Many of my clients have questions about Medicaid. The questions generally arise when we are talking about an overall estate plan, living trust or will. Clients want to know what Medicaid is about or whether Medicaid will take all of their assets if they need Nursing Home Assistance. Clients will also ask whether they need to sell their home to qualify for Medicaid or how much a spouse will be entitled to keep.
Medicaid is a federal program that is administered by state governments. It is a program that helps you to pay for your loved one while in a nursing home. It is not a program that you are entitled to, such as Medicare, so you need to apply for this program. Medicaid is a welfare program and is designed to assist qualified individuals (due to low income, age or disability) with medical care. A recipient of Medicaid will generally be required to “spend down” their assets in order to qualify. A Medicaid recipient will be required to spend down their resources until they have less than $1,500.00 in cash. Certain assets are exempt and will not be counted towards the $1,500.00 amount.
Clients often wish to gift property to children, grandchildren or other family members. However, some of these transfers may create a period of ineligibility for Medicaid benefits. Gifts or transfers made within the 60 month period before an application for Medicaid is filed may create a penalty period during which an individual cannot receive Medicaid benefits. The 60 month period is often referred to as the “look-back” period.
Everyone knows a family member or friend who has had an experience with Medicaid and Nursing Homes. However, you may want to be careful upon relying upon their experience to make your own decisions. The process is a complex one and each circumstance may differ. Therefore, it is important to consult a professional to review your circumstances and to assist you with a plan.
Here is a list of the information needed to apply for Medicaid. You must have an original or photocopy of each item:
- Verification of: Certified Birth Certificate, Citizenship or Naturalization and Driver’s License
- ORIGINAL Social Security Card (this is a necessary verification)
- ORIGINAL Red & Blue Medicare Card (this is a necessary verification)
- Health and Prescription Medical Insurance Cards (copy of the front and back)
- Monthly Medical Insurance Premiums for Health and Prescription Insurance/s (if any)
- Verify if the prescription insurance plan is a “Medicare Part D plan”
- Marriage and/or Death Certificates (if applicable)
- Power of Attorney Papers
- Verification of current gross and net monthly income received and any deductions from the income received (Social Security, Veteran’s benefits, Pension/s, Dividends, etc.)
- Verification if federal and/or state taxes are withheld from any source of income. If taxes arc being withheld, contact the company and request termination of tax deductions.
- Verification of all the current resources held by the Medicaid applicant. Resources include: Checking Accounts, Savings Accounts, Certificates of Deposit, Stock Certificates (number of shares held), Bonds (copies of the bonds themselves), Investments Accounts, Property, etc. (provide as many monthly bank statements as possible)
- Written verification from the nursing facility of bow much money is in the Medicaid applicant’s Resident Trust account (if any) and date of admission to the nursing facility, as well as dates of any hospital or rehabilitation stays prior to permanent nursing home stay.
*** If married, it is necessary to have all bank account balances for any accounts opened as of the first thirty (30) day stay in a nursing facility, hospital or rehabilitation center.
- Verification of an accounts closed within the last five (5) years (provide as many monthly bank statements as possible)
- Copy of any Trust Agreements
- Copy of any Postnuptial or Prenuptial Agreements
- Copy of any Separation Agreements
- Pending law suits
- Automobile Title
- Deed to Home
- Any mortgages owed and/or owned; include copy of mortgage, monthly payment and balance.
- Verification of homeowner’s insurance premium
- If renting, verification of monthly rent owed, verification of any security deposits, and verification of any rental insurance premium
- Verification of gas, electric, trash, water/sewer and phone bills – ONLY IF MARRIED.
- Life Insurance policy(ies). Please verify the face amount of the policy(ies), effective date(s), name of owner, name of insured and the current cash value (if any).
- Cemetery lot verification
- Burial Contract – MUST BE IRREVOCABLE
- Last five (5) years of Federal and State Income Tax Returns including the 1099s
- Proof of all transfers to any children and/or other relatives. These transfers will be considered gifts for the purpose of the Medicaid Application. Please verify all transfers within the last five (5) years.
- High School Graduate or grade completed
- Was he/she a Veteran?
Should the applicant have a spouse still residing in the community you need to provide the information listed above for both spouses. You will also need to provide to us the following information:
- Verification of all resources at the time your loved one first had a hospital, rehabilitation or nursing home stay longer than thirty (30) days after January 1, 1990. This date is very important, even if your loved one returned home for over a year. We still need the verification of the resources at the first date in order to determine the allowable amount the spouse residing at home is allocated to keep.
- Property taxes, Mortgage and/or Rent, Homeowner’s Insurance and monthly Condominium Association Fees
- Gas, Electric, Trash, Water/Sewer and Phone bills only
For your information, Medicaid uses a matching system to check all resources for the Medicaid applicant (and spouse) for a five year period. Please provide all information for the past five (5) years regarding the closing of accounts, transfers of resources, gifts to others and any information regarding the sale of property, stocks and the cashing in of bonds. We need this information in order to provide the best representation as to the depletion of the resource which the client held in that time frame.
Please feel free to contact the law offices of Gallon, Takacs, Boissoneault & Schaffer Co., LPA to schedule your initial consultation at 419-843-2001 if you have questions.