Today, I would like to talk to you briefly about Medicaid in Texas. As an estate planning attorney one of my primary goals has become helping my clients who are getting older and living longer to plan for their long-term care needs. We always want to make certain that we plan so that their assets last longer and are able to pay for long-term care needs that are now becoming more possible, more probable for more of our clients because our clients are living longer and it’s our senior citizens of an advanced age who are the ones who are susceptible to long-term care needs. One way that long-term care needs can be covered is through a government program called Medicaid. Now, a lot of my senior citizen clients will get mixed up between Medicare and Medicaid. Medicare is government health insurance for people who are over the age of 65. Medicaid is assistance for specific health care expenses for people who are in need through the government, and they are completely different.
All of us, once we turn 65, will go on Medicare for our health insurance needs, but not all of us will be able to qualify for Medicaid. Medicaid has many different programs, but the primary program that we’re focusing on today is assistance with nursing home care. We hope that most of our clients can provide proper planning to cover their long-term care needs, whether it be an assisted living or nursing home, but many times clients who are in need do not have sufficient funds to cover nursing home care, and that’s when Medicaid will kick in. Remember, Medicaid is a needs-based program, so there will be income and asset qualifiers, and I admonish anybody who is concerned with finding out about Medicaid to avail themselves of the services of an elder law attorney such as myself or other law attorneys in the area. Sometimes a case worker at a nursing home will also be proficient in Medicaid issues, but in order to determine if an applicant’s assets and income are in line with Medicaid qualifications it’s very important to do an analysis of those assets.
Now, there will be differences between a single applicant and a married applicant. A married applicant might have a spouse at home, and that’s called a community spouse. There will be specific assets and income that will be set aside to help care for the community spouse in the event of a marriage situation. So to know what those set-asides are, what those income and asset limitations are, certainly avail yourself of expert advice. Some assets do not count against the application. These are called non-countable assets. Traditionally, the homestead property, one car, prepaid funeral arrangements, prepaid burial plots, and some other assets are considered non-countable, but again that has to be looked at very carefully. There are always going to be some assets that can be converted from non-countable to countable, but that has to be done very carefully. Assets that are gifted or donated out of an applicant’s name during the five year period before the application is submitted can create a penalty period during which the applicant is not allowed to receive the Medicaid benefits.
So gifting assets away is not advised without getting proper guidance on how to do it to make sure that it’s timely. Some assets can be converted from non-countable to countable, however, without a penalty. The proper use of homestead designation, the proper use of annuities for purposes of qualifying can be looked at, but it has to be done very carefully. When I have clients call me and ask me about Medicaid, the first thing that I do for them is send them what I call an information package so that they can provide me with specific information on their income and on their assets. Without that, I can’t really guide them. So that’s always going to be the first step in determining Medicaid qualification. Once we see that information, we can then advise the client on what they can save, what they can’t save, what they can transfer, what they can’t transfer, and whether or not their income is going to cause problems. I don’t want to get into the specifics of what Medicaid pays or what the income limits are or what the asset limits are and specifically what can be transferred and what can’t. I just want to advise you that these issues are very important and must be handled with care. A mistake that is made prior to application can’t always be undone if it’s done incorrectly. So if you’re interested in Medicaid, please call your friendly elder law attorney or deal with a qualified Medicaid specialist, perhaps a benefits coordinator at a nursing home, and you will get the information that you need. Thank you much.