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Medicaid & VA Pension Planning

NON-EXEMPT ASSETS

Medicaid Spend Down Requirement:

$1500.00 – SINGLE PERSON

$2250.00 – MARRIED COUPLE (both in nursing home)

INCOME:

When a nursing home resident qualifies for Medicaid, to cover nursing home costs, all of the resident's income is transferred to the nursing home for cost of nursing home care, with the exception of $52.00 per month to the nursing home resident for a living allowance and the nursing home spouse's health insurance premium. Veterans or widows or widowers of Veterans during wartime receive $90.00 as a living allowance.

For a married couple, with one spouse living at home (community spouse), the spouse at home, in certain circumstances, will be entitled to keep some or all of the nursing home spouse's income, which does not go toward the nursing home spouses living allowance and health insurance premium, depending on the community spouse's income and shelter expenses.

EXEMPT ASSETS FOR SINGLE PERSON

  • Residence, if planning to return to residence after nursing home care
  • Household Goods
  • Irrevocable Funeral Trust
  • Certain other assets

EXEMPT ASSETS FOR MARRIED COUPLE:

  • Residence of spouse
  • Real Estate – owned solely by non-nursing home resident spouse
  • Household Goods
  • Irrevocable Funeral Trust
  • Certain other assets

TRANSFER HISTORY OF ASSETS

Look back period. The "look back" date is the earliest time transfers will be reviewed by Medicaid. When a person is in a nursing home and applies for Medicaid, the following look back periods apply. For transfers before November 1, 2009, there will be a three (3) year look back period. For transfers after November 1, 2009, the look back period is five (5) years. Accordingly, for Medicaid applications of nursing home residents filed before November 1, 2012, there will be a three (3) year look back period. For applications filed between November 1, 2012, and October 31, 2014, the look back period will extend back to November 1, 2009. For applications filed on or after November 1, 2014, there will be a five-year look back.

Transfers for no consideration (gifts) are generally penalized, but there are exempt transactions, such as gifts between spouses, gifts to disabled children, gifts of property used in a trade or business actively managed by the person, and certain other transfers.

ASSETS OF NURSING HOME SPOUSE WITH OTHER SPOUSE LIVING AT HOME

If one spouse lives in a nursing home, and the other spouse lives at home, Medicaid will cover the nursing home spouse's nursing home costs once the combined non-exempt resources on the "snapshot date" of both spouses (the date the nursing home spouse first commenced 30 days of continuous institutional care after September 30, 1989) are reduced to the proper amount.

ASSETS OF SINGLE NURSING HOME RESIDENT OR MARRIED COUPLE, WITH BOTH IN NURSING HOME

The non-exempt asset spend down requirements in the first section of this outline can, through Medicaid planning, be met so that a substantial amount of the assets are not paid to the nursing home.

IMPORTANCE OF THE FIRST DAY OF THE MONTH

A goal of Medicaid planning is to by the first day of the month in which Medicaid coverage is sought, bring down the non-exempt assets of the person to the spend down amount, which includes placing non-exempt assets into exempt assets, before the first of the month in which Medicaid coverage is sought. If the spend down amount is not met as of the first of any month, the whole month will not be covered by Medicaid.

VA AID AND ATTENDANCE PENSION

Veterans who served during wartime and spouses of deceased wartime veterans can obtain a VA Aid and Attendance Pension while they are in assisted living or in a nursing home when their assets are below a certain level. If assets are above such level, proper gift planning (with careful attention to the potential affect on future medicaid) can be implemented to obtain the pension. The VA Aid and Attendance Pension is paid monthly and can be substantial.

Contact the Firm

If you have questions regarding Medicaid planning issues, contact the law office of Paul D. Eash to schedule an appointment. We are open from 8 a.m. to 5 p.m., and are available for home, hospital or nursing home visits when absolutely necessary. We accept MasterCard, Visa and Discover for payment of most services.