Medicaid Update – the Good News, by Martin Petroff, Esq

Individuals in need of home care or nursing-home careindividuals, but lives in the home or is a resident of a
should understand that despite recent changes in thenursing home and expresses an intent to return home,
Medicaid eligibility rules, they do not have to spendthe individual’s home is exempt as long as the
down their savings or income in all instances to qualifyhome’s value – minus any outstanding mortgage
for Medicaid services. The Deficit Reduction Act ofor loan on the home – is worth $750,000 or less.
2005 burdens the Medicaid laws with newMedicaid may, under some circumstances, be able to
complexities. However, a number of valuable planningimpose a lien on the home or otherwise be able to
options have been left in place and they are outlinedrecover the sale’s proceeds of the property for all
here.it spent on behalf of the Medicaid recipient. However, in
 some instances, this outcome may be often avoided
Home Care & Assisted Livingthrough the use of life estates, trusts and other
Although those persons receiving Medicaid home careplanning options. Note that the transfer of the home will
services are permitted to have no more than $13,050not incur a penalty period for nursing-home eligibility if
in savings, there continues to be no penalty period forthe transfer is made to a spouse; a child who is blind,
transferring assets to become eligible for the services.disabled or under age 21; a brother or sister who has
The Medicaid program includes home care; adult-dayan equity interest in the house and resided there for at
care; private-duty nursing; the Consumer Directedleast one year before the individual was
Personal Assistance Program; community managedinstitutionalized; or a caretaker child who resided in the
long-term care; the Assisted Living Program and more.home for at least two years before the person was
 institutionalized and provided care to maintain the
Nursing Home Careperson at home.
Under the old and new law an individual who transfers 
assets to qualify for Medicaid institutional services maySupplemental Needs Trusts
incur a penalty period during which time the individualA disabled individual under sixty-five-years with savings
will not qualify for Medicaid coverage in a nursingin excess of the amount permitted under the Medicaid
home. However, it is never too late to conserverules may transfer his own savings to a supplemental
lifetime savings. An individual who has resources inneeds trust without jeopardizing his eligibility for
excess of the Medicaid limits and faces immediateMedicaid services in the community or in a nursing
placement in a nursing home, or who is already ahome. The money in the trust may be used to pay for
resident there, may still protect a substantial portion ofluxuries and necessities. Similarly, a relative or friend
his resources and ultimately qualify for Medicaid. In thismay establish a supplemental needs trust and use the
instance, a legal instrument such as an annuity may befunds in the trust for the benefit of the disabled person
used to avoid the spending down. Note also that thereof any age while that individual continues to receive
is no penalty period for Medicaid eligibility if assets areMedicaid benefits in the community or in a nursing
transferred to a spouse; the individual’s child underhome.
age 21; a blind or disabled child of any age; or a trust 
established for the sole benefit of any disabled personPooled Income Trusts
under the age of 65.By participating in a pooled-income trust, disabled
 persons of any age who are receiving community
The HomeMedicaid including home care, adult-day-care and other
An individual’s home – a house, cooperative ornon-institutional services may continue to use virtually all
condominium apartment – is an exempt asset; thattheir income to cover their living expenses. After joining
is, it is not counted by Medicaid, regardless of the valuethe trust they will qualify for Medicaid without having to
of the home, as long as the individual’s spouse, childgive over to Medicaid that portion of their income
under 21, blind child or disabled child lives there. If anwhich is in excess of the Medicaid allowed limit of
individual does not live with any of the above$745 per month.