Eligibility for Medicaid
Medicaid is a federally funded program that pays for nursing home care and in limited situations for care in an assisted living facility. If an individual cannot perform the activities of daily living such as feeding and dressing oneself, the medical eligibility criteria for nursing home care should be met.
Medicaid has a five year look back period. That means that Medicaid will be looking at all financial transactions within the five years preceding the application to make sure that no money or assets were transferred for less than fair market value or gifted. The first day of the month in which a spouse enters a facility that leads to nursing home placement is the date the assets are valued.
To qualify for Medicaid the applicant cannot currently retain more than $2,000 in assets. In the case of a couple all assets in both of names count toward this asset limitation. The “community spouse resource rule” provides that the spouse remaining at home can keep one half the couple’s combined assets excluding the marital home, and other exempt assets such as a car, up to a maximum amount that is fixed annually. Anything over the maximum amount must be “spent down”. This does not need to be spent only on the care of the applicant but can be spent on the community spouse as well. The community spouse may preserve assets by paying for things that spouse needs, such as paying off a mortgage or finishing rooms in a home left unfinished. One may also establish what is known as an “irrevocable pre-paid funeral trust”. The pre-paid funeral trust is an exempt asset.
Schwartz Hunter, PC assists with as little or as much of this process as a client may require.
Contact Schwartz Hunter, PC to arrange a consultation with a lawyer at a reduced rate by calling 973-895-1175 or by contacting us online. For those clients who may have a difficult time coming to our Randolph, New Jersey, office for an appointment, we can make arrangements to meet with you.