Today’s Q&A about Medicaid Eligibility is answered by an Elder Law Attorney from Illinois

Question:  How would I know whether my elderly father is eligible to receive help from the government in order to live in a nursing home? He has no income, to speak of, other than his monthly Social Security check, has a very small checking account, owns his small home, and desperately needs nursing home assistance.

Answer:   You need to consult with an Experienced Elder Law Attorney in your State.  The cost of long term care in a Nursing Home is paid for either with the persons own money, private pay, or if you meet the financial and other qualifications Medicaid.  In addition, long term care may be paid by long term care insurance, by those lucky enough to have it.  However for most people their care is paid by liquidating all their assets and using them to pay the nursing home.  While Medicare pays for up to 100 days of rehabilitative care in the nursing home after 3 days of hospitalization and also pays for 2 weeks of respite or pain management care for hospice patients, it does not pay for long term care.  The government program that pays for long term care is Medicaid.  Unlike Medicare, Social Security Disability and Social Security, there is no right to Medicaid; it is up to you to establish your qualifications for Medicaid.

Medicaid has both asset and income limits.  The limit for non-exempt assets for an individual is $2,000.00. Assets above that amount must be spent down, converted into exempt assets or otherwise handled in a way compliant with the Medicaid provisions.  Your father’s small home is an exempt asset but only as long as he intends to return to it. Once he decides to stay in the nursing home permanently, or once the State has decided that it no longer believes that he is returning, then the home becomes a non-exempt asset and generally must be sold and the proceeds used to pay for his care.  It is important that you speak with an Elder Law Attorney prior to taking any steps with your father’s home, as there are exceptions in some States which allow in limited circumstances that it be transferred without penalty.  There are several strategies which allow you to preserve some additional funds for your father or the family, but whether you can use them depends upon the State in which your father resides and the actual facts of his circumstances.

In general all of his income must be spent on the nursing home with the exception of a small monthly allowance for the applicant’s personal use. In Illinois that personal exception is $30 per month.  In addition, your father’s qualification will be dependent upon what he has done with his money over the past 5 years. This is referred to as the look back period, and any transfers made by your father for less than fair market value, such as gifts, may result in a penalty period where Medicaid would not pay for his care. Based upon the facts you present I believe that with the assistance of an Experienced Elder Law Attorney, your father should be able to have Medicaid pay for his nursing home care, and with the Attorney’s assistance may be able to set aside a small fund of money for him.  Good Luck.

To find Elder Law Attorneys near you who can help you plan for and/or deal with your elder care matters, go to: ElderCareMatters.com – America’s National Directory of Elder Care / Senior Care Resources.

James C. Siebert, Esq., An ElderCare Matters Partner
James C. Siebert, Esq.
Arlington Heights, Illinois
An ElderCare Matters Partner

 

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