Assisted Living Medicaid Isn’t Necessarily Forever – Part 1
Dad is in an assisted living facility (ALF) and is close to running out of money. I would like him to stay in that facility rather than moving him to a nursing home. In the past I have discussed the hurdles of getting assisted living Medicaid, which is different than nursing home Medicaid in many respects. ALFs have to make 10% of their beds available for New Jersey Medicaid if they agree to become a “Medicaid facility”. Most ALFs limit their Medicaid beds to that 10% number so even if you are approved by New Jersey’s Medicaid office you might end up on the ALFs waiting list until a bed opens up and may have to continue to private pay. I have also talked in the past about the need to medically qualify as needing nursing home level care. Not all ALF residents meet that test so a Medicaid application can fail even though the financial requirements have been met. Joe’s recent call highlights another important issue with assisted living Medicaid. Joe had gotten past the hurdles I just mentioned. His dad had spent down his assets and had applied for and was now receiving Medicaid. Everything was fine
Trumpcare – What Doe it Mean for Long Term Care? (Part 2)
Last week I was discussing the impact that the Republican party’s health care bill, dubbed by some “Trumpcare”, might have on long term care. As of Friday it appears that the American Health Care Act is dead and Obamacare, at least for now, is still with us. Nevertheless, let’s take a look at how this bill or any new bill proposed by Congress might impact Medicaid. My point in last week’s post is that the proposed healthcare bill did not appear to have a direct impact on Medicaid’s long term care coverage. By that, I mean to say that it did not contain any changes to the existing Medicaid laws that relate to long term care. There isn’t anything in the proposed law, for example, that would extend the Medicaid lookback beyond the current 5 years. The law meant to address health care coverage, not long term care coverage. That does not mean, however, that long term care coverage under Medicaid wouldn’t be affected at all. Trumpcare included ending Medicaid expansion under Obamacare and cuts to Medicaid funding so that a set amount would be allotted to the states by the federal government for their Medicaid programs. Medicaid is
Trumpcare – What Does It Mean for Long Term Care?
As is a majority of the country, I am watching with great interest the development of President Trump and the Republican party’s proposal to repeal and replace Obamacare. As an eldercare attorney focused on helping families figure out how to pay for long term care, someone asked me the other day how would the new Republican health care bill (the American Health Care Act or not surprisingly being nicknamed “Trumpcare”) would affect Medicaid coverage for long term care. While it is too early to say for certain since the details of the proposed bill were only made public a few weeks ago, the speed with which Republicans will attempt to get the law passed is troubling. As with any bill, changes are often introduced during the process of gaining the votes necessary to get it passed, although Republican party leaders say they intend to get the new law passed in about 4 weeks. Who knows what those changes might look like? Nevertheless, we can certainly consider the details that have been announced so far and project how things might play out. My initial response to the question of how it would impact long term care is similar to my
Getting a Money Settlement While on Government Benefits (Part 3)
The past 2 weeks I outlined for you the problem of what to do with a money settlement that is received by someone currently on Medicaid. A special needs trust is the solution most often recited. But what choices does Joe have? He is the 70 years old client currently in a nursing home receiving Medicaid benefits that I mentioned last week. If Joe has any child that have been deemed disabled by Social Security then an outright transfer to that child or to a trust for the sole benefit of that child can be made. This transfer will not carry a Medicaid penalty because it falls within the exceptions to Medicaid’s transfer penalty rules. From there the money can be placed in a trust and used for Joe’s benefit. What if Joe doesn’t have a disabled child? Then he will need to spend the money down but cannot simply transfer it out of his name. He must spend it on product or services for himself (not others). There isn’t much he can spend it on in a nursing home but depending on his mental and physical capabilities a cell phone, computer or motorized wheelchair are some common expenses.
Getting a Money Settlement While on Government Benefits (Part 2)
Last week I outlined for you a common call I receive from attorneys who have successfully obtained money recoveries for clients who are currently receiving or may in the future need government benefits. Special needs trusts have become more widely known in recent years and recognized as “the solution”. However, as I wrote last week that isn’t always possible or even desirable. Let me explain. A special needs trust – or more specifically – one type of a special needs trust is a possible solution. A first party special needs trust, also known by reference to the specific federal statute that authorizes it, a “(d)(4)(a) special needs trust, is funded with the beneficiary’s own assets. This is to be distinguished from a third party special needs trust which is funded not with the beneficiary’s own assets but rather a third party’s assets. This is commonly the case with parents who set up an SNT to receive the inheritance they intend to leave for a disabled child as part of their estate plan. There are some important requirements that must be satisfied in order to set up a first party SNT. First is that the beneficiary must qualify as a
Getting a Money Settlement While on Government Benefits – Part 1
We get quite a few calls from attorneys who have settled cases or obtained judgments in favor of their clients to compensate them for pain and suffering resulting from slip and falls, car accidents, medical malpractice etc. The amount recovered might be small – say $10,000. In other cases it could be substantial – $1,000,000 or more. In each case the attorneys have brought the matter to a successful conclusion – no doubt getting the very best result they can for their clients. So, why are they reaching out to me? The reason is that in many cases their clients are receiving needs based government benefits. Receipt of the settlement proceeds will in each case cause their clients to lose those benefits. Often the attorney has no idea this could be an issue when he/she took the case. Now the client is understandably concerned about losing the benefit which just might have a major impact on his/her well being. What if anything can we do? Placing the proceeds in a special needs trust may be the solution but that won’t work for everyone and even if it is a possible answer it still may not be desirable or necessary.