Nursing home Medicaid is a program funded by the Federal government and administered by the Georgia Department of Community Health that provides coverage for nursing home care for those who have a medical need for such care. Along with showing a medical need for the care, applicants for nursing home Medicaid have to meet income and asset requirements to receive coverage. The asset limits for Medicaid are extremely low, leaving even those of modest means without coverage.
Applicants who have just enough resources to not qualify for nursing home Medicaid are often the hardest hit. For example, a single individual with $50,000 cash must do planning to reduce those assets to $2,000 or below to qualify for Medicaid. Often, when presented with the options for Medicaid planning, there is a tendency to wait two or three months deciding what to do. Such waiting is costly, as during such time, the individual would be paying monthly Medicaid bills averaging, $6,000 a month. After waiting two or three months, $15,000 of critically needed assets will be spent. It is important for those needing nursing home Medicaid but who have too many assets to seek trusted advice, and quickly follow such advice to protect needed resources from being consumed by nursing home expenses.
The goal of Medicaid planning for someone who has an immediate need for nursing home care is to conserve as many assets as possible to pay for things that Medicaid does not cover, such as the added cost of a private room or experimental treatments.
The following is a brief list of things to consider when planning for an immediate need for nursing home Medicaid.
Residence: The value of a residence owned by the Medicaid applicant is generally, based on appraised value, exempt from counting against qualification for nursing home Medicaid. Although exempt, residences often present two problems. First, once the Medicaid applicant admitted into a nursing home, the residence is often sold quickly,. once the residence is sold, the proceeds received are not exempt and can cause a loss of Medicaid. Secondly, even if the nursing home applicant plans to retain their house while in a nursing home, care must be taken to prevent Medicaid from placing a lien on the residence on the death of the Medicaid resident. Medicaid can place a lien on the home on the death of the nursing home resident for theca amount of money spent on nursing home costs. This can erode any equity that is in the residence. Planning should be made to preserve this equity in the residence.
Life insurance: Georgia Medicaid has complex and confusing rules on whether and to what extent the ownership of life insurance is a countable resource for a Medicaid applicant. Whether life insurance is countable requires looking to each of the policies owned by the Medicaid applicant and determining whether they are term policies or permanent policies, containing cash value. Life insurance further complicates Medicaid eligibility as the amount of money that can be kept in a burial account is reduced dollar for dollar by the amount of life insurance owned by the applicant t. These complicated rules often result in denials for Medicaid.
These rules and others highlight the importance of seeking qualified Medicaid planning advice when an applicant is over assets. The cost of such advice is a sound investment that will yield significant savings which allow the applicant to have the resources needed for the care they require. Delaying planning for Medicaid results in needed resources being unnecessarily squandered. If you or a loved one is facing an immediate need for nursing home care and is over the asset limit for such services, call Nabors Law Group today for a free consultation too review the options.