Medicaid Application

We help nursing home residents in Georgetown, TX and San Antonio, TX qualify for long-term care Medicaid.

Long term care in a skilled nursing home is quite expensive. You may have retirement savings, but how long will it last when the average cost for nursing care is between $4,500 and $6,000 per month? You can afford that care if you qualify for Medicaid and if you avoid the penalty periods Medicaid imposes for gifting and estate recovery after your death.

Your own children may have asked you how you plan to pay for nursing care. Medicare does not pay for long term care in a skilled nursing home. Only long term care insurance, independent wealth, and Medicaid pay for skilled long term care. More seniors are qualifying for Medicaid. You may qualify too. The basic rules for eligibility are:

  • Your gross income cannot exceed $2,349 per month
  • Your assets as a single individual cannot exceed $2,000
  • Gifting your assets will result in a penalty period of ineligibility
  • Medicaid looks back five years to see if you have gifted assets
  • The Medicaid Estate Recovery Program (MERP) will force your heirs to sell your property after you pass away

Navigating the sea of public benefits yourself is difficult and dangerous. You may be penalized for selling your home, gifting your home to a child, and Medicaid may take the rest of your property from your heirs after your death through the Medicaid Estate Recovery Program.

You don’t have to be completely broke to qualify for Medicaid. The State and Federal government have made it difficult for you to qualify for benefits, but the law allows us to help you plan for long term care just like you plan for your income taxes. To sail through the bureaucracy, you should ask your attorney about the “Miller Trust,” the “Lady Bird Deed,” a “Revocable Living Trust,” and the “Spousal Protected Resource Allowance.”

Do you take care of your spouse? “Care,” as the term is used here, means that you help your spouse with activities of daily living like helping your spouse take a shower, get dressed, get out of bed, administer medication, or help you spouse to the restroom or with adult depends. Have you been taking care of your spouse so long that you are stressed out or watching your health worsen? Caregiving is not an easy job. Many caregivers end up in the hospital if they don’t take care of themselves. You might be interested to know that a healthy spouse can save money, get their sick spouse professional help, and qualify for Medicaid to pay for additional care for the sick spouse. Medicaid allows the healthy spouse to have a “protected resource amount.” The Spousal Protected Resource Amount (SPRA) should at least protect $25,728.00, up to $128,640.00, or even more if the healthy spouse has a low income. Which assets does Medicaid count when counting up the countable resources? A Medicaid applicant must report his or her bank accounts, certificates of deposit (CDs), real property, life insurance policies, burial funds, IRAs, stocks, bonds, mutual funds, oil, gas, and mineral rights, jewelry, antiques, cars, other vehicles, boats, recreational vehicles, and other specific assets. Applicants must report all assets even if some of the assets will be excluded.

An individual may qualify for Medicaid to pay for long-term nursing home care or institutionalized care if his is her income is below $2,349.00. What is the individual’s income is higher than $2,349.00? An individual who has a high income may still qualify for Medicaid if he or she meets with an elder law attorney and establishes a Qualified Income Trust also known as a Miller’s Trust. What counts as income? Medicaid counts social security benefits, certain veterans’ benefits, private pensions, interest, dividends, royalties, rental payments, federal employee annuities, railroad benefits, state retirement benefits, local retirement benefits, earnings, and wages. When Medicaid asks how much income a person receives, Medicaid really wants to know what the gross income is. Medicaid also wants to see proof of what the gross income amount is. Medicaid will ask for “verification of income.” That means, Medicaid needs to see that statement that you receive at the beginning of the year from social security that shows what the gross amount is minus the premium for Medicare.

Request to Stop VA after Medicaid has Started

We must notify the VA when a claimant moves into a nursing home and begins Medicaid benefits.

Statement Related to Nursing Home Verification to Medicaid

We ask the VA for a breakdown in pension to base and Aid and Attendance to convince Medicaid that the entire NSC pension plus Aid and Attendance is not countable income for Medicaid purposes. We ask the VA to send the appropriate information to the state’s Medicaid office.

In order for the Medicaid recipient to be allowed to receive cash from Aid and Attendance, the Medicaid recipient must have unreimbursed medical expenses that offset income. If Medicaid is paying the entire cost of care, there are no unreimbursed expenses, and aid and attendance is not allowed.

A married veteran or a veteran with eligible dependents who is in the nursing home might be receiving Aid and Attendance because of high unreimbursed medical expenses for the spouse at home or dependents at home. If the married veteran pays for the care of someone at home, and that care is not being reimbursed, it might be the basis for receiving aid and attendance.

$90.00 Personal Allowance Request

If the Medicaid recipient is single without dependents, and Medicaid is paying the full cost of care, the VA benefit must be reduced to the allowable $90 personal allowance.

If the Medicaid recipient is a married veteran or has an eligible dependent, there is no automatic personal allowance reduction.