Long Term Care Planner: Individual
Medicaid Planning: Protect Independence and Preserve Assets
It is never too late to take steps to protect your life savings from Medicaid liens or to set aside funds for a loved one who must be admitted to a nursing home. Time is also valuable when you consider the daily cost of a nursing home. Every month of lost eligibility costs more than $7,000. When you hire us for Medicaid planning, we will:
- advise you on your options for asset protection;
- explain how your will, power of attorney and health care proxy can be coordinated to manage long term care;
- discuss the options for asset protection such as trusts and transfers to exempt individuals;
- obtain MassHealth/Medicaid eligibility for you as quickly as possible
- handle all the details of filing the application with the Division of Medical Assistance
For one flat fee, we provide you with the advice and services you need to get long term care benefits. Asset transfers are now scrutinized going back five years from the date you file an application for Medicaid benefits. If an asset is transferred within the 5 year period, there is a disqualification period based on the value of the asset. The penalty period begins on the month the transfer was made, OR
the date on which the elder is eligible for Medicaid, and would otherwise be receiving nursing home care paid by Medicaid, if he or she had not transferred the asset.
If an asset is transferred today . . . |
the asset transfer must be reported on any Medicaid application that is filed within the next 5 years . |
A transfer made today is not reported on the Medicaid application after 5 years from today, in: |
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2012 |
2013 |
2014 |
2015 |
2016 |
2017 |
When you are caring for a loved one who may need nursing home care, your time is precious. Your time and attention is devoted to making sure your family member is receiving the care that protects their health and well being. The sooner you start planning, the more options and choices you have.
A client's intent must be clearly expressed if the client intends to plan for long term care, When we draft a Will or Trust document, the intent of the person who transfers assets as part of their lifetime plan for long term care must be clear and understandable. If Medicaid case workers or judges have to review the plan in future years, clearly documented plans can explain the elder's intent.
Community Spouse Resource Allowance for 2012: $113,640
If the person who applies for MassHealth nursing home benefits is married, that person's spouse is known as the "community spouse" because that spouse continues to live in the community. The community spouse is allowed to keep an amount of assets called the Community Spouse Resource Allowance. Under Massachusetts Medicaid law [Chapter 118E, Section 21A (a)(1)(v)] the state legislature requires that our MassHealth agency “shall establish the maximum community spouse resource allowance permissible under 42 U.S.C. s.1396r-5(f)(2).” That maximum amount is set by the Centers for Medicare and Medicaid Services. The CSRA allows elderly spouses, usually women and widows, to maintain a measure of financial security. It will help elderly spouses avoid the indignities of impoverishment, and can prevent the need for premature nursing home placements. If you have a spouse, mother, father, uncle, aunt, or other relative who receives nursing home care now, or may need care, we can help your family plan for the future. |
Minimum Monthly Maintenance Needs Allowance For July, 2011 - July, 2012: $1,839
If the nursing home resident is married to a spouse who lives at home or in assisted living, the healthy spouse needs income to live. The healthy spouse is allowed to keep some, or all of the income that is paid in the name of the spouse who is in the nursing home. This is called the Minimum Monthly Maintenance Needs Allowance ("Minimum MMNA"). You can hear about people who have been allowed to keep all of their income by listening to our case summaries on this page. The spouse who needs nursing home care is only allowed to keep income of $72.80 per month as a personal needs allowance. Housing expenses for the spouse at home that are more than a standard amount can be added to increase the Minimum MMNA. If you are entitled to an increased amount, we can help you obtain the increased amount. Federal Medicaid Law [Section 1396a(a)(3)] gives the right to a fair hearing for "any individual whose claim for medical assistance is denied or not acted upon with reasonable promptness." Federal Regulations [42 CFR 431.230] require that Medicaid payment for services be continued during the time an application is waiting for a fair hearing, and the state must make corrective payments if the applicant wins the fair hearing. History: July 1, 2009 - $1,821.25
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Max Monthly Maintenance Needs Allowance: $2,841
The Maximum MMNA is $2,841. This is the upper limit on a nursing home resident's income and/or assets that are allowed to his/her spouse, unless the healthy spouse shows exceptional circumstances. I can help you and your family if a hearing or court decision is needed to explain exceptional circumstances and obtain a higher amount. The Standard Shelter Expense is the amount included in the Minimum MMNA for rent, mortgage payment, property taxes and insurance, and/or condo maintenance charges. If these housing expenses are greater than an amount set by MassHealth, the extra expenses can be credited to the community spouse's Minimum MMNA.
Additional amounts can be credited for heat and utilities. Housing expenses that are more than the standard amounts can be added to increase the MMNA. |
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COMPARE THE CASES: |
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Following the Rules, with Good Faith Intent: |
NO Advance Medicaid Planning or Elder Law Counsel: |
| Courts protect elders' rights to Medicaid coverage for nursing home care Because "basic health care is at stake" MassHealth must "humanely recognize that miscalculations about the value of transferred assets are bound to occur." Massachusetts Appeals Court says Medicaid regulations "provide a relief mechanism in which good faith intent is the controlling factor." Read more in September, 2010 Email Update Read the full case: Normand v. Dir. of Medicaid Sept., 2010 |
Lack of planning leaves family home and income property tied up in Medicaid dispute For more than 15 years, Irene Lusignan’s daughter provided her with at-home in a duplex in the Fall River-New Bedford area. In 2005, Irene transferred the duplex, and an apartment building to her daughter. Then, one year later, Irene suffered a stroke that left her paralyzed. Read what happened next in September, 2010 Email Update Read Appeals Court decision: Lusignan v. Scty of HHS July, 2010 |
Call 567-5600 for an appointment to learn how Medicaid can help you and your family manage the costs of long term care.
