Medicaid Planning and Applications
Serving Clients on Long Island and in New York City
Sudden Changes and Big Decisions
Change is life’s only constant. Sometimes these changes strike without warning. If you or a loved one has experienced a sudden illness or serious accident, you understand how abruptly everything can change. Are you or a loved one suddenly in need of home care, assisted living, or nursing home care? Finding and affording quality care on short notice can be stressful and draining. We can help you determine the best options for care and how to qualify for Medicaid to help finance them.
Long-term Care: Counting the Cost
Long-term care is expensive and continues to increase in cost as baby boomers age. Although the range varies depending on where you live, in the New York Metropolitan area the average annual cost of a nursing home room is approximately $180,000 with a 3% annual increase projected. With improved medical care, the average life span of adults also is increasing; this translates into more years of care at increasingly higher rates. Without some sort of financial assistance, these costs could be financially devastating. In fact, your entire life savings could be quickly depleted within a few years of needing long-term care. This is where Medicaid can help and be the “safety net”.
Medicaid is a joint federal and state program which can assist those with long-term care expenses. While Medicare provides very limited coverage, Medicaid is much more extensive. However, because of its restrictions, qualifying for Medicaid can be extremely difficult. But paying for home care, assisted living, and nursing home without it could be all but impossible.
The Medicaid Maze
Although Medicaid requirements vary from state to state, they all share one common element: complexity. Each state specifies a maximum allowed income for individuals and couples in order to qualify for Medicaid. Also, the applicant’s total countable assets cannot exceed a specified amount called the Resource Allowance, which is consistently very low, (i.e., $15,750 in New York in 2020)*. Although certain possessions, like your home and automobile, may be “exempted” for purposes of determining Medicaid eligibility under certain circumstances, this figure is still alarming. If the applicant is married, the process becomes even more complicated. For the recipient to qualify for Medicaid in any state, the applicant’s spouse can keep only half the couple’s assets up to a Maximum Community Spouse Resource Allowance of $128,640.**
What can you do if the value of your “non-exempt” assets exceeds the applicable allowances? If you give your extra assets away, which seems like an obvious choice, you may be subject to the “Transfer Penalty Rule” disqualifying you from receiving Medicaid for months or years, depending on how much you gave away. However, with proper legal advice, the “Transfer Penalty Rule” may be able to be minimized or even completely avoided.
If your need for home care, assisted living, or nursing home care is immediate, time is not something you can afford to lose. Why? If you wait too long or fail to get proper legal advice and your non-exempt assets are above the applicable allowances, you or your loved one may be ineligible for Medicaid benefits at a time such services are desperately needed.
The Medicaid Qualification Process = Legally Protecting the Maximum Amount the Law Allows
This is only a brief and oversimplified review of a few Medicaid rules, of which there are many more. Navigating them on your own could be a nightmare at best and subject you to penalties at worst. Fortunately, though, our experienced professionals can guide you through the Medicaid maze. Our legal team can advise you throughout the application process, ensuring that you (and your spouse, if applicable) retain the maximum income and total assets allowed by law.
Seek appropriate counsel before you apply for and seek to qualify for Medicaid. We can give you – and your family – peace of mind during a difficult and uncertain time. When dealing with Medicaid, legal advice is something you cannot afford to go without.
* The Resource Allowance varies from state to state.
** Since these amounts (e.g., the “Community Spouse Resource Allowance,” etc.) are adjusted annually, these numbers may vary slightly depending on when the most recent figures are released.