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What assets can Medicaid require to be spent down before a person becomes eligible?
Assets such as cash, bonds, savings, stocks, life insurance cash values, real property, etc. However, with proper planning and competent advice, all of these assets can be preserved.
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If the Medicaid applicant has a spouse, are the spouse's income and assets included?
The well spouse's income is not considered in determining the applicant's eligibility; however, all marital assets are considered. Income and savings above maximum allowable limits can be protected if you know your legal rights.
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Why is this planning so important?
The money saved from years of hard work can be depleted quickly when a family member requires long-term care. The loss of lifetime savings can have a devastating financial and emotional impact on the entire family. With competent advice it's possible to preserve all of your life savings, your family home and investments, and still qualify for Medicaid.
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Is it's too late to do anything to protect a person's assets if the person is already in a nursing home?
No, it's not! The law allows assets to be protected any time there are assets that can be protected - even after a person's admission to a nursing home. Granted, in most cases the earlier a person acts with the help of us, the more of their assets can be protected. But in all cases, a significant amount of assets can always be sheltered, even if nothing is done prior to nursing home admission.
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If I haven't put into place an appropriate financial plan five years or more before nursing home admission, is there anything that can be done?
There is a five-year look-back, which requires that an applicant for nursing home benefits disclose all financial transactions made within the prior five years. Regardless of those transactions, many people are able to protect a significant portion of their assets even if actions are started after nursing home admission. The key is working with an advocacy group who understands the system. It's always better to act earlier, but it’s never too late to start.
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When adding a child's (or other person's) name to the title of a bank account, stock, brokerage account, CD, bond, or other type of account, is it true that half of the account will not have to be paid to the nursing home?
The general rule is that any account bearing the name of a resident of a nursing home is considered 100% available for paying nursing home bills. Many parents add a child's name to an account to avoid probate. After a parent enters a nursing home, many children are dismayed to find out that 100% of the jointly titled account is available to pay the nursing home. The good news is that with proper counseling, a significant portion of the assets held jointly can always be protected from the nursing home even if the person is already receiving nursing home care.
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If a married couple has titled some assets to the wife alone and some assets to the husband alone, then the assets titled to the spouse who does not go into the nursing home are safe, right?
For married couples, a principle called "deeming of resources" is applied. "Deeming of resources" means that married couples are treated as a unit. Assets titled to each spouse individually, as well as jointly titled assets, are considered as a resource of the marriage and therefore available to pay for nursing home care regardless of who is in the nursing home. Although a spouse remaining at home is permitted to keep a limited amount of the couple's assets, with competent advice, a couple can shelter virtually all of their assets from The Medicaid Spenddown.
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In West Virginia, single person can keep their house and receive nursing home benefits. When the single parent dies the children will inherit the house, right?
Under certain circumstances a single person in a West Virginia nursing home can receive benefits without selling their house. However, all but $50 of the parent's monthly income goes to the nursing home leaving the children to pay the maintenance, taxes, utilities and insurance, all out of their own pockets. In addition, if no action is taken to protect the house, the state can recover against the house after the parent passes away. The good news is that by acting now, even if a person is already in a nursing home, the house can be protected from West Virginia estate recovery.
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If a person doesn't have a lot of money, does that mean they cannot get into a good nursing home, or they will have to go to the "county home?"
There are two types of nursing homes. Those that accept government payment for long term care in the form of Medicaid, and those that do not. The vast majority of skilled nursing facilities, including most of the "best," accept Medicaid, and those facilities cannot discriminate against applicants on the basis of ability to pay. Many clients get into the best nursing homes and never pay privately, even for one day.
Some facilities are owned and operated by the different counties. Contrary to the stereotype, county run homes often are reported to be among the best. Regardless of who owns the facility, all facilities that accept Medicaid must follow the same rules.
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Does Medicare pay for the first 100 days of nursing home care?
Medicare will pay up to the initial 100 days of nursing home care if certain conditions are met. How many skilled nursing days Medicare will pay for in a facility is a medical decision usually related to how well the individual is responding to therapy. Often, Medicare payment ceases long before 100 days are up. Once Medicare ceases paying, the facility will look for private payment from the individual receiving the care. With competent advice, much if not all of the person's assets can be protected from the Medicaid Spenddown.
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Can a person wait until just before nursing home admission and then give $10,000 to each child and grandchild to spend down the person's assets?
Any gifting done within five years before nursing home admission must be reported, and there is no $10,000 per person gifting exemption when it comes to paying for nursing home care. Although the IRS allows annual $15,000 exclusion for Federal Estate and Gift Tax purposes, Medicaid makes its own rules and is not bound by Internal Revenue exemption limits.
