Nursing home Medicaid is a program funded by the Federal government and administered by the Georgia Department of Community Health to pay for nursing home care for those who have a medical need for such services. Along with showing a medical need for nursing home care, an applicant for nursing home Medicaid must also meet income and asset requirements. These income and asset requirements are found in the Georgia Medicaid Manual. The rules surrounding the exclusion for burial funds for Medicaid applicants are confusing and can lead to a Medicaid denial if care is not taken.
Burial funds consist of money that is set aside in a separate account to be used to pay for the burial expenses of an individual receiving Medicaid. The burial fund can be funded with up to $10,000 and be excluded from counting towards nursing home Medicaid. This is in addition to burial space items, such as caskets, grave markers, and headstones, which are excluded from counting towards Medicaid eligibility when purchased for the Medicaid recipient. Georgia has unique rules governing how the burial contract amount is connected to the life insurance held by the Medicaid recipient.
The $10,000 burial fund exclusion is reduced dollar for dollar for the face amount of life insurance on the life of the Medicaid recipient. Therefore, if the Medicaid recipient has life insurance on their life with a face amount of over $10,000, the Medicaid recipient cannot have any money in a burial fund, as the entire amount of the burial fund will be countable. This can cause an issue where the Medicaid recipient has a life insurance policy they forgot about, such as one from a former job.
As is evident from the discussion of burial policies, determining the amount of excluded assets can be difficult. Applicants for nursing home Medicaid who have considerable assets are encouraged to seek the guidance of an experienced elder law attorney.