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The Top 10 Medicaid Questions Answered

June 16, 2016
Elder Law
1. How long does it take to get Medicaid?

The answer varies depending on each person’s situation, but basically it is dependent on cquiring all the documentation needed to satisfy the Department of Human Resources that the applicant has met the income and resource limitations and the medical needs required by the program. Typically, we will set a goal date by which we would like to have all the paperwork and have reached financial qualifications.

Once the application has been submitted, we typically receive a request from DHS asking for dditional documentation and/or information. Usually, however, DHS is able to reach itsdecision within 3 months of receiving the initial application. This is NO GUARANTEE. Everycase is different.

2. What are countable assets?

All banking and investment accounts of any nature, cash value in all life insurance policies (with minimal exception), any real estate or time-share that are not the applicant or the applicant’s spouse’s primary residence (with minimal exceptions), every vehicle except one, anything tangible that is not personal belongings.

3. Do I have to sell my house?

If the applicant has a home and intends to return there, or a spouse or disabled adult child lives there, it is not a countable asset. However, the reality of the situation is that many people who need to enter nursing homes are never able to return home. There are other financial considerations that accompany attempting to keep a house when the applicant has permanently relocated to a nursing home and no spouse resides there. Discuss this with your attorney before placing the house on the market.

4. What can I do if life insurance is keeping me from qualifying?

There are limited options, but there usually are options. All options are not always available. Discuss this with your FCM and attorney.

5. How much money can the applicant keep?

A single person can have no more than $2,000 in COUNTABLE assets. We recommend a number closer to $1,500.00. For a married person, the number varies depending on the value of the COUNTABLE assets the couple had at the time the applicant entered either the hospitalization that led to the long term care or the date of entry into the long term care Facility.

6. What is a Miller Trust?

A Miller Trust is a specialized income trust that allows an applicant who, otherwise, makes too much money to qualify for Medicaid benefits, to qualify for Medicaid benefits. See the handout on that topic for more information.

7. Should I pay the nursing home?

It depends. You owe the nursing home the full cost of care for months that precede your qualification for Medicaid. So, if you know you are not yet qualified, then yes, pay the nursing home. Often this is a key element in becoming qualified for benefits. If you are waiting until the last minute to pay the nursing home, then use a cashier’s check or money order so that the funds are not in the applicant’s account on the 31st of the month. If you do not have enough funds to pay the nursing home in full, discuss this with your FCM. If you are already qualified, but have not received DHS formal approval yet, then you will be asked to pay the nursing home an amount estimated by your lawyer to be the “client participation” that DHS will assign.

8. I will not be using my car. Can I give it away or sell it to a relative for less than the full
fair market value?

No. One car is a non-countable asset. Leave it in your name until after we have secured Medicaid benefits, and then we can discuss disposition of it. Keep insurance on the car. No one should be driving it. If there are two cars, one will need to be sold for fair market value. If it is sold for less than fair market value, we will need an affidavit from someone that justifies why it was not worth the fair market value ascribed to it by Kelly Blue Book.

9. I sold my house less than five years ago. How do I prove that I got the fair market value
for it?

We have a form for your real estate agent, or another knowledgeable real estate agent to complete, that will satisfy this request from DHS.

10. Will the state take my house when I die?

It depends. If you are not married and on Medicaid, you will likely not have a house when you die. However, if you have a child who has lived with you for 2 years, for the purpose of delaying your entry into a nursing home, then the state will allow your child to keep your house, and not require that it be sold to pay their debt. If you are married, the state will not make a claim against your estate. They will wait and make a claim against your spouse’s estate. So, if your spouse still owns a house at that time, and little or no other assets, then it will likely have to be sold to pay the state back.