Medicaid Planning/Qualification

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Medicaid for aged, blind and disabled is a public assistance program that provides a benefit to help individuals and married couples pay for long term care costs in the home, in an assisted living facility, or in a nursing home. Medicaid is often confused with Medicare. Medicare covers doctors’ visits, medical tests, x-rays, and care provided in hospitals but has a very limited nursing home benefit (maximum 100 days or less). Medicaid may be needed if an individual does not have adequate resources to pay for care or desires to prevent their spouse from facing poverty due to their need for long term care.

Medicaid is administered by the Ohio Department of Medicaid through the local county Department of Job and Family Services. Medicaid requirements are established by both Federal and state law. A Medicaid applicant must meet certain income and asset eligibility conditions to qualify for benefits. Medicaid will pay health care expenses not covered by Medicare or a supplemental insurance plan. A Medicaid recipient is entitled to the same quality of care as an individual paying privately.

 

 

 

 

Medicaid Planning & Qualification

Medicaid planning involves taking the necessary steps now to ensure that if the need for long-term care (nursing home or assisted living) arises for you or your spouse or a loved one, they will be eligible for Medicaid to pay for that care.

The Medicaid system is a maze of complex rules and special exceptions that are unique and inconsistent with other areas of the law. The application process can be overwhelming for the family member assisting the Medicaid applicant. Navigating the Medicaid maze on your own can be perilous leading to costly mistakes. Applications are often denied for a variety of reasons including the failure to meet strict income and asset requirements, failure to provide complete documentation, or an incorrect interpretation of the law. It is important to know and understand the legal rights of the Medicaid applicant, as well as the community spouse. A spouse living in the community does not have to be impoverished because his or her partner needs long term care.

Our Medicaid Planning program at Butcher Elder Law is not a mechanism to give away all of your assets to ensure you qualify for Medicaid, but rather an overall planning strategy that follows the rules of law so you can legally retain what you need to maintain your lifestyle and become eligible for Medicaid without having to lose your lifetime accumulation of assets.

Butcher Elder Law has established a process to help each client successfully navigate the Medicaid maze. We simplify the complex to make it easily understandable. We guide you through every step in the process. Our process includes the following services:

  • Initial Meeting to explain Medicaid basics and understand the needs of your family.
  • Analysis of income, assets, and Medicaid eligibility.
  • A comprehensive plan to achieve Medicaid eligibility with customized letters at each stage of the process.
  • Continued guidance in implementing the plan to achieve eligibility.
  • Filing the Medicaid Application.
  • Preparation of a Medicaid submission manual on your behalf to put your best foot forward.
  • Representation for all Medicaid communications including any face to face meetings

 

 

When is it time to start planning for Medicaid Eligibility?

Don’t be misled by a common misperception. It doesn’t take 5 years for Medicaid benefits to begin. 

  • When you or a loved one receives a diagnosis, indicating that long term care may be needed in the future.
  • When you notice that a loved one needs help with bathing, dressing, transferring, eating, cooking, toileting or managing medications.
  • When caregivers are already coming into the home on a regular basis.
  • When you consider quitting your job to care for a loved one.
  • When your family is struggling to come up with a schedule to care for a loved one.
  • When your own health begins to decline due to the added stress of caring for a loved one.
  • When a loved one has entered an assisted living facility, giving rise to a concern over depleting resources.
  • When a loved one is forced to enter the nursing home.
  • When you are told that Medicare will no longer cover the rehabilitation stay for your loved one who will now have to pay privately for care.

 

For additional information regarding Medicaid Planning, please contact us.

Check out our blog on Common Medicaid Terminology.