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Medicaid Planning and Spend Down

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What is Medicaid?

Medicaid is a federal and state program that covers medical care for certain people with limited income and assets. These groups of people include: older people, people with disabilities, and people who are blind, as well as children and pregnant women.

Medicaid contributes to the cost of skilled nursing home care for people with limited incomes and assets who require this level of care. Medicaid also covers home and community-based care to people with limited incomes and assets who need long-term care services.

What Are “Long-Term Care Services”?

Long-term care services can include in-home care, community-based care, and skilled nursing home care.

Do I Qualify For Medicaid?

Qualifying for Medicaid is a two-step process. First, you must qualify medically for Medicaid.  This requirement is met if you need help with one or more activities of daily living.  Second, you must qualify financially by having assets below an amount set in the Medicaid guidelines. In North Carolina, as a general rule for Medicaid financial qualification, you must have less than $2,000.00 in assets.

What If I Have Too Many Assets, Can I Still Qualify For Medicaid?

Yes, it might be possble to qualify for Medicaid after performing a well planned “spend down”.  “Spend down” is the process in which you can pay medical bills, give gifts to family and friends, pay off debt, purchase life insurance, purchase a pre-paid funeral contract, purchase a vehicle, or make home improvements, in order to get your assets below a certain level to become eligible for Medicaid.

 However, many purchases and gifts can result in penalties, and these penalties can further delay the time when you are able to receive Medicaid. Your marital status can also affect qualifying for Medicaid. Therefore, it is important to consult with a qualified attorney to discuss how to appropriately spend down your assets to qualify for Medicaid.

What Is “Mediciad Spend Down”?

Mediciad Spend Down is the process of spending one’s asset with the goal of qualifying for Medicaid. Spend Down often occurs during a “Medicaid crisis”, which is when a person needs skilled nursing home care now and has been informed that they have too many assets to qualify for Medicaid. A key component of Spending Down is to spend the assets in a way that the person in need becomes eligible for Medicaid as soon as possible. The rules for Medicaid Spend Down are very tricky and often require a skilled attorney to provide guidance through the process.

What Is “Medicaid Pre-Planning”?

Medicaid pre-planning is the process of protecting your assets from being depleted by long-term care costs. Pre-planning must take place at least five years before you become incapacitated and your assets are needed to pay for long-term care costs. Incapacitated generally means you are unable to make medical and financial decisions for yourself. Planning to protect your assets might enable you to pass some of your assets to your heirs that you would otherwise have to spend on your long-term healthcare needs. We can design an estate plan that helps preserve your assets, as well as adequately manage your personal and financial affairs, should you become incapacitated years from now.

What Can We Do For You?

Navigating the complex rules of Medicaid and Medicaid eligibility can be overwhelming.  Our attorneys have the skill and dedication to work with you in crafting a plan for Medicaid eligibility. Schedule a consultation today to meet with us and begin to explore your options.

 

Nick Fernez leads our Elder Law practice. Please click here to see his biography.

 

We Invite You to Schedule a Free Medicaid Planning Consultation

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