Medicaid Planning – “Failing to plan is planning to fail”

Post author By sps
Post date September 3, 2014

If a hiker was setting out to cross Arizona’s Sonoran Desert, he would begin by planning weeks or even months in advance. He would be certain to pack all necessities such as water, clothing, a trail map, sun hats and anything that may be needed along the way. He will take the time to educate himself on the plants, snakes and scorpions that are found in the Sonoran desert.

As an avid hiker, I often reference hiking metaphorically as an analogy easily understood. I find that it helps folks mentally prepare for the Medicaid application mindset. When asked by prospective applicants “at what point should I start thinking about Medicaid for myself or my loved one?” I reference the Sonoran desert. Certainly, the time to think about the process is well in advance. Otherwise, if you wait too long, you are like the poor desert hiker who hasn’t prepared. Certainly, this is not an enviable position to be in. Alan Lakein once said ” Failing to plan is planning to fail.”

In order to help folks prepare for the Medicaid journey I would like shed light on some guideline that can positively impact prospective Medicaid applicants.

Medicaid guidelines dictate that an applicant may not gift money within the five years prior to Medicaid eligibility, generally referred to as the five year ”look-back” period. However, many mix up the Gift Tax Exclusion Act with the Medicaid gifting laws and believe that gifting $13,000 annually is permitted for Medicaid purposes. For the IRS it is permitted, but for Medicaid purposes it is not. Should Medicaid identify any transfers or gifts in the applicants reviewed financial history, Medicaid will impose a penalty. A penalty period is a defined period of time in which Medicaid will not pay for care. The penalty period is calculated based upon the amount of funds that were gifted or transferred divided by the penalty divisor. The divisor is a figure derived from the average cost of care at a nursing home.

Most of us generally don’t know whether we will be needing Medicaid for ourselves or our loved ones over the next five years. Therefore, planning in advance is crucial in order to preserves ones assets. There are numerous asset preservation opportunities that Medicaid guidelines afford applicants. There are spousal rules that protect the community spouse. There are rules that protect disabled children. There are possible methods of preserving the home in certain instances. There are options that require forethought and planning in order to successfully achieve the desired goals.

When I am given the opportunity to speak to the senior population, the above is something that I always stress to prospective applicants. Understanding the rules and the possible scenarios that may arise ranks as the most critical aspects of a successful Medicaid outcome. Prospective applicants need to be ahead of their needs or risk finding themselves In the Sonoran desert without their sunscreen.

Medicaid New Jersey

NJ Medicaid guidelines – when there is a community spouse

Post author By sps
Post date June 17, 2014

NJ Medicaid guidelines – When there is a community spouse

By Neil Stern
I am often asked many questions about New Jersey adult Medicaid. People want to know about Medicaid guidelines. They stress over whether or not their loved ones will be eligible.

Some of the common questions I’m asked relates to scenarios where there is a community spouse. This means that one spouse has been institutionalized for care while the other spouse stays home in the community. Some of the common questions include the following:

When applying for Medicaid for my spouse, can I keep my house?
I’ve been told that all our money needs to be spent on his care before we become eligible for New Jersey Medicaid. Is this true?
How much of my savings can I keep for my self and still have my spouse approved for Medicaid benefits?
May I keep my spouse’s social security check and pension?
Is my money and my spouse’s money considered one pool for Medicaid purposes? Or can they be separated?
To answer some of these common questions, let me tell you a story about a sweet elderly couple I recently helped. I will call them Sue and Ed.

Sue and Ed married in the late nineteen fifties. They settled down in NJ and have owned their home in Monmouth County for the last half century.

They both earn money every month through their social security and pension benefits. Although Sue’s income is a very small amount, they have always managed financially since Ed’s social security and two pensions total over $3,700 monthly.

Recently, Ed’s health has been declining. In fact, things got so bad that there was no way for Sue to continue caring for him at home. In May 2011, Ed fell for the third time and broke his collar bone. Ed was hospitalized and then transferred to a local nursing facility in Monmouth County New Jersey.

Although the couple had over $70,000 in savings, they both realized that Ed was going to be in the facility for a while. They were worried that the cost of living in a facility would quickly deplete their savings. Thankfully, they were wrong.

The $70,000 they had in savings was accruing a low interest rate in two separate savings accounts. One account was in Ed’s name while the other was in Sues. They also had a modest checking account that was used for their living expenses. There were no life insurance policies, CD’s or annuity’s.

After spending the day with her husband, Sue reached out to the business office at the nursing home. They told her that she would need to “spend down” and then apply for NJ Medicaid benefits. They also referred her to Senior Planning Services for Medicaid guidance and advice. They explained to her that Senior planning Services can help her obtain Medicaid eligibility if she qualified. Naturally, sue was overwhelmed and scared.

I got the call from Sue in November. Sue was frantic. By that time, her husbands care had already drained their savings to $40,000 and Ed still needed to be cared for in the nursing home. In fact, it was unlikely that he would be able to leave.

She knew she was not going to lose her home, but she was very concerned with the prospect of losing her savings. Another concern was about her husband’s income. She had been told by a neighbor that upon Medicaid eligibility all her husband’s income would be paid to the nursing facility! In essence, she worried how she would live without her husband’s income. After all, it had been his pensions and social security benefits that had always covered the bills.

I began to calm her down by explaining that she would not be left destitute! We spent forty five minutes discussing Medicaid guidelines and how it would impact her and her husband. I explained that although her account and her husbands account are considered one for Medicaid purposes, she could still keep approximately $35,000. In fact, it was more then likely that Ed was eligible for Medicaid benefits as early as the following month. This information was vital to Sue, and it saved her from needlessly draining her entire savings.

I explained to her that as a community spouse, she would be able to keep half of the money based on the “snap shot” date. The snap shot date analysis would be based on their complete financial situation on the first day Ed had been institutionalized. I also confirmed that she was correct and that she would continue to live in her home.

As I mentioned, she was very frightened that she would be losing Ed’s income. I reassured her that there are times when a community spouse may keep some or all of the other spouse’s income.

Based on variables such as Sues shelter expenses and her own monthly income, I determined that a large part of Ed’s income would go to her. Imagine Sue’s relief when I outlined how I would ensure that she did not lose even one penny that she was entitled to.

Sue was comforted with the knowledge that I would manage the entire Medicaid application for her.

More importantly, I did obtain the maximum dollar amount that she was entitled to. We got the approval, and now sue no longer worries about Medicaid or spend downs. She spends her time with Ed and that’s how it aught to be.

Clearly, had she not called me, there would be many problems for Sue to deal with. Aside for all the money she would have lost and never recovered, she would be responsible for the gathering of all required Medicaid documents. Suffice it to say, that the outcome would be different.
Boy, am I sure glad she called

At Senior planning Services, Our experienced case workers guide families and educate seniors about the Medicaid application process. My advice- take advantage of the rules that favor you. Be sure that you get every cent that you are entitled to. Why? Because it’s yours. You earned it and you need it. In fact, perhaps now more then ever.

For your free Medicaid consultation call Senior Planning Services toll free at 855.S.PLANNING (855. 775.2664) or email us at Consultations@senior-planning.com

Medicaid New Jersey

New Jersey Medicaid Eligibility- obtaining proof of identity

Post author By sps
Post date June 17, 2014

New Jersey Medicaid Eligibility Criteria –

Proving ones identity using a passport, birth certificate or baptismal certificate
By Neil Stern
When a nursing home or assisted living resident contemplates applying for adult Medicaid benefits, they will often find the rules and guidelines to be quite confusing. Since Medicaid eligibility depends on what has occurred over the previous five years, there may be questions as well as general confusion regarding what documentation is required.

Aside for the five years of financial documentation that needs to be submitted, there is also a requirement for documentation proving the identity of the New Jersey Medicaid applicant.

In this article, I will discuss the topic of “Proof of Identity” for New Jersey adult Medicaid eligibility. The required documentation includes the following:

Proof of citizenship
Proof of age
Proof of identity
Proof of marital status
There are numerous documents that can satisfy the required identity proofs.

If the applicant has a US passport, that will suffice for proof of identity. Even an expired passport will work. The passport will obviously only work for the first three identity proofs (citizenship, age, and identity). It will not work as proof of marital status. Of course, although a passport is an excellent and versatile proof of identity, not everybody has a passport.

One of the most common proof of identity documents used is a birth certificate or baptismal certificate. Although it is the most commonly used proof of citizenship and age, many people do not have copies of their birth certificate. Even though it may prove to be a bit challenging to obtain, there are methods in obtaining birth certificates from government agencies.

Aside for knowing how to obtain the birth certificate, there is certain basic information that you would need. This includes the name and birth date of the person in question, as well as the names of both parents. You also need to know which city and state the person was born in.

When proving marital status for New Jersey nursing home or assisted living Medicaid, you may be required to provide a marriage certificate. Also, where applicable, you may need to furnish either a death certificate or divorce decree for the former spouse.

As is usually the case when it comes to New Jersey adult Medicaid, understanding the guidelines will make applying much easier. By researching the rules and regulations, you may successfully prevent denials and reduce Medicaid penalties.

Senior Planning Services is a social service firm based in Howell, NJ that obtains Medicaid eligibility for their clients. They offer free Medicaid consultations to help people navigate the complexities of the Medicaid process. Although Senior Planning Services is based in Monmouth County, they do Medicaid consulting in all 21 New Jersey counties. Most of their Medicaid work is for nursing home or assisted living residents in the following counties;Monmouth County, Ocean County, Middlesex County, Mercer County, Camden County, Hunterdon County, Union County, Warren County, Bergen County and Passaic County.

For your free Medicaid consultation, call Senior Planning Services toll free at 1-855.S.planning (775-2664) or email us at Consultations@senior-planning.com

resources

NJ Medicaid guidelines – When there is a community spouse

New Jersey Medicaid Eligibility Criteria –