.
Not Everyone Qualifies for Medicaid.
At Miller Estate and Elder Law, we help clients with long-term care planning and the Medicaid application process. For a free consultation, contact us at 256-251-2137 or use our convenient Contact Form. Download a copy of our free guide, What You Need to Know About Medicaid Planning in Alabama.
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 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.
