Nursing home Medicaid is a program funded by the Federal government and administered by the Georgia Department of Community Health to provide coverage for nursing home care for those who have a medical need for such care. Along with showing a medical need for nursing home care, applicants for nursing home Medicaid must meet financial criteria to qualify for Medicaid. There are income and assets test that must be satisfied to qualify for Medicaid. Therefore, when an applicant applies for Medicaid they must disclose all their assets and sources of income. This information must be updated whenever there is a material change.
Updating the financial information of the Medicaid applicant after the applicant is approved for Medicaid is not only required, but could save the applicant money. Our office currently has a case in which our client applied for Medicaid at a time when his wife was receiving significant monthly income. Under the Medicaid rules, this income does not count towards the Medicaid applicant’s qualification for Medicaid. However, due to the existence of such income, the spouse could not receive any income from the Medicaid applicant through spousal diversion that allows for income to be redirected to the spouse who does not need nursing home care. As this income could not be redirected, the spouse receiving nursing home care was forced to pay almost all of his income to the nursing home. The large monthly income of the spouse not receiving nursing home care was temporary. When the amount was no longer being received each month, the Medicaid receiving spouse could redirect all of his income to the community spouse, leaving no liability for the nursing home.
It is important to constantly review the income numbers by which Medicaid is calculating the amount owed for nursing home care. Out of date or incorrect income numbers can result in the Medicaid recipient t paying hundreds of dollars aa month more than required to the nursing home. Applicants for nursing home Medicaid who have assets or income higher than the requirements for Medicaid should seek the advice of an experienced elder law attorney in structuring a Medicaid spend down to reduce assets.