Looking for a quick answer? Take a look at the common questions you’ll need to address when applying for Medicaid.
Keys To Medicaid Eligibility
There are many Medicaid eligibility criteria that a person must meet before they can secure a Medicaid approval. We’ve compiled recurring themes found during the Medicaid planning process. Engaging an experienced Medicaid and elder law attorney can help you navigate the maze and protect your life savings.
Are you or your loved one in a nursing home or about to enter one soon?
More than 1.3 million people live in nursing homes in the U.S., according to the Centers for Disease Control and Prevention. More than 10 million American sage 65 and older need long-term services and support to help them with daily activities, according to the Kaiser Family Foundation.
Even if you answered no, many Americans have no plan for long-term care costs. Someone turning 65 today has almost a 70% chance of needing long-term care services.
Did you know the average cost of long-term care in a nursing home is between $4,000 to $6,000 per month?
The national average for long-term care costs in a nursing home is $6,360 a month. In Texas, the average cost for a semi-private room in a nursing home is over $57,000 a year and a private room can exceed $8,000 a month.
Did you know that Medicare and most private health insurance will not pay for long-term care?
Medicare typically covers primary care needs, hospital visits, and rehabilitation. It does not cover long-term care in a nursing home. Most private health insurance does not cover long-term care.
Does your family have the resources to pay for long-term care?
The median household income in Texas in 2017 was just over $57,000. At current rates, a year in the nursing home can cost as much as the average family’s entire yearly income.
Did you know that Medicaid is the number one payor source for nursing home bills?
Unlike Medicare and private health insurance, Medicaid pays for long-term care in a nursing home. According to the Kaiser Family Foundation, Medicaid pays over 62% of all long-term care costs in the U.S.
Does the person who needs long-term care have more than $2,313 in monthly income?
A single individual applying for Medicaid cannot have more than $2,313 in gross income per month. A married person applying for Medicaid cannot have more than $4,626 per month.
Does the person who needs long-term care have more in than $2,000 inchecking, savings, investment accounts?
A single individual applying for Medicaid cannot have more than $2,000 in what Medicaid calls “countable resources.”Cash, bank accounts, and certain types of investment accounts are all “countable resources.”
Does the person who needs long-term care own and home or other real estate?
Real estate is a countable resource. However, the person’s home is exempt from countable resources for up to $585,000 in value.
Does the person who needs long-term care have a spouse or dependent family members?
In some cases the Medicaid applicant’s spouse may keep more than $2,000 in countable resources,depending on the type and amount of assets they own. An Applicant with disabled children or other dependents may also keep more than $2,000 in countable resources in some cases.
Have a pension, 401(k), IRA, annuities, or other retirement savings?
Most retirement accounts are countable resources, but certain types of annuities and IRAs are exempt from the $2,000 limit.
Own a vehicle?
Medicaid allows the applicant to own one car of unlimited value and still qualify.
Does the person who needs long-term care own a business?
The Applicant may own a business or business-property that is essential to self-support, such as rental properties that generate the person’s income.
Did the person who needs long-term care give away any money or property in the last five years?
Medicaid will delay eligibility if the Applicant gaveaway money, property, or real estate for the purpose of qualifying for benefits and without getting equivalent value in return.
Are you worried that Medicaid will try to take your house if you or your spouse receives benefits?
Texas has a “Medicaid Estate Recovery Program” or MERP. MERP may file a claim against the Applicant’s estate if they received Medicaid benefits before they died. However, MERP claims can be eliminated entirely with proper planning from an experienced Medicaid planning attorney.
Are you aware that many Medicaid applications prepared by nursing homes or family members are denied?
Many families and some nursing home employees try to file Medicaid applications on their own. These areoften denied because the person filling them out did not understand the complex web of Medicaid rules and regulations.
Medicaid Eligibility Doesn't Just Happen We Make it Happen
- If your parent or spouse is over the income limit, We can fix that.
- If your parent or spouse is over the asset limit, We can protect their assets and get them under the limit.
- If your parent or spouse has made gifts and may have a Medicaid penalty, We can minimize the damage and get them Medicaid as soon as possible.
- If you need help getting through the application, We can walk you through the entire process.