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Home / General / Why Mediciad Eligibility Matters If You Need Nursing Home Care

Why Mediciad Eligibility Matters If You Need Nursing Home Care

November 4, 2016 by Jon J. Gasior, Estate Planning Attorney

Medicaid and gift givingMedicaid eligibility is essential if you need nursing home care in the state of Maryland. In Maryland, the average annual cost of a semi-private room in a nursing home is $101,379. For a private room, you can expect to spend an average cost of around $110,230, according to the Genworth Financial 2015 Cost of Care Survey. Most insurance won’t pay for this when you need care, so you could end up spending your own money. With costs this high, it is easy to see that your life savings could be gone in the blink of an eye

You have options to try to qualify for Medicaid coverage without wasting all of the money you’ve earned and without having to sell all of the property you’ve acquired over your life. You just need to make a strategic Medicaid eligibility plan, ideally long before you actually need nursing home care.

When most people go into a nursing home, they go because they can’t live alone or manage their lives any more. They need so-called custodial care, rather than skilled services such as treating surgical wounds following an operation. Unfortunately, Medicare and private insurers typically limit coverage for nursing homes to skilled services only, when they pay for nursing homes at all. This means that seniors who don’t qualify for Medicaid usually end up having to pay out of pocket.

If you don’t want to spend all of your money you’ve worked for over your entire life, you thus need to make sure you know Medicaid eligibility rules and that you can qualify for benefits if you have to get nursing home care.

For many seniors, Medicaid eligibility is a problem because they have property they own and because they have saved money. Medicaid is a needs-based program with income limits and resource limits. If you own too many assets, benefits aren’t available to you.

The good news is, you can take steps to protect assets by structuring the ownership of the property you own so it does not count as a resource for purposes of assessing Medicaid eligibility. The process is complicated and protecting the maximum value of assets requires you to start early. Medicaid looks back five years from the time you applied for care to see if you transferred assets, and they will disqualify you for a period of time if they see you engaged in Medicaid planning in the five years prior to requiring care.

To protect the maximum value of your assets, you should contact a qualified and experienced attorney who can provide you with comprehensive assistance during the Medicaid planning process.

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Jon J. Gasior, Estate Planning Attorney
Jon J. Gasior, Estate Planning Attorney
Attorney/Owner at Sinclair Prosser Gasior
His personal experience with family and the problems that resulted from their failure to create an estate plan resulted in his desire to learn more about this area of the law. From his work in the Elder Law Clinic, he further realized the need to plan not only for death, but also for incapacity during their lifetime.
Jon J. Gasior, Estate Planning Attorney
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Filed Under: General, Nursing Home Expenses Tagged With: Attorney Jon J. Gasior, custodial care, elder law, Elder Law Attorney, five year look back period, income limits, Maryland Estate Planning and Elder Law Attorneys, Medicaid, Medicaid Eligibility, Medicaid Eligibility Rules, Medicaid Planning, needs-based program, nursing home care, resource limits, seniors, SinclairProsser Law, Skilled Nursing Care, wpdiary.net/sinclairprosserlaw

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About Jon J. Gasior, Estate Planning Attorney

His personal experience with family and the problems that resulted from their failure to create an estate plan resulted in his desire to learn more about this area of the law. From his work in the Elder Law Clinic, he further realized the need to plan not only for death, but also for incapacity during their lifetime.

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