Valuable Medicaid information from Molly Janczyk: Protected income/assets: Medicaid: General info

From Molly Janczyk, April 6, 2007
Subject: Protected Income/Assets: Medicaid: General info

ALL cases vary and this is only general info for consideration of your status. EACH person must seek advice and particulars for themselves. This info may raise questions or motivate readers to search for personal answers.

SEEK a reputable ELDER attorney who specializes in Medicare and Medicaid laws. Be sure they are well versed and handle a large volume of such cases.

Sources:
1. US Dept of Health: _www.aspe.hhs.gov_ (http://www.aspe.hhs.gov/)
Page down or type in the following posting: "Spouses of Medicaid Long Term Recipients": April 2005
2. Ohio State Bar Assoc.: _www.ohiobar.org_ (http://www.ohiobar.org/)
3. Attorney sites

Spousal Protection In 2004, income protection was $1505 per mo. adjusted yearly for inflation. States could raise to a max of $2319 per mo as 35 states did.

Couples income divided into his and hers by name on the checks including pension checks, IRA payouts, etc paid only to account holder.

Joint income divided in 1/2: Community spouse (non institutionalized at home spouse) receives all his or her income including own assests plus 1/2 shared income. There are minumums and maximums applied. If 1/2 of shared income is less than the minimum, then then institutionalized spouse must be allowed to supplement the at home spouse up to the minimum or if the at home spouse is very low in income, they may receive all combined income.

If the at home spouse receives high income, they may receive little or no supplement for the institutionalized spouse. Even if the income of the at home spouse is high, Medicaid cannot require any of it spent toward the institutionalized spouse's care.

The at-home spouse keeps the home, household goods, personal effects and
1/2 assets up to current maximum of $101,640. Minimums are in the $20,000 range.

An individual with no spouse or child living in home must spend down to $1500 of total assets to qualify for Medicaid. If a child is living in home, the home is protected.

If the house is in the institutionalized spouse's estate at death, proceeds go towards the cost of care while institutionalized. If a spouse or child is living in the house, the home is often protected for them.

Protected Assets: (THIS IS ALL GENERAL INFO AND NOT TO BE CONSIDERED UNLESS UNDER KNOWLEDGABLE ELDER ATTORNEY'S ADVICE) Assets are added together. Subtract $2000 for use by institutionalized spouse's needs. Divide assets in 1/2. If the at home spouse is less than total of State's minimum and maximum, the at home spouse gets to raise to the minimum. If the at home spouse receives more than maximum, the at home spouse is limited to the maximum.

Transfer Assets: (THINGS TO ASK ELDER LAW ATTORNEY WELL EXPERIENCED ON MEDICAID LAWS):

To at home spouse must be done 36 months prior to institutionalization or
60 months prior if for trusts.

There are laws and formulas for gifting money. Age and amount are factored. For every $4806 (average cost of a nursing home in Ohio) gifted in one month, you must wait one month to go into a nursing home. So, if you gift $48,060, you are disqualified for 10 mo. of institutionalized nursing home care.

My mother gifted money to her grandchildren for education and kept her formula amount determined in her Elder Law attorney free consult.

Assisted living in Ohio pays for limited at home care under the Passport Waiver Program and includes 1800 living placements this year. I assume this is a low income program. Due to the amount gifted, she could not go into a nursing home for custodial care without paying herself for 2 and 1/2 years. She kept that amount back in her accounts should she need a nursing home and gifted all the rest of her money to her grandchildren so as to pay her fair share for custodial nursing home care but not have her entire life's savings taken by one.

I advised her on this as she wanted to pay her fair share and refused to live with one of us if she had to be under custodial care adamant about not being a 'burden'. Fortunately, long term custodial care in a facility did not occur. The average stay in a custodial care facility long term is 1 yr. But, we all know folks who have lived in such for years.

Annuities transferred must be to recipient with reasonable life expectancy.

Some planning tools available to research:
1. Hybrid policies: ties to annuities and life insurance

2. Medicaid Annuities

3. Twist on single premium life insurance with guarantee issue and no medical underwriting if in phase of pay down for Medicaid or soon to be in this phase. Medicare typically provides 100% for 1st 20 days in a hospital or skilled
(non custodial) facility. Then reduced coverage for the next 80 days.

This is meant to raise questions for your own future status for gaining advice for your personal. All info taken from sites listed above. Please list questions you have and take to an Elder Law Attorney. BE SURE FREE CONSULTS

are available and answer most these issues. It is your choice then to go on and use the attorney for trusts, wills, annuities, etc. or simply write down info and leave the office for free with your personal status questions answered.

That is what my mother and I did when we visited an Elder Law Attorney who helped write the Medicare and Medicaid laws for Ohio.

STRS and ORTA are hoping to print some Medicare HC info in newsletters in answer to questions raised. Questions and concerns for Gary Russell who is reviewing them with his HC dept for accuracy and will tweak the article before circulation. Both Gary and Ann Hanning have agreed it is important for retirees to be well informed on these confusing issues. I hope OEA-R will also consider adding this final report in their newsletter.