Most people confuse Medicare and Medicaid. Medicaid is a “means tested program”, available to those who meet the state’s medical and financial eligibility requirements. Medicaid provides medical care to the poor, to children and to pregnant women living under the federal poverty level. It is funded jointly by the states and federal government. Low income is only one test for Medicaid eligibility; assets and resources are also tested against established thresholds. For Long-Term care, Medicaid is the single largest financier in the U.S. More than two thirds of Medicaid spending for long term care is on institutional services (nursing homes).
Seniors who have assets and income at poverty levels have neither the income nor the assets to purchase long term care insurance or pay the costs of long term care on their own. Seniors who qualify for Medicaid benefits through a medically needy determination aee those who face medical bills, including long term care expenses, in excess of their ability to pay.
While Medicaid clearly provides a safety net for many seniors, the decision to rely on Medicaid entails some risks. Good financial planning can help the family determine if this type of funding is a reasonable option.
Bill Ridgell can help you plan for the possibility that you may need Medicaid.
Families who face long term care decisions and wonder how to pay the high costs of care may be able to transfer countable assets so they are inaccessible to both the Meidicaid applicant and the Medicaid program.
Each state may have different eligibility requirements. Medicaid counts Social Security income, defined benefit pensions, alimony, and income from immediate annuities as income. Most income counted by Medicaid will be applied toward nursing home and other care costs. Contact Bill to find out more.
Federal law requires states to seek recovery for Medicaid benefits by placing a claim against the probate estate of the deceased beneficiary. States may also seek to recover non-countable assets (such as the home). Contact Bill for more details.