If you’re a senior in need of long-term care, it’s understandable if you’re more than a little bit apprehensive about your options. Nursing home costs are sky-high right now, and they’re expected to continue to increase in the coming years. All of that can be a frightening thing for elderly Americans who may not have the resources needed to cover those costs on their own. The good news is that the Medicaid program can help you to meet those expenses. However, there are 5 facts about Medicaid eligibility in Michigan that every resident should know long before they apply for benefits.
The Benefits Aren’t Automatic
Some seniors can be thrown aback by the application process for Medicaid, especially when they’ve grown accustomed to enjoying the automatic benefits they receive from the Medicare program. Medicaid has a more intrusive and demanding application process that requires applicants to prove document claims in a way that satisfies the person responsible for approving the application. That’s something that many applicants simply aren’t adequately prepared to do.
There are Age or Disability Requirements
Medicaid nursing home benefits are not available to everyone, but only to those who can satisfy the program’s stringent requirements. To meet the eligibility standards, you need to be at least 65 years of age, suffering from a disability, or blind. Minor disabilities are insufficient to warrant Medicaid coverage, however. Your disability must be serious enough that you are eligible to receive disability benefits from Social Security. Thus, minor injuries that partially disable you won’t entitle you to coverage under the Medicaid program. However, more serious disabilities will meet that eligibility standard.
There Must be a Medical Need for Long-Term Care
You also can’t qualify for benefits unless there has been a medical determination of need for that level of long-term care. Medicaid will only pay for nursing home expenses when there is an actual medical need that requires that level of care. To meet this requirement, there must be a medical diagnosis and assessment that declares your care needs to be such that they can only be met with this level of nursing assistance. That typically involves an assessment that finds that you not only need intense nursing care, but assistance with activities of daily living as well – things like using the bathroom, bathing, cooking, and even eating.
There are Strict Asset and Income Guidelines
In addition to those requirements, applicants also need to satisfy the program’s asset and income limit standards. The income standards are reasonably simple to address. However, the asset limit can be more difficult for some applicants to cope with, since it limits the nursing home patient to no more than $2,000 in countable assets.
Certain assets are exempt, of course. For example, the applicant’s home can be exempted, as well as one personal vehicle. Personal belongings in the home, prepaid burial plots, and certain other forms of property may also be exempt. As a rule, though, most asset types are countable, and that can create serious problems for seniors who are trying to qualify for this important benefit. In many instances, these applicants can find themselves in a type of legal limbo – possessing too many assets to qualify for the benefits they need for nursing home assistance, but too little in wealth to pay for that care on their own.
Medicaid Planning Can be Essential for Qualifying
Medicaid planning can be an effective alternative to spend-down strategies and other emergency Medicaid techniques. With early planning, future Medicaid applicants can work to arrange assets in ways that protect them from the costs of nursing home care, while ensuring that they qualify for program assistance when they need it most. There are several different strategies that can be used to accomplish that goals, but two main techniques are among the most popular:
- You can use gifting strategies to reduce the size of your estate, while transferring assets in a way that avoids any potential future problems with Medicaid’s five-year look-back penalty provisions. This can be especially beneficial for those who plan to leave inheritances for their heirs, but who fear that their wealth could someday be consumed by nursing home costs and leave them with nothing to give their loved ones after death.
- Irrevocable trusts can also be an effective part of any long-term care planning strategy. These trusts effectively shield wealth from nursing home costs, while preventing those assets from being considered for Medicaid eligibility purposes. Because the assets in the trust are beyond your control, they cannot be counted as part of your estate. As an added benefit, these trusts also provide protection against creditors and future litigants, as well as estate tax liability.
An Attorney’s Advice Can be Crucial to Success
Some people try to manage Medicaid eligibility concerns on their own. That can often cause them to make mistakes that can result in penalties that render them ineligible for benefits for months or even years. There are many pitfalls that can create problems for applicants at virtually every stage of the application process. Application errors can delay a decision or result in a denial of benefits. Improper asset transfers can create penalties that can have far-reaching effects. To avoid that, applicants should consult with competent Medicaid planning attorneys with experience in this area of the law.
The fact is that your Medicaid benefits are too important to be left to chance. And if you’re like most people, you can’t afford to make mistakes on your application that could threaten your ability to get the help you need. At Biddinger & Estelle, PC, our team of experts can help you to safely navigate the process to ensure that you get the assistance needed to pay for your nursing home costs. When you need to ensure your Medicaid eligibility in Michigan, you should rely on experienced experts committed to meeting your needs. To learn more about how we can help you with these critical concerns, contact us online or call us today at (989) 872-5601.