A version of this article appeared in print on July 22, 2017, Section B, Page 1 of the New York edition with the headline: The Ethics of Trying to Qualify for Medicaid. The numbers quoted, and some facts have changed since 2017. I am publishing this edited article because I have had a number of people / clients ask if Medicaid planning is legal. The answer is YES. However, you have a choice to pay privately or go on Medicaid. But what happens if you need dentures, hearing aids, even cable tv for your room and you have no money!…
One of the greatest fears of older Americans is that they may end up in a nursing home. This not only means a great loss of personal autonomy, but also a tremendous financial price. The average nursing homes cost, in our area, is approximately, $10,000 per month, that’s $120,000 a year, and the average stay in a nursing home is 4 years, that’s $480,000. For many people this will wipe them out financially. Most people end up paying for nursing home care out of their savings until they run out. Then they can qualify for Medicaid to pick up the…
In order to qualify for Medicaid, in Maryland, you can't have more than $2,500 in assets. Many people forget about life insurance when calculating their assets, but depending on the type of life insurance and the value of the policy, it can count as an asset. Life insurance policies are usually either "term" life insurance or "whole" life insurance. If a Medicaid applicant has term life insurance, it doesn’t count as an asset and won't affect Medicaid eligibility because this form of life insurance does not have an accumulated cash value. On the other hand, whole life insurance accumulates a…
At the turn of the 20th Century, the average life expectancy was about 47 years. Now in the 21st Century, life expectancy has doubled that. As a result, we face more challenges and decisions in our life than those who came before us. One of the major transitions people face is the change from independent living in their own home or apartment to living in a long-term care facility or nursing home. There are many reasons for this while the transition is so difficult. One is the loss of home; a home where the person lived for many years with…
Do you worry about the cost of long-term care? Are a wartime veteran with healthcare needs? Do you need information on Nursing Homes and Medicaid? Is your spouse is ill and you are worried about paying for her care? Do you need more information on Veterans benefits? Do you have wills, trusts and powers of attorney? Are you are wondering if your will, trust and powers of attorney need to be updated? You will want to hire the attorney who regularly handles matters in the area of law of concern to your particular case and who will know enough…
DON’T GO BROKE PAYING THE NURSING HOME Do you have over $500,000 to pay the nursing home? Our FREE Report “NINE QUESTIONS TO ASK THE NURSING HOME” is Available to Seniors and families to Help Pay the Cost of the Nursing Home. The average cost of a nursing home facility in Maryland is approximately $10,000 PER MONTH, that’s $120,000 PER YEAR. Also, the average length of stay at a nursing home is approximately 48 months, that’s $480,000. Unfortunately, spouses and their families use all their hard earned lifetime savings, sell their home, to pay the nursing home, and now they…
The notice must also provide instructions on how to appeal the decision made by the Medicaid agency. In some states, the first step in the Medicaid appeal process is an administrative hearing, commonly known as a "fair hearing." Other states, however, provide for a local "evidentiary hearing," which may then be appealed through the fair hearing process. The notice should tell you how to request a hearing. You may request a hearing whenever either your application for Medicaid has been denied or your existing Medicaid benefits have been reduced or terminated, and you believe the state Medicaid agency is mistaken…
With the Health Insurance Marketplace underway, there is information available for those on Medicare about what the Marketplace means to them. The Centers for Medicare and Medicaid (CMS) and the National Council on Aging (NCOA) have developed helpful factsheets for your clients who are 65+ and for people ages 55-64. View the CMS fact sheet and NCOA fact sheet. View the NCOA fact sheet for people under 65.
In another sales-sapping blow to Eli Lilly and Co., the Centers for Medicare and Medicaid Services has decided not to pay for patient use of a Lilly imaging drug used in Alzheimer’s assessments. The Indianapolis drugmaker said that it’s disappointed in the decision, which it called “contrary to expert opinion.” The CMS decision is a financial blow to Lilly’s Amyvid, a new drug marketed for use in brain scans to evaluate patients for Alzheimer’s disease and other brain dysfunctions. Approved by the Food and Drug Administration last year, Amyvid is the only drug of its kind on the market. In…
The CMS has approved a waiver that means Arkansas won't put residents eligible for the expansion on traditional Medicaid, but will instead be able to offer them private coverage. Arkansas Gov. Mike Beebe, a Democrat leading a deeply conservative state, crafted the option as a way to expand health care coverage without fully signing on to an expanded government program. His administration has been negotiating with the Centers for Medicare & Medicaid Services (CMS) for months over the waiver after the idea received an unexpectedly warm reception from Health and Human Services Secretary Kathleen Sebelius. Several other states have been…
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