Medicaid Eligibility

The most common option to pay for long-term care is Medicaid.  A joint federal-state program, Medicaid provides medical assistance to low-income individuals including those who are 65 or older, disabled or blind.

Medicaid is the single largest payer of nursing home bills in America and serves as the option of last resort for people who have no other way to finance their long-term care.
As a result of the Deficit Reduction Act of 2005, there are complex eligibility requirements in those in need of Medicaid benefits.  There are a myriad of regulations involving look-back periods, income caps, transfer penalties and waiting periods to plan around. 

Medicaid Pre-Planning vs. Crisis Planning

There is a 60 month look-back period to determine whether or not any transfer of the assets has occurred which would delay the start of Medicaid benefits.  As a result of this, many seniors desire to plan ahead for long-term care as part of their regular estate planning process.  This is what we would call Medicaid pre-planning.  This can include the purchase of long-term care insurance.  It may also include a Medicaid asset protection trust as a way of planning to insure the passing on of certain assets to the next generation.  We assist senior in implementing plans that can protect assets in case of future need for assisted living or nursing home care.  Please call for an appointment if we may help you in any of the following areas.  Lloyd Culp 713-599-1000.

Crisis Medicaid planning typically occurs when the senior has received an extremely serious medical diagnosis, most commonly when the hospital or rehabilitation facility medical personnel have determined that the senior cannot return home after rehab.  At this point, the senior and his or her family is faced with extended nursing home time.  Again, there are rules regarding assets that may be retained such as a single individual may only be able to maintain $2,000.00 in assets in order to receive Medicaid care.  Even if the individual is married, there are limits as to what the community spouse will be able to retain.  There are also limits as to what income the in-care spouse and the community spouse may be able to receive.  Medicaid crisis care planning is essential to protect what can be saved under these drastic adverse circumstances.

Additional Resources

Estate Planning
Probate & Estate Administration