Community Spouse, Community Spouse Resource Allowance (Minimum and Maximum), Monthly Maintenance Needs Allowance (Minimum and Maximum), Penalty Divisor, Resource Limit, Exempt and non-Exempt Resources — should you care what these terms are? Well, if you're part of a married couple and you're concerned about the possible need for nursing home care for you and/or your spouse, you should. The option for paying for the nursing home are discussed in our previous article “Who will pay for the nursing Home?” Let's start first with the average monthly cost of nursing home care is approximately $10,000 per month, i.e. $120,000 per year….
Unfortunately, most people do not plan for the nursing home, until the crisis occurs. As an elder care attorney I see this situation time and again. Therefore, it is important to educate my clients on the options they have available. The nursing home is a strong possibility for most Americans. People are now living longer than they ever have before. Consequently, for most they cannot care for themselves. Therefore, you will need some form of long-term care, usually, the nursing home. We, if the need occurs, help you plan for how to make this possibility happen. Medicare does not pay…
Medicaid eligibility rules are extremely complex and confusing, and impossible to understand without legal assistance. The United States Supreme Court has called the Medicaid laws “an aggravated assault on the English language, resistant to attempts to understand it.” Schweiker v. Gray Panthers, 453 U.S. 34, 43 (1981). Additionally, the United States Court of Appeals for our own Fourth Circuit (just below the U.S. Supreme Court), in a case arising out of Virginia, has called the Medicaid Act one of the “most completely impenetrable texts within human experience” and “dense reading of the most tortuous kind.” Rehab. Association of Virginia v. Kozlowski,…
Pursuant to the applicable provisions of the Federal Deficit Reduction Act of 2005 (DRA 2005), the look back period for Medicaid is five years (60 months). That federal statute requires that any uncompensated transfer that occurred during the relevant look back period will cause a penalty period with regard to the receipt of Medicaid benefits. The penalty period is the amount of the uncompensated transfer ( say gifts of $68,000)divided by the state's reimbursement rate (Maryland is $6,800). The result is ten (10) months that will constitute the penalty period. The penalty period begins in the month in which the…
If you need nursing home care, how will you pay for it? The average cost of nursing home costs can easily exceed $100,000 per year. This makes it a challenge to pay for care, let alone leave an inheritance for future generations. The Medicaid program can provide nursing home coverage – but only if you qualify i.e your assets are below $2,500. Therefore, most people do not have automatic Medicaid eligibility, until all their assets are spent down. Consequently, people need Medicaid Planning. Medicaid Planning involves repositioning assets in accordance with strict rules, so that you meet Medicaid eligibility requirements….
CMS has a wealth of publicly available summary statistics regarding enrollment, spending, treatment patterns, cost sharing and other topics for both Medicare and Medicaid beneficiaries. This information can be accessed through the Medicare & Medicaid Statistical Supplement website. The site includes statistics on the following topics: Personal Health Care Expenditures Medicare Enrollment Medicare Program Payments Medicare Cost Sharing Medicare Short Stay Hospitals Medicare Skilled Nursing Facilities Medicare Home Health Agencies Medicare Hospices Medicare Physician Services Medicare Hospital Outpatient Services End Stage Renal Disease Medicare Managed Care Medicaid Medicare Part D There is data available from 2001 to 2010.
As reported in Financial Advisor, a growing number of residents are aware of the need to conduct long-term care planning, but a majority admit that they still fail to plan as properly as they should. Specifically, the study found that eight out of ten Americans believe that it is vital to prepare ahead of time for the assistance they might need as they age. Yet, nearly half those respondents claimed that in their own case they remain unsure how they will provide for their long-term care when they reach their golden years. Long-term care costs are high and rising. Most…
Medicaid is a combined federal and state program that pays for nursing home costs. The combined assets of spouses are available for the care of the ill or "institutionalized" spouse, regardless of which spouse owns the assets. However, many assets ("resources") are exempt from Medicaid when there is a spouse at home (the "community" spouse). The exemptions follow: The home, up to a value of $500,000; Up to $110,000 in resources; One automobile; Prepaid funeral and burial for applicant and spouse; Household furniture, personal effects and jewelry with sentimental value; Annuities paying out a monthly income naming spouse as…
A Wisconsin appeals court rules that a Medicaid applicant who transferred funds to her children, who then put them in an irrevocable trust for her benefit, is ineligible for Medicaid because the trust is an available asset under state law, even though the transfer occurred 17 years before she applied for Medicaid. Oftentimes, Medicaid and Medicare can be entirely necessary programs. They also can be pretty tricky to navigate, especially if you, or a loved one, fall just above the income limits. That said, Medicare and Medicaid don’t like it when they feel you are “gaming” the system. Elder Law…
Have you heard the news? It seems the grand experiment failed. The Congressional supercommittee, charged with doing what the Congress at large could not do, has run out of time. And, by running out of time, failed in its mission to come up with budget cuts. What does that mean for Medicare and Medicaid beneficiaries? As Reuters reports, in the event the supercommittee should fail, as it has, then automatic and sweeping cuts go into effect. For Medicare, that means a two percent cut across the board, or about $123 billion over the next decade. However, it might have been…
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