5 Secrets of Obtaining Medicaid Benefits in New York State

FACT: According to the Agency for Health Care Policy and Research, 4 out of every 10 people over the age of 65, will wind up in a nursing home at some time.

FACT: The average cost of nursing home care on Long Island is approximately $12,000 per month.  That number can even be much higher depending upon the nursing home facility and the required care.

QUESTION: Would you be able to afford those fees should you or a loved one need to be placed in a nursing home?

Medicaid is a Federal program that will pay for most of your Long Term Health Care needs.  Medicaid is the single largest payer of Long Term Health Care in the country.

Chances are, Medicaid is the right choice for you.  However, you need to know the rules of Medicaid to successfully have them pay for your Long Term Health Care needs.  Those rules can be maddening to understand, so we thought it would be an excellent idea to reveal 5 secrets about the Medicaid program.

Secret 1:      No penalty for transferring assets to a spouse. You can legally transfer as many assets as you want to your well or community spouse and not suffer a penalty from Medicaid.  That’s right, you can transfer $1 million if you wish to your spouse, and still successfully apply for Medicaid benefits, so long as you use Secret # 2 along with the transfer.

Secret 2:       Spousal Refusal. In New York State, a well or community spouse can sign a statement refusing to pay for the medical expenses of the institutionalized spouse and Medicaid, in New York, will determine eligibility of the applicant without considering the resources of the community spouse.  This is known as “spousal refusal”.  This will allow for the institutionalized spouse to receive nursing home care services right away and have those services paid for by Medicaid.

Secret 3:       You can legally transfer all your assets away to a disabled child. If you have a child that is receiving Social Security Disability, you can hand over all of your resources to that child, thereby protecting your assets and still have Medicaid pay for your Long Term Health Care immediately. A pretty nifty tool if you fall under this category.

Secret 4:       No look back period for Home Care. If the institutionalized spouse needs only non-nursing or custodial care (ex: toileting, bedding, assistance walking around, etc.), and that care takes place at home…there is no look back period of 5 years.  The look back period is 0 days!  That means you can transfer all your wealth away and the 1^st day of the month following the transfer, you could be eligible for Medicaid benefits. A great option if you are not in need of full blown nursing home care.

Secret 5: Preplan!! The ability to preserve your assets and still have Medicaid pay for your future Long Term Health Care can be greatly increased if you just plan for that in advance.  Plan when you are healthy and the 5 year look back period will not be such a huge obstacle.  With preplanning you will still be able to keep control of your assets and you will avoid having to rely on the first 4 secrets. Transfers can take place to an irrevocable trust, or to other non-exempt recipients not discussed in this article.

Keep in mind that the information contained in this article is a simplification of the extremely complex rules and laws surrounding New York State Medicaid.  By transferring assets to another person or to an irrevocable trust, you can protect all or part of your savings, but often times there can be adverse tax consequences and/or a penalty period of ineligibility.

It is always a wise idea to have the rules and concepts behind Medicaid explained to you by an experienced attorney who concentrates on Medicaid Planning. Furthermore, it is best to consult an attorney before making any transfers on your own.

Call the Law Office of Craig A. Andreoli, P.C. for a complimentary consultation on Medicaid Planning.  We can help advise you as to whether with proper planning you can qualify for New York State Medicaid benefits.