Senior Planning Services Resources

Here Is Your Holiday Gift… Followed By Your Medicaid Penalty!

Post author By sps
Post date December 19, 2014

The holiday season is just around the corner. So tradition entails gift giving to family and friends. For many, gifting $14,000 according to the IRS’s Gift Tax Exclusion is the perfect holiday gift. The annual Gift Tax Exclusion is the total sum of money per year that an individual may gift to an unlimited number of people without having to file a gift tax return or pay any gift taxes. Married couples may combine their annual exclusions, allowing them to gift $28,000 to each recipient.

While gifting is certainly allowed according to the IRS, Medicaid views gifting differently. No monies may be gifted within the five years prior to an applicant’s Medicaid eligibility date. Should Medicaid identify gifts or transfers when scrutinizing the financial history of the applicant, a Medicaid penalty will be assessed. The penalty will disqualify the applicant from Medicaid benefits for a period of time corresponding to the amount of care the gifted monies would have provided.This calculation is made using the CT Medicaid (Title XIX) penalty divisor rate of $11,851.00 per month.That would mean that if an individual gifted $11,851.00, they would would have one month of ineligibility for Medicaid benefits.

Seniors must exercise caution when gifting to family and friends, as they may be jeopardizing their Medicaid benefits.

Happy Holidays!

Understanding Life Insurance Policies And How They Relate To Medicaid

Post author By sps
Post date December 3, 2014

Understanding Life Insurance Policies And How They Relate To Medicaid

When an individual is applying for Medicaid and has assets that exceed Medicaid’s resource limit, a Medicaid spend-down is necessary. Assets in excess of the allowable amount must be spent down in order to achieve financial eligibility. Some kinds of life insurance policies are included in the spend-down with a few exceptions. Below is a breakdown of what needs to be liquidated in order to be eligible for Medicaid.

There are two popular types of life insurance policies that have different effects on the Medicaid application process.

Term Life Insurance Policies:

Term Life Insurance Policies have premiums that increase as the individual’s age increases. These policies only carry a death benefit. They are also referred to as protection policies; their purpose is to assist the beneficiaries in the event of the policy holder’s sudden death. Since there is no current cash value in term policies they are not considered an asset according to NJ Medicaid guidelines. These policies may remain active and will not impede one’s Medicaid eligibility. Once an individual is on Medicaid he/she will have minimal assets and may not have the money to cover the monthly premiums. Some beneficiaries choose to cover the monthly premiums so that they can ultimately benefit from the death benefit once the Medicaid recipient passes.

Whole Life Insurance Policies:

Whole Life insurance policies generally have fixed premiums, death benefit and cash value reserves. These policies may be liquidated at any time. Being that they carry a current cash value, they are not exempt from the Medicaid spend-down and must be liquidated in order to meet Medicaid’s financial eligibility requirements. There is one exception to the rule! If the Whole Life Policy has a face value of less than $1,500.00, regardless of the cash surrender value, it is exempt from the Medicaid spend down and may remain open and active. “Face Value” is the original death benefit amount on the day the policy was purchased, prior to the policy holder making monthly premiums. While the policy is active it will accumulate cash value from the premiums as well as dividends from reinvestment money. The cash value may exceed the original death benefit (or Face Value). Once the policyholder passes, the beneficiaries will then be able to claim the total death benefit from the policy.

Medicaid Connecticut Medicaid New Jersey Medicaid New York

Utilizing A Special Needs Trust With The Excess “Spend-Down” Money

Post author By sps
Post date November 24, 2014

In order for an individual to be eligible for Medicaid, there are financial standards that need to be met. Many Medicaid applicants will have to spend some of their assets in order to meet Medicaid’s financial threshold. There are a few excludable resources that are exempt from the Medicaid spend down. These assets can be retained by the Medicaid applicant and will not impede Medicaid eligibility. An individuals personal possessions, a prepaid irrevocable funeral trust, and a special needs trust for a disable child are just a few excludable resources when applying for Medicaid.

Today we will discuss utilizing a special needs trust with the excess “spend-down” money. When a Medicaid applicant has a disabled child, a special needs trust allows the transference of assets from a parent to the child without jeopardizing the child’s government benefits.

Special needs trusts are also referred to as “supplemental care trust”. These trusts supplement the disabled child’s Supplemental Security Insurance (SSI) and Medicaid benefits. The money in a special need trust may only be used for specific items or services. The trust is meant to supplement and not pay for basics such as food and shelter. Some things that may be purchased through a special needs trust include:

• Home modifications to assist the disabled
• Medical treatments and equipment not already covered by government assistance programs.
• Education and recreation equipment
• Computers
• Musical instruments
• Sports equipment
• Travel expenses
• Prepaid funeral

When a parent creates a special needs trust for a disabled child, he/ she chooses a trustee. A trustee is an individual or institution who manages the assets in the trust. The trustee’s responsibility is to follow the terms and guidelines outlined in the trust as well as transferring the funds from the trust to the beneficiary or disabled child. A trustee can be a family member, attorney, bank or anyone that one chooses to assign as a trustee.

The trust restricts the beneficiary (or disabled child) and parent access to the assets in the trust. Only the trustee would have accessibility to the funds and therefore it’s considered an unattainable asset for both the parent and disabled child. To summarize, the Medicaid Applicant who transfers assets to a special needs trust for a child will not incur a Medicaid penalty. Additionally, the recipient will not jeopardize the government benefits which they receive.

Medicaid Connecticut

Connecticut – Prepaying A Funeral & Burial Plot For Medicaid Purposes

Post author By sps
Post date November 12, 2014

When one is applying for Medicaid / Title XIX, there are very limited assets that one may keep and still be eligible for the Medicaid benefit. In CT, the asset limit is $1,600 for a single individual. Nursing homes have an average daily rate of $390 a day, causing many to be in need of Medicaid at some point in their later years. Some people think they can give all their money to their children or others and still be eligible for Medicaid. They are wrong. Medicaid will not allow an individual to transfer assets within the five years prior to their Medicaid eligibility date. There are exceptions in which Medicaid will allow applicants to preserve assets.

Prepaid Irrevocable Funeral Trust /Prepaid Funeral Contract

Prepaying a funeral is just one of the very few exceptions of transferring assets. One may prepay up to $10,000 towards their funeral (2020). The funds set aside for the prepaid funeral must be put in an irrevocable funeral trust. This means that the trust is non-refundable and cannot be cashed in at any time. The funeral trust is portable and can be transferred to another licensed funeral home if one desires to do so.

Revocable Burial Allowance / Revocable Burial Space Contract

One may also set aside funds for their burial plot and burial items that are placed in a revocable trust, there is no limit on how much money one can spend on this. Some items that can be included are:

• Burial Plot; opening and closing expenses
• Headstone or Marker
• Crypt, Mausoleum
• Casket or Urn

These purchases do not have to be placed in an irrevocable trust – meaning that they can be refundable. If one refunds the purchases when the individual is already on Medicaid the funds must be given to the State. If the funds are not given to the State, the Medicaid recipient may be over the $1,600 asset limit and can potentially lose their Medicaid benefits. As long as the funds remain in the revocable trust, it will not impede the individuals Medicaid eligibility.
There are some other exempt assets that Medicaid allows an individual to keep. Look out for future posts on exempt assets and allowable Medicaid spend downs.

Medicaid Made Simple

Happy Veterans Day

Post author By sps
Post date November 11, 2014

We at Senior Planning Services would like to take a moment and convey our deep appreciation to our Veterans. The brave men and women who defend our country, and enable us to live with the freedoms we have. These are our true heroes May these brave men and women be blessed for their selfless dedication and services to the United States of America.

Gifting Medicaid New Jersey

When a Medicaid applicant owns a home – could it be successfully transferred to a child?

Post author By sps
Post date November 5, 2014

Senior Planning Services is the premiere Medicaid application company in the states of NY, NJ, PA and CT. We have been privileged to successfully process thousands of Medicaid applications on behalf of our clients. Our unique vantage point allows us to identify trends that have been occurring in regard to Medicaid’s enforcement of rules and policies. The following is a recent trend that we have identified.

When a Medicaid applicant owns a home, there are circumstances in which the asset is exempt and may be transferred without jeopardizing Medicaid eligibility. In the past, the applicant’s home could successfully be transferred to a child if the following two criteria were met:

1. The son or daughter has lived in the home of the applicant for a minimum of two years prior to institutionalization

2. There is a signed doctor’s note stating that the applicant was kept at home (as opposed to a facility) due to the care of the child who lived with the applicant.

Senior Planning Services has noted that the above referenced criteria have become less liberal. Medicaid may now disallow the transfer on the basis of any of the following:

1. If the child had a job that would impede their ability to fully care for the applicant, the Board of Social Services may request documentation in order to determine whether or not
the care was supplemented

2. If the applicant’s medical records do not reflect a need for care, a doctors note may not suffice as proof that there was a need for care.

Although we have seen numerous cases approved without the additional scrutiny, we have also seen cases where the additional requirements were enforced. If the Medicaid applicant meets the criteria of the more stringent interpretation of the policy, educating them to provide this information when applying may help facilitate faster Medicaid approvals.

Senior Planning Services is the most comprehensive and efficient Medicaid application company in the industry. The fact is that many long term care facilities absorb financial losses caused by preventable errors. Slow Medicaid approvals preceded by long pending periods, Medicaid penalties and worst of all Medicaid denials rob facilities of untold sums of revenues. Very often, the root cause of the aforementioned issues are based on actions or inactions attributable to the Medicaid applicant.
For a free Medicaid consultation contact Senior Planning Services at 1855.S.Planning (775-2664).