Medicare and Medicaid Healthcare Information

One of the most common problems our Elder Law attorneys face is helping families to provide long term nursing home care for an elderly parent or other relative. We are here to help you plan to qualify for Medicaid benefits and to help you with your Medicaid application.  The weapons in our arsenal include a Qualified Income Trust (Miller Trust) for those persons whose income is over the limit to allow them to qualify for Medicaid. Planning is essential to both qualifying for Medicaid and for protecting assets from Medicaid recovery.

A Deeper Understanding of Medicaid

There is a common misconception throughout society on the medical benefits and requirements for Medicaid and Medicare. Although the thought of growing old and becoming ill is not something that anyone wants to think of, being prepared and gaining a deeper understanding of these benefits is very important. While there are attorneys who have studied for years to gain deep understanding of elder law and categories included within this, having a basic knowledge will assist you in determining if hiring an attorney is right for you.

Medicaid healthcare is a program that assists individuals who have no other means to pay for medical care. A common myth for this government and state funded program is that you must contribute to receive the assistance. Unlike Medicare, Medicaid benefits entitlement is based on strictly the recipient’s need. Each Medicaid requirement is mandated by both state entities and the federal regulations. For the state you reside in to be reimbursed for funds paid, states must follow federal regulations such as services rendered, eligibility, and estate recovery.

There are two types of benefits offered by Medicaid: community and institutionalized. Community benefits are generally offered to disabled people and families on public assistance. Institutionalized refers to long term care benefits funded by the state. While there are long term care insurance plans that can be purchased, many people are not prepared in this event and cannot afford the coverage. One important factor to understand with these benefits is that when the state pays for long term care of senior citizens, it is required to try and recover the funds allocated to their care in the event of their death. So while many believe this is a state funded program, property as well as assets can be claimed by the state during probate.

There are many income and asset requirements for those needing assistance. One requirement is that an individual can have no higher then $2000 in assets. This varies among states but is the limit in Texas. The recipient’s spouse, however, can keep part of the couple’s assets to a limit in their name. Another qualification is the income of a recipient. A percentage of a recipient’s income will be used as their deductible to pay for a six month period before benefits are paid out.

Medicaid requirements can become very complicated in the event that the senior citizen owns property or has assets that exceed the limits. While they may not be able to pay for care, they will not qualify. Consulting an Elder Law Attorney could be a great alternative to selling off property before you completely understand the laws. Make a list of your elder law common questions and consider receiving a consultation of your specific situation.

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