The headline of a New York Times article on June 13, 2017, was “You’re Probably Going To Need Medicaid.”
Some of the assertions in the article were:
–Roughly one of every three people now turning 65 will require nursing home care at some point
–Over 3/4 of long stay nursing home residents will eventually be covered by Medicaid
–Many Americans think Medicaid is only for low income adults and their children – for people who are not “like them.” But Medicaid is not “somebody else’s” insurance. It is insurance for all our mothers and fathers and, eventually, for ourselves.
What is Medicaid?
Medicaid is a federally funded health insurance program administered by the state for the financially eligible. There is no age restriction to qualify, but there are income and assets standards that must be met in order to be eligible for Medicaid. If your income or assets exceed the qualifying limits you may still be eligible if you meet one of the many exceptions.
The person applying for Medicaid must need skilled medical services provided in perhaps their home, but most probably in a skilled nursing facility.
The average monthly cost of skilled nursing services in New Hampshire is approximately $10,000.00.
The rules surrounding Medicaid eligibility are complex.
Medicaid is a needs-based program. This means that people with excessive assets or income cannot qualify for Medicaid. For many, this will be the only government program that they will ever seek.
These are things that you can own without becoming unqualified for Medicaid. Generally these are:
Prepaid burial plans
Family burial plots
Term life insurance
Whole life insurance with face cash value below 1500.
Retirement accounts and payment status.
Almost everything else is considered a resource that Medicaid reviews to determine whether or not you qualify. These can include:
Cash, money market accounts, CDs
Stocks, mutual funds, bond funds
Second or more cars
Cash value in life insurance policies
Income generating properties
Persons with excess assets must “spend down” countable assets so that they do not count. Medicaid eligibility is not affected by spending on the following:
Repairs or improvements to the home
Purchasing prepaid burial policy’s
Paying off debts are taxes
Paying for services
Purchasing Medicaid qualifying annuities
A single person, in New Hampshire, can have no more than $2500 in countable assets. The single person’s home, as long as the equity value is less than $552, 000, does not initially affect eligibility; however, if the single applicant is the sole owner of the home and has no spouse or children living with her, the state requires that the home be sold within six months of qualification.
A married person in New Hampshire will be eligible for Medicaid if her monthly income does not exceed the medical reimbursement rate for the cost of care which is approximately $4000. All the rest of her income must be paid over to the nursing home. The married person’s at home spouse is able to keep the greater of $23,844 or 1/2 of the couples asset up to $119,220. These figures usually increase twice yearly.
This is only a brief and oversimplified review of a few of the myriad Medicaid rules.
We are pleased to provide additional advice and counsel tailored to your individual situation