What is Medicaid?
Medicaid is a needs-based health care benefits program governed by Federal and State statute but administered by the individual states. In Missouri, our Medicaid agency MO HealthNet looks at the value of your assets and in some cases your income, to determine your eligibility for benefits. If you can afford your care, you will not qualify for benefits.
Our firm can assist you with qualifying for Nursing Home benefits (also known as vendor benefits) and Home and Community Based benefits.
How Do I Qualify for Medicaid Nursing Home Benefits?
To qualify for Missouri Nursing Home Medicaid benefits you must:
1
Need skilled level of care
2
Be in a Medicaid qualified bed in a nursing home
3
Have non-exempt assets that do not exceed:
$5,726.00 for an individual qualifying for benefits
$11,452.00 for a couple qualifying for benefits
$154,140.00 for a spouse not applying for benefits
4
Assets that are exempt are:
Primary residence if the spouse or qualifying person remains
Personal belongings
Car
Irrevocable prepaid funeral plan or $1,500.00 cash value life insurance policy
5
Have not made transfers to others for less than fair market value within 5 years of applying for Medicaid benefits
What is Medicaid Spend Down?
Medicaid requires resources (assets) over the allowed amount to be spent down. These resources may only be spent on the nursing home resident or the spouse, of they will be considered a transfer that will cause a delay in qualification for benefits.
Medicaid cannot tell people what they may spend on themselves but does not allow people to spend their money on others or give assets to others and then receive Medicaid benefits.
What Is The Five-Year Lookback Period?
One factor that may affect how much someone spends on nursing home care is the Medicaid five-year lookback period.
If an individual transferred assets or cash for less than fair market value, such as a gift, in the five-year period prior to applying for Medicaid benefits, you may be subject to a penalty. Initially you will not qualify for benefits and will have to pay for your nursing home care.
It is advisable to speak to an attorney if the Medicaid five-year lookback period applies to you. There may be options available to help mitigate the impact of this rule.
Qualify for Medicaid Benefits Earlier
Although this makes sense, if you have worked your entire life, supported the Medicaid system through your taxes, lived frugally, saved money and played by the rules, Medicaid expects you to spend your savings potentially leaving your spouse with half or less of the assets you saved and may not be able to leave a legacy for your family.
Get Medicaid Advice From Lawyers, Not Your Friends
Many people have listened to advice from well-meaning friends, financial advisers, banks, funeral homes, CPAs, social workers in the nursing home, and even non-elder law attorneys who do not go to the Medicaid office, who do not know what the laws really are, and who do not know what can be done to preserve assets.
Much of this information is just plain wrong. We have even had instances where someone has gone to a Medicaid office on his own, has been given completely wrong information from a state Medicaid worker, and has made very expensive mistakes.
The state will acknowledge these errors but will not reimburse you for their errors.
How Can I Protect My Assets?
High long-term care costs can swiftly erode an individual’s life savings. Medicaid laws can be used in your favor to protect your assets – and you don’t have to try to understand and interpret these laws by yourself.
It is imperative to work with a law firm that understands the complex and ever-changing Medicaid laws, identifying ways they can be used to protect your assets.
