Q: Why do I always hear stories about other people getting Medicaid benefits for nursing home care without having to wait through a Medicaid penalty period?

A: There are various reasons why a person can get Medicaid benefits without being penalized. The most obvious is that they qualify for Medicaid. Meaning, among other things, they have a resource level below $13,050. Medicaid will deny you benefits if you have more than $13,050 (increased recently from $4,350) of available resources. A penalty period will be imposed for non-exempt transfers of assets, during a 5 year look back period, meant to reduce the applicant’s available resources below the $13,050 resource level. Notice I mentioned non-exempt transfers. There are exempt transfers, i.e. transfers that a Medicaid applicant can make without having Medicaid invoke a penalty period. You could use these exempt transfers to divest yourself of assets. Transfers to a spouse and/or a disabled child will not affect Medicaid eligibility. A Medicaid applicant can also transfer assets to certain types of trusts that will not interfere with an applicant’s eligibility. One such trust is a Special Needs Trust. Strict adherence to the statutory requirements must be taken to effectively create a Supplemental Needs Trust and they are only available to applicants who are disabled. Using any of these exempt transfers may help to reduce your resource level and decrease or eliminate any Medicaid penalty period.

It should be noted that any course of action taken to divest assets may have adverse consequences for the applicant, his spouse or even any perceived beneficiaries of the applicant’s estate with respect to taxes or government benefits. Therefore, it is always a good idea to have a competent legal professional outline a balanced estate plan that can achieve your desired goals.