There’s no “income cap” anymore for Medicaid long term benefits

When I first started filing Medicaid applications for my clients back in 1995, a person who needed long-term care services in the home or assisted living but had run out of money could not even apply for Medicaid if their gross monthly income was higher than the “income cap.” Of course, the income cap was well below the amount that was needed to pay for care, which meant that a lot of people couldn’t receive necessary services. Basically it meant that many people who would have done well in a community environment with a home health aide and other support ended up moving into a nursing home, because that was the only setting where Medicaid would pay for them. Or they had to do without care or cobble together a plan in which family members took care of them.

Finally, in 2014 when the State’s Comprehensive Medicaid Waiver went into effect, the income cap was eliminated as a bar to receipt of community & assisted living services. There is a special procedure that the applicant has to use, because the income has to be funneled through a structure called a Qualified Income Trust (QIT), but at least the person can now apply for Medicaid benefits. You can read more about QIT’s in our earlier blogs.

We continue to meet people who haven’t heard this good news. If your family is struggling with how to arrange and pay for long term care, call us for legal advice regarding Medicaid eligibility that fits your specific situation.

For personalized advice about a Medicaid plan call … 732-382-6070

Save your receipts and bills for five years, for the look-back

If medical catastrophe strikes and someone in your family needs nursing home care, they may want to apply for Medicaid to pick up those costs.  The regulations are complex, but there are lots of legal strategies that we use to help a person become eligible and to protect the rest of the family at the same time. The process doesn’t stop there, though. The applicant has to prepare and file an application for Medicaid, which we do for people through their local board of social services. And to support this application, we need five complete years of documentation. We can be most effective for you and seniors in your situation if the application is complete.

To best protect your ability to pursue a Medicaid application should it be necessary, save every bit of documentation. Bank statements, cancelled checks, credit card statements, receipts, withdrawal and deposit slips, and tax returns. Photographs of things you bought for cash. Proof that a person who you’ve hired is actually working for you. Are you worried about Mom or Dad? help them create a system to save all this paperwork on a rolling five year basis. The burden of proof is on the applicant within the framework of the published laws, but time and again we see that applications are being denied for failure to produce proofs. It is easier to save these things as you go along than to try to track them down later in the midst of applying for Medicaid.

The 5-year lookback requires the agency to scrutinize all transactions that occurred during the 5 years preceding your application. We have to prove that money which was spent was used to purchase goods and services, and wasn’t used to make gifts. This means a lot of paper verification. So save those bits and scraps, keep things organized, and call when you are ready to apply.

Call us about elder care planning for seniors and for Medicaid eligibility planning and applications … 732-382-6070