What is Medicaid Planning? - Netska Law Group

What is Medicaid Planning?

October 20, 2022 Admin Comments Off

Medicaid Planning is the process of legally protecting income and assets so that you do not have to go broke paying for long term care before qualifying for Medicaid, which is the point where the government steps in and contributes towards the cost. Medicaid Planning relies upon State and Federal laws to convert ‘countable’ assets into exempt, or ‘non-countable’ assets to either qualify for Medicaid right now or later when you will need it.

Medicaid Institutional Care Program (“Medicaid ICP”)

This is a long term care Medicaid program for those requiring skilled nursing, rehabilitation, or nursing home level care only. There is no waitlist for this program and approval is typically granted the same month. Once approved, the Medicaid recipient will pay their portion of responsibility, which is essentially all of their income and Medicaid the entirety of the difference. ‘Paying all of your income’ to the nursing home is where the planning strategies also come in. Additionally, if your spouse is well and lives at home without the need for Medicaid or nursing home care then there are also strategies to employ to essentially re-route assets and income to the well spouse up to a certain level.

Medicaid Waiver (“Home and Community Based Services”)

This long term care program is for those who only require Assisted Living Facility (“ALF”) care, or they are able to resize at home with the assistance of some home-health care. This type of care typically has a long wait-list, and the hours covered by Medicaid are limited (20-40 hours per week). Once approved for this Medicaid benefit, the recipient keeps all of their income. If the recipient requires going into an ALF, then Medicaid contributes about $1,500 toward the monthly expense.

There is also a program called QMB (Qualified Medicare Beneficiary) and MEDS-AD (Medicaid for the Aged or Disabled) that can be used in conjunction with the Medicaid Waiver applicants who are on a waitlist. These programs will pay for Medicare premiums, co-pays, deductibles, and will provide financial assistance while waiting for home health care or ALF to begin.

There are a variety of governmental programs and benefits that many people are uninformed about, or believe they won’t qualify. Protecting your assets and income through legal and ethical planning strategies is a smart financial investment for you and your family because working a lifetime to build a legacy, just to spend it all on long term care is an unfortunate scenario that we see too often when there are strategies and tools you can implement instead.