Medicaid is a vital program for seniors in need of long term care. It's also very complex. Let me help!
Medicaid pays the cost of care for thousands of Hoosiers admitted to nursing homes, but the program is notoriously complex and ever-changing. If you have questions about Medicaid eligibility, applications, or how it affects the family home and the spouse who often remains there, contact me!
Medicaid is an incredibly important program for seniors because long term care is so expensive.
The average cost for a nursing home stay in Indiana is about $5,000 per month. As a result of this high cost, few seniors (or their children) can afford to pay for a prolonged stay at a nursing facility. This is where Medicaid steps in.
Medicaid is a needs-based health insurance program that pays the medical and nursing home bills for low-income seniors.
Medicaid typically pays 45% of a patient's total nursing home bill. To be eligible for Medicaid you must fall below a certain income and asset level.
Applying for Medicaid is an involved process that requires collecting many documents. Each Medicaid applicant must submit the following information for each person in the household:
- Names and dates of birth;
- Social Security Numbers;
- Income from jobs or training;
- Benefits received (or got in the past), such as Social Security, Supplemental Security Income (SSI), veteran's benefits, or child support;
- Family and tax relationship information;
- If aged, blind, disabled, or receiving Medicare, the amount of money in checking accounts, savings accounts, or other resources owned; and
- Payments for adult or child care health coverage and/or medical benefits you currently have.
Medicaid also limits the amount of income that can be earned by the spouse of a nursing home resident, when the spouse still lives in the family home. Medicaid's Spousal Impoverishment rules change every year, and violations can result in Medicaid ineligibility (and bills!) for the "institutionalized" spouse.
When it comes to assets, certain items are exempt, meaning they aren't included in Medicaid's calculation of your total assets. The family home, for example, is exempt and will not make you ineligible for Medicaid. The look-back period complicates things further, because it penalizes Medicaid recipients who transfer assets in the 5 years prior to applying for Medicaid.
Medicaid is a joint federal and state program, administered in Indiana by the Family and Social Services Administration ("FSSA"). Medicaid's rules and regulations are notoriously complex, and because Medicaid is often the last resort for many seniors, even a simple error on a Medicaid application can cost thousands of dollars in nursing home bills.
The fact is, the need for Medicaid often arises in the midst of a healthcare or financial crisis. As a result, adult children are forced to collect dozens of documents and fill out countless forms to obtain Medicaid (and stop the nursing home bill from sending them the bill) all while dealing with the deteriorating health of a mother or father.
As an Indiana Medicaid Attorney, I help families apply for Medicaid and navigate the maze of rules and regulations that govern the Medicaid program. Significant savings can also result in many cases, either by preventing unnecessary "penalties," or by avoiding delays in eligibility caused by missing documents or inaccurate applications.
HOW CAN I HELP YOU?
- Medicaid planning
- Assistance with spend-down requirements
- Asset/real estate protection and transfer
- Medicaid applications
- Medicaid eligibility counseling
- Medicaid appeals