Articles Posted in Medicaid Planning

It’s a universal truth that we all get older, and it’s also a universal truth that we can’t be sure what the future holds. For many individuals, aging means finding long-term care. Unfortunately, the cost of elderly care is incredibly expensive in this country, and it is difficult for many clients to piece together enough funds to cover their expenses. In order to avoid this crisis, we recommend that you begin your Medicaid crisis planning as soon as possible, which can help you avoid the need to panic down the road.

Medicaid crisis planning is the process of preparing today for your possible needs down the line. In the future, you might need a fulltime nurse, a nursing home, or other specialized care. By starting to plan now for how you might pay for these services, you can save yourself significant stress in the future.

Medicaid and Public Benefits

In Texas, you can apply for Medicaid, which will cover large portions of the cost of long-term care. Importantly, when deciding if an individual qualifies for Medicaid, the government will look at the past five years of the person’s financial history. Thus, if you have been financially stable but you’ve recently hit a tough spot, or if you are hoping to transfer assets to a loved one in hopes of qualifying for Medicaid, there is still a substantial likelihood that you will not meet the requirements.

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As healthcare improves over time, the median age of adults in the U.S. also rises. While this is certainly a net positive for adults and their families, it also means that individuals have more planning to do regarding their elder years. Today, our blog reviews some important topics regarding senior public benefits planning in Texas that you might want to think through as you and your loved ones prepare for the future. As always, there is more to discuss than included in this post, and we recommend you reach out to a trusted estate planning attorney to learn more.

Medicaid Eligibility

Medicaid is a state-provided benefit that provides healthcare for individuals with limited resources. If you qualify for Medicaid, the State calculates a co-pay for you, which you then pay through Social Security or other sources of income. Then, when you go to a doctor’s office, the government pays the difference between your co-pay and the rate that the medical facility charges.

There are two main criteria you must meet to qualify for Medicaid: you must be both medically eligible and financially eligible. To be medically eligible, a doctor must sign off, confirming that you need a certain level of care. To be financially eligible, your assets and income cannot be higher than the government’s designated limit.

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By definition, Medicaid is a government benefit that is available to individuals with lower incomes that need to pay for long-term care. It was created in 1965 and provides coverage to millions of Americans, including pregnant women and older people who need health insurance. Despite its widespread availability, it can sometimes be difficult to access Medicaid, and Houston Medicaid planning attorneys can be incredibly helpful in making sure you receive the benefits you need when times are tough.

When You Might Consider Hiring a Medicaid Planning Attorney

If you or a loved one is considering long-term care, you might want to contact an attorney that can help you think through what benefits are available to you. Additionally, if you are currently undergoing a financial change in circumstances, it could be in your best interest to talk to an attorney to see if you qualify for Medicaid.

Working through a serious illness or planning for retirement might also be reasons to talk to a Medicaid attorney. This can be especially helpful when you feel as if your medical issues require enough attention that it is difficult to focus on taking the time to apply for Medicaid benefits on top of everything else you have going on.

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Medicare and Medicaid have similar names but are two completely separate government health insurance programs. Understanding the difference can help you and your family plan for aging and retirement.

What is Medicare?

Medicare is a program administered by the federal government—the Centers for Medicare & Medicaid services—that is essentially available to anyone, regardless of income. If you are over 65 years of age or are younger and have a specific disability, you may qualify for Medicare. People covered under Medicare pay into a trust from which medical bills are paid. Most long-term care costs are not covered under Medicare, making it difficult for aging individuals and their families to pay for care facilities or long-term rehabilitation.

What is Medicaid?

Unlike Medicare, Medicaid is administered by individual states, such as Texas. It is catered to serve low-income people at any age, and also covers the costs of long-term care in nursing home facilities. In Texas, Medicaid is extremely complex and can be difficult to navigate. Medicaid applicants must either have a disability, be caring for a disabled child, or have a monthly income under a limit set by the government each year. Medicaid applicants must also have less than $2,000 in certain assets, which can exclude primary residences, vehicles, and some personal property. The government will look at the most recent five years of financial statements to ensure an applicant’s eligibility, making it difficult for applicants to transfer assets in anticipation of filing for Medicaid benefits if they wait until the last minute.

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Thinking about long-term care—especially as a person ages—can be an overwhelming and scary process. However, as time goes on, it can be more difficult for seniors to obtain proper long-term care. This is why planning ahead is essential. Elder law attorneys will discuss financing for long-term care, which includes often applying for Medicare and Texas Medicaid. Although these are difficult conversations to have, starting the process as soon as possible can ensure a smooth transition when the time does come for new housing or medical care.

Plan Now, Avoid Care Issues Later

The Massachusetts Attorney General recently announced a settlement with a nursing home to resolve allegations that they failed to meet the needs of their residents. The Attorney General’s investigation found that within the time span of a year, the nursing home admitted residents that they did not have trained staff members to properly care for them or the necessary equipment. This also included the staff failing to properly prevent the development of ulcers on residents. The case is an example of a nursing home failing to properly care for its residents.

As we have discussed in other posts, planning for the eventual need for long-term care is a crucial element of any Houston estate plan. With the costs of nursing home care rapidly increasing across the country, more families are taking a proactive approach when it comes to deciding how to pay for these future costs.

For families with significant assets, the concern is not necessarily whether they can pay for the necessary care, but how they can limit the amount their own assets will go towards paying for the care. Thus, Medicaid planning is focused on how to strategically structure familial assets in a way that will enable the family member in need of long-term care to quickly and easily qualify for Medicaid while preserving their assets.

Medicaid is a needs-based program, and applicants must meet strict asset and income limits to qualify for benefits. One of the most important elements of Houston Medicaid planning is understanding these asset and income limitations. Applicants with excess assets or income will be required to “spend down” the excess before they can qualify for benefits. Of course, this can leave a spouse who is not in need of care in a challenging spot, because the money they need to continue to live independently may be diverted to pay for long-term care.

While Medicaid planning is a term often tossed around, not many people know exactly what the process entails. In general, Medicaid planning is any assistance provided to an individual in advance of their Medicaid application. These tasks widely vary depending on the needs of the person, but may include anything from collecting documents to restructuring assets. Medicaid eligibility is complicated and even a simple mistake in the application may result in being denied benefits. Because of this, people will often consult a Houston Medicaid planning attorney to help them with the process and ensure their family’s assets are maintained while their loved one receives the long-term care they need.

Reviewing Medicaid Eligibility

It is important for an individual to determine their Medicaid eligibility in order to have a full grasp of the potential benefits that they could receive. The consequences of being denied Medicaid benefits can be detrimental not only for the individual, but also for their family. The American Council on Aging provides a free eligibility status checker to determine eligibility.

As people age, it becomes even more important to plan ahead for unexpected illnesses and disabilities. While creating an estate plan may seem like enough, a life care plan can help to ease the stress that comes with taking care of an elderly loved one. This is critical because it defines and organizes all aspects of a senior’s care. By establishing a Houston life care plan, a family can be prepared for any future care needs that may arise and feel confident in their decision.

What is a Life Care Plan?

A life care plan is a holistic look at your specific planning options, choices, and decisions. Besides including an estate plan, the life care plan will address the legal, financial, housing, and long-term care issues caused by the loved one’s chronic illness, disability, or even just their aging. Unlike traditional estate planning which focuses on preserving an elderly loved one’s hard-earned money for future generations, life care planning focuses on maximizing their quality of life and independence. Because there are a lot of unexpected situations that arise when a loved one continues to age, developing a life care plan allows families to be prepared for any situation that might arise. Overall, the goal of life care planning is to promote and maintain the health, safety, and well-being of the elder and their family.

When putting together a thorough Houston estate plan, one important consideration is how care expenses will be paid later in life. This includes long-term care planning, which can be one of the most significant expenses for older Americans. For those with limited assets, Medicaid will typically pay for nursing home expenses.

Many people anticipating the need for long-term care have used several methods for gifting assets to others in order to qualify for this benefit. The goal of Medicaid planning is to qualify for Medicaid benefits that cover long-term care, while minimizing the penalty that would result from the transfer. Recent changes to Medicaid laws have rendered several of these methods that were formerly used to achieve these objectives obsolete. Below are a couple of strategies that will no longer be effective, moving forward.

The “Half a Loaf” Strategy

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