The Medicaid Situation

The cost of nursing care is extraordinary and many people rely on the idea that Medicaid will pay for their care or the care of their family member.    People call my office on a regular basis with questions about Medicaid.  It is not uncommon that they are calling for an elderly parent or relative who needs to go to a nursing home, and the caller has been given a Medicaid application and asked to fill it out.  That application asks for a huge amount of the personal and financial details and frequently people don’t know what to put on the form.

It's important to remember that Medicaid is considered a “welfare” program and that there are financial eligibility requirements.  The threshold to qualify for Medicaid is low, so even a people of relatively modest means can be denied Medicaid and expected to pay for their own nursing care for some time before Medicaid will kick in.  A number of variables can affect a person’s Medicaid eligibility.

  • Is the person in need of care married?
  • Does that person own a home?
  • If the person has a spouse, where does the spouse live?
  • What money do they have on hand?
  • Do they have life insurance?
  • Do they collect a pension?
  • Does the person collect social security?  How much?

There are a number of other variables, but you get the idea.

There are some common misconceptions about Medicaid too – number one among them is that if you own a house, and apply for Medicaid, then Medicaid will take your house.  That’s not really accurate.  What does happen however, is an applicant who owns real estate is considered to be above Medicaid’s financial eligibility threshold and is directed to pay for his or her own care.  The person in need of care and his or her family is faced with making the decision to sell the house to get money to pay the nursing home bill, or finding some other way to drum up the money to pay the bill.

If you have a spouse, and the spouse resides in your house, than there can be an exception to this rule, but the law is very specific.  Girlfriends, kids, your dog – none of them count.

The law is complex but ultimately it allows attorneys to make long-range estate and Medicaid plans to help people succeed in their Medicaid applications and prevent the need to liquidate their assets on the fly as they are in need of care. These plans need to be put in place at least five years in advance, and if real estate is involved, at least ten years in advance.

What this means is if you or a family member is close to retirement, its time to sit down and talk about long-range planning.  Because “saving the family house” has to be done ten years before you need Medicaid if you’re not thinking about it by the time your 60, there’s a risk that by the time we do talk about it it will simply be too late.

Give me a call at the office at (518) 413-0889.  I’m happy to talk to you about planning for Medicaid and will help you make a plan that prevents you and your family from scrambling for cash when the time comes.