Medicaid Planning in Iowa

Iowa has two main Medicaid programs to assist residents in paying for medical care. One program serves people who need to reside in a nursing home, and this is what most people think of when they think of Medicaid. The other program is called the “Elderly Waiver.” This program provides funding to pay for in-home medical assistance to people who need help, yet still live in their own homes or in independent or assisted living. For those over the age of 55 years, residing in Polk or surrounding counties, and living either at home or in assisted living that does not include memory care, there is a third program that parallels the Elderly Waiver program, which is called the PACE program. Eligibility for the PACE program and the Elderly Waiver program are the same.

The eligibility requirements for each program depending on whether you are married or not, live in your own home or not, etc. The rules for qualification are complex. It is often helpful to meet with an attorney who understands the TitleXIX requirements and can help set up a plan to allow you to receive these benefits when you need them most. Whether you are in crisis and need to get qualified now, or are looking ahead to be prepared, Letsch Law Firm can help you plan. Proper planning is essential so that you do not do anything that would inadvertently disqualify you from eligibility for benefits.

Older mother and daughter laughing together while sitting outdoors.

Most married people are surprised to learn just how much assets they are able to protect for the use of the spouse who is not needing Title XIX benefits.  There are even tools we can use to redirect some funds to your children, if you are single – all of which is well within the rules, but not commonly known by the folks who actually work in the care facilities.  Do not put all of your hard-earned savings and your assets at risk. Contact Letsch Law Firm today to help plan for your future care needs. We will work with you to determine the best possible options to protect your assets, while still making sure you get the benefits you deserve when you need them most.

The Medicaid application process can be very confusing, but we are here to help.  You can depend on the Letsch Law Firm for assistance in preparing for Title XIX eligibility. Call us today at (515) 986-2810, and we will meet with you and help you determine your best options.

Financial Eligibility

There are two components to financial eligibility for the Medicaid programs.  The first is income. The second is countable assets. If the Medicaid applicant’s income is over the limit (which changes every year), not to worry.  A Medicaid Assistance Income Trust (also called a Miller Trust) can be easily used to rectify that situation.  If you are married, your spouse’s income is not used to pay for your nursing home care.  

The second factor is countable assets.  Some assets are not counted, such as your home, one vehicle, your personal and household possessions, and some limited funeral products.  A Medicaid applicant can have no more than $2,000 in countable assets in order to be financially eligible for benefits (with the exception of a benefit program designed for people with disabilities who are working). If you are married, there is a process to determine how many countable assets your spouse is entitled to keep. In some cases, financial eligibility is achieved by changing the characteristic of assets from countable to non-countable or turning assets into income. This is NOT something you will want to try by yourself or rely on the advice of non-legal professionals.  Mistakes can be very costly.  At Letsch Law Firm you will be provided with the education to help you make an informed decision about how and when to restructure your assets so that your family can become eligible for benefits.

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How to Qualify for Benefits in Iowa

Qualify in Iowa

Glossary of Terms

Applicant

The person who is applying for Medicaid benefits.

Assets

All financial accounts; cash value in life insurance policies or annuities; all real estate including time shares and life estates; all registered vehicles and trailers; stocks and bonds; crops in the field or storage bin; livestock; money that other people owe you due to loans, refunds, or deposits; precious metals excluding personal jewelry; collections with a marketable value. 

Beneficiary

Someone who expects to benefit from another person or program, for example a person who expects to receive an inheritance or a person who is receiving Medicaid benefits. 

Community Spouse

Term used to describe the legal or common law spouse of a person who is a Medicaid applicant or recipient, if the spouse is not residing in a residential long term care facility. 

Monthly Maintenance Needs Allowance

The minimum amount of monthly income the community spouse needs. If the community spouse’s income is less than this, the community spouse may be entitled to some or all of the Medicaid recipient’s income. This number changes every year.

Client Participation

The amount of money the Medicaid recipient is required to pay for his or her own care, each month.

Attribution Date

The date that is used to determine the amount of countable assets that the community spouse is allowed to have on the date of claimed eligibility.  For persons in a residential care facility, it is the first of the month, of the month in which the Medicaid applicant was last home overnight. 

Independent living

Either living in a private home or apartment, or in housing designated as such on a complex operated by a company that also offers assisted living and/or residential care facility. 

Long Term Care Insurance

Private insurance that pays according to the terms of the insurance. Typically, there is a waiting period before the policy will begin paying, a daily maximum that the policy will pay, and a lifetime maximum that the policy will pay.

Miller Trust

Officially, this is a Medicaid Assistance Income Trust. It is a trust that is needed if a Medicaid applicant or recipient’s gross monthly income is above the income cap, in order to meet the income eligibility guidelines.

Lookback Period

Currently 60 months prior to claimed eligibility for Medicaid benefits. 

Penalty Divisor

The average cost of nursing home care for the state, as set by the state each year, and used to determine the length of penalty if the applicant or applicant’s spouse has given a disallowed gift during the lookback period. 

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