Posts Tagged ‘medicaid’

2013 Medicaid Eligibility Figures

New Medicaid Eligibility Criteria

The new Medicaid eligibility criteria for 2013 were recently announced. A Medicaid applicant/recipient is eligible with available resources of $14,400 up from $14,250 in 2012. Residences and retirement funds continue to be protected in certain circumstances under the new eligibility criteria. A spouse in the community who has an ill spouse in a nursing home or the Lombardi program may retain assets ranging between $74,820 and $115,920 and income of $2,898. The actual amount is determined by the value of the couple’s combined resources. Some community spouses may successfully argue for an even higher income or resource allowance.

If assets are gifted by the applicant or spouse within 5 years of seeking Medicaid nursing home benefits, a period of ineligibility will result if the gift is not exempt. In 2013, the value of the gift is divided by $12,034 in Nassau and Suffolk counties and $11,350 in New York City to determine the length of the period in which the applicant will be ineligible for Medicaid benefits. There is a proposal to extend the look back period to ten years. It may be a reason to consider making a plan sooner than later.
Penalty periods are not imposed on those who apply for Medicaid benefits at home. However if the home care recipient later requires nursing home care the prior gifts are an issue. Considerable planning can be done to address this concern.
New Medicaid Eligibility Criteria

 

Medicaid recovery in NY: Where are we?

Several months ago we blogged about New York’s emergency regulations which expanded the definition of “estate” for Medicaid recovery purposes. These regulations, allowing recovery from interests such as jointly held assets and life estate interests, enhanced Medicaid’s ability to recover its costs from a decedent’s estate.

The emergency regulations expanding the definition of “estate” expired last fall.  New York law referring to this expanded definition of “estate” is still in place without regulations to clarify what the new definition is.

We are hearing two possible alternatives going forward. The first is that final regulations will be issued effective for Medicaid recipients dying after July 1, 2012. These would be similar to the emergency regulations that have expired with some changes. The second alternative which we think is more likely is the elimination of the law expanding the definition of “estate” and going back to the original law. This would mean that for Medicaid recovery purposes, only assets passing from the decedent pursuant to a court process (probate or administration) would be available for recovery.

We will keep you posted as we know more about New York’s attempt to expand estate recovery.

2012 Medicaid Income and Resource Allowances

Medicaid income and resource allowances for eligibility change every year. The  numbers effective January 1, 2012 are:

Nursing home resource allowances

Applicant: $14,250

Applicant’s spouse in the community: $74,820-$113,640

Nursing home income allowances

Resident: $50 (plus cost of health insurance, if any)

Spouse in the community: $2,841

Community Medicaid resource allowances

Single care recipient: $14,250

Married care recipient: $20,850 (this includes resources for both spouses)

Community Medicaid income allowances

Single care recipient: $792 (plus $20 if over age 65

Married care recipient: $1,159 (including spouse’s income)

Anyone considering a Medicaid application whose income and or resources exceed these figures should consult a knowledgeable attorney.  There are many opportunities to achieve Medicaid eligibility when these allowance are exceeded.

Budget includes expanded Medicaid Recovery

We now have the wording of the NYS Budget Bill in regard to the expanded recovery from estates of Medicaid recipients. The legislation states that in addition to assets passing under a valid will or by intestacy,

“..an individual’s estate also includes any other property in which the individual has any legal title or interest at the time of death, including jointly held property, retained life estates, and interests in trusts, to the extent of such interests;…”

The legislation takes effect April 1, 2011. There is no reference to grandfathering such  assets created prior to the effective date. There will be efforts made to modify the legislation to include grandfathering. Hopefully these efforts will be successful.

Medicaid planning will be significantly affected by this new legislation.

Just in: NYS Budget Affects Medicaid Recipients

The NYS Budget for 2011 has been passed.  According to the information we just received, there is one significant change that will affect many Medicaid recipients. The budget includes a provision for a regulation which will expand the assets from which Medicaid may recover its costs on the death of a Medicaid recipient. These newly recoverable assets may include  life estates, joint accounts and revocable and irrevocable trusts. More details will follow as we get more information.

The good news, if there is any, is that according to our current understanding, this provision is the only change in the new budget affecting Medicaid applicants and recipients.

Ninety Is Not The New Sixty

We all like to think that we will live a really long time. Although many of us harbor fantasies of being able to retain our youthful hearts and bodies, ninety is not the new sixty.  Young-old is different from old-old and we need to be sure that we are prepared for it. Susan Jacoby authored a thoughtful essay in the December 31, 2010  edition of the New York Times entitled Real Life Among the Old Old.   In her essay Ms. Jacoby reflects on her Mom who appeared active and ageless at 75 but who at ninety, has no more “adventures” in her future, because pain from age related illnesses made the smallest errand an “excruciating effort.”

Modern medicine has many living longer and longer.  According to Ms. Jacoby the over 85 set is the largest growing segment of the over 65 population and at least fifty percent of this population  will spend some time in a nursing home before they die because of a mental or physical disability. Ms. Jacoby’s musings point out  that we all need to have a plan for health care decision-making, surrogate financial decision-making and a plan for protecting assets in the event long term care is required at home or in in a nursing home.  Ninety is not the new sixty, do you have a plan?

Super Lawyer 2010

I have just returned from a New York State Bar Association Elder Law Section Meeting where I addressed Section Members on the newest developments regarding surrogate health care decision-making. This happened to roughly coincide with the publication of the Top 50 Women SuperLawyers List, and many of my colleagues at the meeting congratulated me for making the list.  I feel honored, though I have to say it is an unusual feeling to be publicly acknowledged in this way.  Our firm works hard to help people with their problems, so it’s a funny thing  when word gets around!

It has been a great year for our firm, Raskin & Makofsky, because  both my partner Judy Raskin and I were named to the SuperLawyers List in the Elder Law category. We are very proud to have both firm partners named and to be two of the twenty nine listed Elder Law attorneys in the New York Metropolitan area. The SuperLawyers List, which begins with nomination by one’s peers and factors in credentials, experience, and awards, represents the top five percent of lawyers in New York State. That must also mean that our clients are in the top five percent as well, doesn’t it?

Great Meeting!

I’ve just returned from the NYSBA Elder Law Section Summer Meeting in Philadelphia which I co-chaired. I am very pleased that the many months of work in putting this meeting together were well worth it. Judging from the very positive comments of the attendees, the meeting was quite a success. The 141 attorneys in attendance heard great speakers on topics including irrevocable trusts, annuities and promissory notes, Medicaid issues, power of attorney issues, special needs trust cases, and waivered services. Ideas and information were freely exchanged, particularly in the interactive sessions. Our evening event and dinner at the Constitution Center was a highlight for all including the 33 children of all ages who accompanied their parents.

Coping With The Loss of A Spouse

The passing of a beloved spouse is an awful thing.  The emotional loss coupled with the disappearance of the day to day companionship leaves the surviving spouse trying to fill a cavernous space.  In her June 15, 2010 New York Times column, Jane E. Brody  writes of the challenging job a surviving spouse has in making an emotional adjustment to the loss.  I think you will find the column interesting and you can access it at http://www.nytimes.com/2010/06/15/health/15brod.html. Ms. Brody not only addresses the difficulties of the emotional issues surrounding the loss of a spouse but  she concludes her column by remarking on the concerns many widows and widowers have in regard to what will happen as they age and perhaps grow ill and require long-term care. This is a real concern.  One way to assuage these fears is to learn about what the options are in regard to receiving long-term care and how to pay for long-term care.

Long-term Care: The Middle Class Dilemma

Recently I gave the keynote address for the Annual Meeting of the Visiting Nurse Association of Long Island, Inc. I titled the presentation, “Long-term Care: The Middle Class Dilemma.” The dilemma for the middle class is having too much to qualify for Medicaid and other government benefits but too little to pay for care without spending down a lifetime of savings. Many think that as they get older Medicare will pay for all medical costs. This is a sorry fable. Medicare does not pay for the custodial care that long-term care requires.
Long-term care insurance is a good investment for those who purchase it early enough to make the insurance affordable. The problem for many is that the insurance becomes too expensive to purchase as the individual gets older or some pre-existing medical problem makes the individual uninsurable. So again it is a middle class dilemma. Recent legislative initiatives have tried to address the dilemma on the federal and state levels but none go far enough in finding a solution for the hard working middle class. Medicaid, a program originally envisioned as the medical safety net for poor people, is often the only option available for extended payments for long-term care needs. Medicaid eligibility often requires impoverishment.
It is the fear of losing a lifetime of savings if long-term care is required which sends many to seek the advice of an Elder Law attorney. Medicaid rules are complicated, often penalty periods are imposed, but generally the sooner one starts planning the better the result.
So how did this keynote address end after I had explained the difficulties of financing long-term care? I advised those present that there was one sure fire solution to the dilemma. Live a long and healthy life, enjoying everything along the way. Good advice for everyone!