Medicaid Questions

If you are looking at your finances for retirement plans, you may have a lot of Medicaid questions that you want to run by an experienced lawyer.

Medicaid Questions | Can I sell my home to my son/daughter for less than its full value and still get Medicaid?

Any transfer for less than full value is subject to imposition of a period of ineligibility calculated on the difference between what full market value of the asset was and the amount which the individual received for the asset. 11.

Medicaid Questions | Will Medicaid pay for home care?

Medicaid home care services include:

  • Part-time or intermittent nursing;
  • Home health aide services;
  • Physical, speech, and occupational services;
  • Personal care services;
  • Care provided through the long-term health care program (“nursing without walls”).

To obtain these services, one must have a written order for a plan of treatment by his or her physician, and must pass a “nursing assessment” and a “social assessment”, which will assess the individual’s need for and appropriateness of the care. The plan of treatment must be approved by the provider prior to commencement of the home care services.

Most importantly, the average net monthly cost of the proposed care is then compared against the average monthly cost in a residential facility to determine if the plan of care is cost effective. If the average monthly cost of the home care exceeds 90% of the cost of institutionalization, the home care will be denied in favor of placement in a facility, subject to certain exemptions, which are stringent. 12.

Medicaid Questions | How do Medicaid rules differ for a single person and a married person whose spouse is still living in the community?

A single individual applying for nursing home coverage is allowed to keep $15,150 in resources and $50 in monthly income and be eligible for Medicaid. A married person in the community is allowed to keep a maximum of $123,600 in resources and $3,090 in income monthly.

The residence of a single individual who will not return home will become an “available” resource for Medicaid qualifying purposes. An institutionalized married person who will never return home retains the exemption on his or her personal residence as long as the community spouse lives there. If you have any further Medicaid questions, please call our Rochester Medicaid lawyers today.

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