Crisis Medicaid Planning – Why it’s never too late to save money

By: Jane-Marie Schaeffer, Esq.

While it is advisable to create a long term care plan five years in advance of needing the care, what happens if you experience a medical crisis that requires long term care yet haven’t done any planning? Your first thought may be that it is too late to do anything, but don’t despair, whether you have five years or five days, there are many last minute planning techniques that are available.

A common misconception about long term care costs and getting Medicaid coverage is that you need to plan five years in advance to protect your assets. While that statement is generally true to protect all of your assets, there are several other options for those who have not planned outside of the five year “look-back” period to protect a majority of their assets.

Here are some considerations for saving assets while getting Medicaid in a Nursing Home:

  1. If you need nursing home care, and you are married, you can transfer assets to your spouse without a penalty. Your spouse who stays living at home (also called a “community spouse”) may retain assets of up to $120,900 and you can still qualify for Medicaid.
  2. If your spouse has assets in excess of $120,900, your spouse can sign a “spousal refusal” which says that your spouse cannot use these assets to pay for the nursing home, as they are needed for the spouse’s own care. You will still qualify for Medicaid.
  3. If you have a disabled child, you may transfer assets to the disabled child without a penalty.
  4. If your adult child has been living in your home and taking care of you for the past two years, you may transfer the house to the caregiver child without a penalty.
  5. If you have assets in excess of the amount needed to qualify for Medicaid (currently $14,850) you may still protect about 1/2 of these assets by gifting 1/2 of these assets (to your children for example) and entering into a Promissory Note with your children for the remaining 1/2 of the assets.  The monthly payments made to you when the children repay the Promissory Note will be used to pay the nursing home during any penalty period until you qualify for Medicaid.Helping the Elderly

These are all techniques that help you qualify for Medicaid to pay for nursing home care. But, let’s face it, the majority of people don’t want to go to a nursing home and would rather receive care at home. What if you could receive care at home, have it paid for by Medicaid, and you don’t have to wait 5 years to qualify? Sound too good to be true?  Well it’s not. There is an option in New York to receive Community Medicaid which pays for your long term care needs at home.

You need to qualify financially for Community Medicaid just like you do for Medicaid for nursing home care (called Chronic Care Medicaid). However, because there is no look-back period, you do not have to wait five years to qualify for Community Medicaid.  We often will recommend that you transfer your assets to a Medicaid trust and then apply for Community Medicaid the following month which serves to simultaneously qualify you for Community Medicaid while also starting the five-year clock to protect your assets for Chronic Care Medicaid.

Community Medicaid pays for many types of services for you at home: home health care aides, transportation to medical appointments, adult daycare, even paying friends and family members to take care of you through a program called the Consumer Directed Program. Community Medicaid is a great option for many people, and allows one to maintain their independence and dignity while still living at home.

Feel free to contact us to schedule a free consultation to discuss your personal situation, or come to one of our seminars on Medicaid Crisis planning to learn more.


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