Medicaid Eligibility is complex and varies from state to state. Therefore, many myths about financial and personal factors determining a senior’s eligibility status have been established. Yet, despite many inaccurate beliefs about the program, with the right knowledge and planning resources, Medicaid can often fund nursing homes and long-term care for seniors who believe themselves to be ineligible.
Below are five common misconceptions about Medicaid eligibility and the truth about these claims.
Sam is 69 years old and the proud owner of a home, a car, and a great life insurance policy. In addition, he still receives a monthly income of $3,500 from the supermarket he had founded. His physical health has deteriorated to the extent that it is clear to his spouse and children that he requires nursing home-level care. A quick online search reveals that the current income and asset limits in New Jersey for seniors are $2,742 income per month and a total of $2,000.00 in assets.
Unaware of the various options available to applicants in NJ and other states who are above the income limit, such as setting up a QIT, Sam’s family assumes that he is ineligible for Medicaid.
Recalling that their aunt – who only owned a car and several stocks and bonds – was unable to be approved for Medicaid when she required care, convinces them not to even waste their time applying.
Thus, they continue spending upward of $2,000 each month for a live-in caretaker, while pushing through the days and weeks until they’d be forced to pay the astronomical fees involved in nursing home care.
The Complexity of Medicaid Eligibility Criteria
What Sam’s family, among many other families struggling with the costs involved in caring for an aging, loved one, fails to realize is that there are different types of care available through Medicaid and that each category of income and assets are evaluated differently.
Why is Medicaid recertification important and how do you navigate the process?
After a lengthy application and approval process, your aging loved one has finally been approved for Medicaid. A huge financial burden is lifted, and you are now free to focus on other vital aspects of their elderly, such ashiring a caregiver,Implementing safety precautions, anddeciding what level of care is best for their specific needs.
You can stop submitting endless amounts of paperwork to your application. You should heave a sigh of relief. But, you should not discard any communication you receive from Medicaid. Eligibility for Medicaid is recertified periodically. And although it is usually a simple process, Medicaid recertification is important to take care of in a timely manner to ensure there is no gap in coverage.
As David’s mother Betty aged, her health rapidly declined and David was faced with a slew of new responsibilities. As her primary caregiver, he needed to stay on top of her medical and financial needs. Throughout all these new challenges, one hurdle scared him most — would Mom need to sell her home to qualify for Medicaid?
If Mom won’t be moving to a facility for the next five years, there are asset preservation steps you can take to ensure that her home will be protected. Seek legal advice to determine your options.
Are you running into an issue where Mom or Dad has an income that is higher than the Medicaid income limit yet insufficient to cover their skilled nursing facility bill? Three letters, Q-I-T may be the answer to this problem.
A QIT otherwise known as a Qualified Income Trust or Miller Trust is a program that allows for Medicaid eligibility specifically for seniors with a high income. It is a trust funded solely for the purpose of Medicaid eligibility with income above the institutional limit- $2,523 in 2022 and fluctuating yearly depending on any federal cost of living adjustments (COLA).
Does a simple Google search for Medicaid guidance feel like gibberish? That is a common sentiment echoed by people like you who are looking for a clear understanding of Medicaid.
The following article provides a brief explanation of various Medicaid terms without going into the finer details. These explanations should be used as a basic reference; they are in no way intended as financial or legal advice. Senior Planning Services can assist you with a more in-depth understanding.
The Medicaid application process sometimes requires legal advice and the assistance of an attorney. Senior Planning Services does not provide any legal advice or services. You may wish to consult with an attorney concerning your Medicaid application.
