Ralph Robbins
Certified Financial Planner
Ralph S. Robbins, CFP©, is a licensed Certified Financial Planning Practitioner and an Accredited VA Claims Agent specializing in Eldercare Financial Planning. He works everyday helping families in crisis find creative ways to fund long-term care expenses and deal with family financial issues.
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Question
Will my Mom lose her Veterans Aid and Attendance Benefit if she leaves assisted living, and instead lives at h...
Badabbot....Sorry, you cannot receive a higher award because of your wife's needs. All benefits are based on the veteran's... Badabbot....Sorry, you cannot receive a higher award because of your wife's needs. All benefits are based on the veteran's eligibility and requirements.
If you were receiving Improved Pension Aid and Attendance as opposed to Special Monthly Compensation Aid and Attendance then her unreimbursed medical expenses for care could be deducted from household gross income to arrive at a higher Pension A&A benefit but that does not work with compensation as it is based purely on your rating, not your income and expenses. see more
If you were receiving Improved Pension Aid and Attendance as opposed to Special Monthly Compensation Aid and Attendance then her unreimbursed medical expenses for care could be deducted from household gross income to arrive at a higher Pension A&A benefit but that does not work with compensation as it is based purely on your rating, not your income and expenses. see more
Question
I quit jobs to caregive for Dad (80) 24/7. What monies do I qualify for?
Some states have Medicaid programs where family caregivers can receive funds for self directed care:... Some states have Medicaid programs where family caregivers can receive funds for self directed care:
http://www.bc.edu/schools/gssw/nrcpds/cash_and_counseling.html/
The only other program that will provide funds to a family caregiver is VA pension which is available to wartime veterans and eligible surviving spouse. see more
http://www.bc.edu/schools/gssw/nrcpds/cash_and_counseling.html/
The only other program that will provide funds to a family caregiver is VA pension which is available to wartime veterans and eligible surviving spouse. see more
Question
She has Medicare part A, but needs part B and E. where to start?
Your Area Agency on Aging: http://www.fortpayne.net/agingprograms/ Ask them about applying for SSI Related Programs specifically:... Your Area Agency on Aging:
http://www.fortpayne.net/agingprograms/
Ask them about applying for SSI Related Programs specifically:
http://medicaid.alabama.gov/documents/3.0_Apply/3.2_Qualifying_Medicaid/3.2_Medicare_Savings_Programs_Revised_5-23-14.pdf
If her SSDI income is under $721 per month she can apply for SSI to bring it up to that amount.
Part C "Medicare Advantage" programs might work for her once she gets Part B - depends on what is being offered in her county, but forget about Medicare supplements, she can't afford it. see more
http://www.fortpayne.net/agingprograms/
Ask them about applying for SSI Related Programs specifically:
http://medicaid.alabama.gov/documents/3.0_Apply/3.2_Qualifying_Medicaid/3.2_Medicare_Savings_Programs_Revised_5-23-14.pdf
If her SSDI income is under $721 per month she can apply for SSI to bring it up to that amount.
Part C "Medicare Advantage" programs might work for her once she gets Part B - depends on what is being offered in her county, but forget about Medicare supplements, she can't afford it. see more
Question
Is it necessary to do a legal division of assets if all my parent's assets are in a savings account?
In the State of Florida it works like this: The spouse applying for Medicaid cannot have more than $2,000 in their name. It will be... In the State of Florida it works like this:
The spouse applying for Medicaid cannot have more than $2,000 in their name. It will be required for the applicant spouse have a checking account in their name only to which their income will be deposited and NOT commingled with the income of the Community Spouse (spouse not applying for benefits).
Since there is no penalty for transfers between spouses, and since there is no reason for the applicant spouse to have any assets at all, simply transfer everything to the Community Spouse. In this case, the Community Spouse will be able to keep the entire $20,000 in her name only. see more
The spouse applying for Medicaid cannot have more than $2,000 in their name. It will be required for the applicant spouse have a checking account in their name only to which their income will be deposited and NOT commingled with the income of the Community Spouse (spouse not applying for benefits).
Since there is no penalty for transfers between spouses, and since there is no reason for the applicant spouse to have any assets at all, simply transfer everything to the Community Spouse. In this case, the Community Spouse will be able to keep the entire $20,000 in her name only. see more
Question
Is it necessary to do a legal division of assets if all my parent's assets are in a savings account?
JessieBelle has it about it. If your parents live in the same state as you, Florida, the Community Spouse (the spouse not receiving... JessieBelle has it about it.
If your parents live in the same state as you, Florida, the Community Spouse (the spouse not receiving Medicaid) can, 2014 retain a minimum of $1,939 of the couple's combined monthly income and up to $117,240 in assets (in addition to the house, car, and personal effects).
From your description of your parent's circumstances it appears no pre-planning is required.
Make sure, however, that you have valid and complete Powers of Attorney and Health Care Surrogate Proxy's for both of them. see more
If your parents live in the same state as you, Florida, the Community Spouse (the spouse not receiving Medicaid) can, 2014 retain a minimum of $1,939 of the couple's combined monthly income and up to $117,240 in assets (in addition to the house, car, and personal effects).
From your description of your parent's circumstances it appears no pre-planning is required.
Make sure, however, that you have valid and complete Powers of Attorney and Health Care Surrogate Proxy's for both of them. see more
Question
Will my Mom lose her Veterans Aid and Attendance Benefit if she leaves assisted living, and instead lives at h...
VA Aid and Attendance Pension is a needs based benefit. If she has already qualified and is receiving benefits, any changes in expenses or... VA Aid and Attendance Pension is a needs based benefit. If she has already qualified and is receiving benefits, any changes in expenses or income must be reported.
She has already met the asset test and we can presume that her income is relatively steady with only COLA increases.
The award, however, is actually granted based on income relative to expenses. To receive the maximum award for a surviving spouse (assuming here that she is not the veteran), which for 2014 is $1,130 per month, her net income for VA (IVAP) purposes must be $0.
To arrive at IVAP, start with gross income and subtract unreimbursed medical expenses which can include payments for medically related insurance premiums such as those for a Medicare supplement and Medicare Part D plans, ongoing out-of-pocket co-pays, ongoing services and supplies (such as those for incontinence), and the cost of care - whether it be home care or room and board and cost of care in an assisted living facility. If IVAP is $0, a full award will be granted.
The fact is, if her care at home is more expensive than in AL, her award might go up.
I applaud you for making the effort to grant your mother's desires. Caring for loved ones at home can absolutely work - even in complicated cases. For many there is indeed no place like home. Good luck! see more
She has already met the asset test and we can presume that her income is relatively steady with only COLA increases.
The award, however, is actually granted based on income relative to expenses. To receive the maximum award for a surviving spouse (assuming here that she is not the veteran), which for 2014 is $1,130 per month, her net income for VA (IVAP) purposes must be $0.
To arrive at IVAP, start with gross income and subtract unreimbursed medical expenses which can include payments for medically related insurance premiums such as those for a Medicare supplement and Medicare Part D plans, ongoing out-of-pocket co-pays, ongoing services and supplies (such as those for incontinence), and the cost of care - whether it be home care or room and board and cost of care in an assisted living facility. If IVAP is $0, a full award will be granted.
The fact is, if her care at home is more expensive than in AL, her award might go up.
I applaud you for making the effort to grant your mother's desires. Caring for loved ones at home can absolutely work - even in complicated cases. For many there is indeed no place like home. Good luck! see more
Question
Is it legal to purchase life insurance for my Mom who is in residential care home with her money?
If your mother has cognitive capacity she can certainly enter into contracts and agreements herself. If she does not, you can enter into... If your mother has cognitive capacity she can certainly enter into contracts and agreements herself. If she does not, you can enter into contracts and agreements for her only if you have Power of Attorney.
Your question may also be with respect to Medicaid eligibility and the purchase of life insurance. How life insurance is treated as an asset varies by state and the face amount/cash value permitted is usually quite low.
There are, however, several ways to prepay funeral expenses that will not impact Medicaid eligibility.
1. Prepay funeral expenses by contract with the provider(s). If the contract is made irrevocable the value of the contract will not be countable as an asset.
2. Fund an Irrevocable Life Insurance Trust. This may or may not be funded with life insurance. Most states have a limit of the amount that can transferred to such an arrangement...usually about $12,000.
3. Some states, in addition to the above, permit a separate bank account to be established as a "burial fund". The contribution permitted varies between $1,500 and $2,500.
Be wary of buying "burial insurance" as seen on TV as it may not be an exempt for Medicaid eligibility purposes. see more
Your question may also be with respect to Medicaid eligibility and the purchase of life insurance. How life insurance is treated as an asset varies by state and the face amount/cash value permitted is usually quite low.
There are, however, several ways to prepay funeral expenses that will not impact Medicaid eligibility.
1. Prepay funeral expenses by contract with the provider(s). If the contract is made irrevocable the value of the contract will not be countable as an asset.
2. Fund an Irrevocable Life Insurance Trust. This may or may not be funded with life insurance. Most states have a limit of the amount that can transferred to such an arrangement...usually about $12,000.
3. Some states, in addition to the above, permit a separate bank account to be established as a "burial fund". The contribution permitted varies between $1,500 and $2,500.
Be wary of buying "burial insurance" as seen on TV as it may not be an exempt for Medicaid eligibility purposes. see more
Question
Can I qualify for the PACE program if I don't qualify for Medicaid?
"PACE" or "Program for All-Inclusive Care for the Elderly" is a dual Medicare-Medicaid managed care program offered... "PACE" or "Program for All-Inclusive Care for the Elderly" is a dual Medicare-Medicaid managed care program offered under a Medicaid waiver so a participant must be eligible for both Medicare and Medicaid.
PACE is not a reimbursement program. A participant in a PACE program has all of their medical and long-term care needs provided by the sponsor. This can/will include all medical services, home care, adult day care, assisted living care, and nursing home care.
All services are provided by the sponsor's network of providers; a participant may have limited or no choice.
The PACE programs I am familiar with offer top-notch services and care.
By the way, owning land does not automatically mean you do not qualify for Medicaid. If the property is income producing, for example, the property is a non-countable asset. In some states a property listed for sale at fair market value may be considered "unavailable" and therefore non-countable. see more
PACE is not a reimbursement program. A participant in a PACE program has all of their medical and long-term care needs provided by the sponsor. This can/will include all medical services, home care, adult day care, assisted living care, and nursing home care.
All services are provided by the sponsor's network of providers; a participant may have limited or no choice.
The PACE programs I am familiar with offer top-notch services and care.
By the way, owning land does not automatically mean you do not qualify for Medicaid. If the property is income producing, for example, the property is a non-countable asset. In some states a property listed for sale at fair market value may be considered "unavailable" and therefore non-countable. see more
Question
How can I purchase Dad's house from him (at fair market value) to comply with the look-back period?
Purchasing your father's home as a Medicaid planning strategy will only make sense if you have a plan to dispose of the proceeds he... Purchasing your father's home as a Medicaid planning strategy will only make sense if you have a plan to dispose of the proceeds he will receive in a manner that will not cause an eligibility penalty.
The home is an exempt asset for Medicaid eligibility purposes if it is the homestead property of the applicant. It also remain as an exempt asset if it is rented and the net income goes to his cost of care (Caution: in either scenario the house may be subject to Medicaid Estate Recovery at his demise).
Purchasing the home from him will cause him to own an countable asset (cash).
What is your goal? Do you want to keep the house? Do you want cash to take care of his needs beyond those provided for by Medicaid?
Think carefully about the desired outcome and then seek professional help. Unguided, you are treading in dangerous territory and the financial consequences could be dire. see more
The home is an exempt asset for Medicaid eligibility purposes if it is the homestead property of the applicant. It also remain as an exempt asset if it is rented and the net income goes to his cost of care (Caution: in either scenario the house may be subject to Medicaid Estate Recovery at his demise).
Purchasing the home from him will cause him to own an countable asset (cash).
What is your goal? Do you want to keep the house? Do you want cash to take care of his needs beyond those provided for by Medicaid?
Think carefully about the desired outcome and then seek professional help. Unguided, you are treading in dangerous territory and the financial consequences could be dire. see more
Question
How and when should assets be assessed to protect aging of the care providing partner?
Planning considerations will largely be dependent on the total dollar value of Medicaid countable assets and the state in which you live as... Planning considerations will largely be dependent on the total dollar value of Medicaid countable assets and the state in which you live as asset protections afforded spouses against Medicaid spend-down are state specific.
For instance, some states will allow the spouse not applying for Medicaid (known as the Community Spouse) to retain up to $117,240 (in 2014) in countable assets (home, automobile, personal effects and other items are not counted). Since asset transfers between spouses are never penalized, if you live in one of these states and have under $117,240 you presently have nothing to be concerned about. Other states have Community Spouse protections that are not so lenient.
For your own peace of mind, it would make sense to speak with a professional about the options you will have when the time comes for your husband to apply for Medicaid. I would suggest this consultation also make sure that your current Powers of Attorney and other advance directives are in order. Another consideration to discuss is what happens if you predecease your spouse or become incapacitated yourself. Having the correct documents in place and a well thought out estate plan is as important as the financial planing. see more
For instance, some states will allow the spouse not applying for Medicaid (known as the Community Spouse) to retain up to $117,240 (in 2014) in countable assets (home, automobile, personal effects and other items are not counted). Since asset transfers between spouses are never penalized, if you live in one of these states and have under $117,240 you presently have nothing to be concerned about. Other states have Community Spouse protections that are not so lenient.
For your own peace of mind, it would make sense to speak with a professional about the options you will have when the time comes for your husband to apply for Medicaid. I would suggest this consultation also make sure that your current Powers of Attorney and other advance directives are in order. Another consideration to discuss is what happens if you predecease your spouse or become incapacitated yourself. Having the correct documents in place and a well thought out estate plan is as important as the financial planing. see more
Question
What's the best way sell Dad's house?
Igloo...Also with respect to NY "changing the law" as you suggested, this is not the case. The basis for purchasing the life... Igloo...Also with respect to NY "changing the law" as you suggested, this is not the case. The basis for purchasing the life estate is codified in federal law, not state law.
For the life estate to be effective the purchaser (the elder) must live in the residence for at least one year. In the New York case the Medicaid application was denied because the state contended that the elder did not meet this requirement. see more
For the life estate to be effective the purchaser (the elder) must live in the residence for at least one year. In the New York case the Medicaid application was denied because the state contended that the elder did not meet this requirement. see more
Question
What's the best way sell Dad's house?
Igloo...Just to clarify, I did not suggest a living trust, I suggested the purchase of a life estate in the new home by the elder. ;-)
Question
What's the best way sell Dad's house?
Here is my recommendation: Assuming your father has no other assets, I would suggest not using all of proceeds of the sale towards the... Here is my recommendation:
Assuming your father has no other assets, I would suggest not using all of proceeds of the sale towards the purchase of a new property. Veteran provided care notwithstanding, there will be emergencies as well as routine expenses for which he will need funds (e.g., clothes, dental work, etc.).
With the proceeds that will be used towards the new property I would suggest considering the purchase of life estate.
Essentially it works like this:
Your father makes his contribution to the purchase of the house in the form of the purchase of a "life estate" in the property.
His "life estate" gives him the right to live in the property for the balance of his life.
The purchase of the life estate is not counted as gift for Medicaid eligibility purposes and therefore the "5 year look-back" does not apply.
At his demise the life estate is terminated and you retain full ownership of the property.
Further, if he became a Medicaid beneficiary before his demise, there will be no Medicaid Estate Recovery against the property.
P.S. If he is a wartime veteran he may qualify for non-service connected pension to assist with care, including that provided by a family member. The maximum award for 2014 is $1,758 per month. see more
Assuming your father has no other assets, I would suggest not using all of proceeds of the sale towards the purchase of a new property. Veteran provided care notwithstanding, there will be emergencies as well as routine expenses for which he will need funds (e.g., clothes, dental work, etc.).
With the proceeds that will be used towards the new property I would suggest considering the purchase of life estate.
Essentially it works like this:
Your father makes his contribution to the purchase of the house in the form of the purchase of a "life estate" in the property.
His "life estate" gives him the right to live in the property for the balance of his life.
The purchase of the life estate is not counted as gift for Medicaid eligibility purposes and therefore the "5 year look-back" does not apply.
At his demise the life estate is terminated and you retain full ownership of the property.
Further, if he became a Medicaid beneficiary before his demise, there will be no Medicaid Estate Recovery against the property.
P.S. If he is a wartime veteran he may qualify for non-service connected pension to assist with care, including that provided by a family member. The maximum award for 2014 is $1,758 per month. see more
Question
I'm about to sell my home for $100,000. Can I gift some money to my children?
Many confuse the financial requirements for Medicaid Long-Term Care programs with those of other Medicaid and relief programs. There are... Many confuse the financial requirements for Medicaid Long-Term Care programs with those of other Medicaid and relief programs. There are different financial requirements for different programs.
The fact is that asset limits have been removed for many food stamp programs (SNAP) in most states although income limits remain. (For a list of state asset limits go here: http://assetlimits.newamerica.net/content/asset-limits-your-state)
Similarly, there are senior housing programs with income limits, but no asset limits.
So the answer to your question is yes, you can probably gift the proceeds from the sale of your home to your children without jeopardizing your benefits. Keep in mind, however, that if you apply for Medicaid Long-Term Care benefits within five years of such a gift, you may be penalized and have to wait before receiving benefits.
I can't imagine why you would want to gift assets to your children when the likelihood is that you will need these funds yourself. If there is residual at your demise let them have it then.
However, if you are adamant about making gifts, I would encourage you to first talk to an advisor familiar with Medicaid eligibility for Long-Term Care so as to find a transfer strategy that will not harm you if you require Medicaid Long-Term Care benefits. see more
The fact is that asset limits have been removed for many food stamp programs (SNAP) in most states although income limits remain. (For a list of state asset limits go here: http://assetlimits.newamerica.net/content/asset-limits-your-state)
Similarly, there are senior housing programs with income limits, but no asset limits.
So the answer to your question is yes, you can probably gift the proceeds from the sale of your home to your children without jeopardizing your benefits. Keep in mind, however, that if you apply for Medicaid Long-Term Care benefits within five years of such a gift, you may be penalized and have to wait before receiving benefits.
I can't imagine why you would want to gift assets to your children when the likelihood is that you will need these funds yourself. If there is residual at your demise let them have it then.
However, if you are adamant about making gifts, I would encourage you to first talk to an advisor familiar with Medicaid eligibility for Long-Term Care so as to find a transfer strategy that will not harm you if you require Medicaid Long-Term Care benefits. see more
Question
Is there a way to protect my Dad's assets from the nursing home?
You are referring to a "Pooled Supplemental Needs Trust" and it is indeed a Medicaid planning tool designed to assist those with... You are referring to a "Pooled Supplemental Needs Trust" and it is indeed a Medicaid planning tool designed to assist those with assets over the resource limit with Medicaid eligibility.
I love this tool because it assists Medicaid beneficiaries with their true needs while making good public policy via the "payback" provision inherent in these arrangements.
If your father is in a nursing home, has assets, and is currently paying privately, he can indeed use this trust to immediately qualify for Medicaid while protecting his assets for his own use while receiving benefits.
It works like this:
The trust is established and maintained by a 501(c)(3) non-profit organization. Therefore, you do not need to hire an attorney to draft a new trust; your father will simply be completing a "joinder agreement" to the existing trust.
All assets above the Medicaid resource limit (typically $2,000 in most states) are transferred to the trust. Your father becomes eligible for Medicaid in the month of the transfer.
The assets transferred are available for virtually anything regarding his health, maintenance, and welfare while in the nursing home. The trustee administering the trust will give you the specifics, but typically the list of eligible expenditures is quite long and includes necessities like eyeglasses, dental work, hearing aides, and clothing and can extend to things like legal fees, entertainment items, upgrade to a private room, newspapers, etc. etc.
The caveat is that this is a Medicaid "payback" trust in that at the grantor's (your father's) demise any funds remaining in the trust must first be used to payback Medicaid to the extent benefits were expended for him. Any residual thereafter may go to heirs.
Do a search for "pooled supplemental needs trust Massachusetts" and those that are available will come up. I strongly urge you to consider using this tool. see more
I love this tool because it assists Medicaid beneficiaries with their true needs while making good public policy via the "payback" provision inherent in these arrangements.
If your father is in a nursing home, has assets, and is currently paying privately, he can indeed use this trust to immediately qualify for Medicaid while protecting his assets for his own use while receiving benefits.
It works like this:
The trust is established and maintained by a 501(c)(3) non-profit organization. Therefore, you do not need to hire an attorney to draft a new trust; your father will simply be completing a "joinder agreement" to the existing trust.
All assets above the Medicaid resource limit (typically $2,000 in most states) are transferred to the trust. Your father becomes eligible for Medicaid in the month of the transfer.
The assets transferred are available for virtually anything regarding his health, maintenance, and welfare while in the nursing home. The trustee administering the trust will give you the specifics, but typically the list of eligible expenditures is quite long and includes necessities like eyeglasses, dental work, hearing aides, and clothing and can extend to things like legal fees, entertainment items, upgrade to a private room, newspapers, etc. etc.
The caveat is that this is a Medicaid "payback" trust in that at the grantor's (your father's) demise any funds remaining in the trust must first be used to payback Medicaid to the extent benefits were expended for him. Any residual thereafter may go to heirs.
Do a search for "pooled supplemental needs trust Massachusetts" and those that are available will come up. I strongly urge you to consider using this tool. see more
Question
How do I provide financial help to aid my Mom in another state?
I would recommend handling this in a progressive manner, meaning I would try to use the least severe methods first. Initially, I would... I would recommend handling this in a progressive manner, meaning I would try to use the least severe methods first.
Initially, I would suggest contacting and hiring a Certified Geriatric Care Manager (GCM) in her area to do an evaluation and determine her competency and her needs. A talented GCM may be able to create a trusting relationship with her and be the intermediary between the two of you.
If mom does indeed lack capacity to make decisions for herself, and if she refuses to cooperate with the GCM, then you may wish to proceed to guardianship. You do not have to be the guardian if you feel it would not be in your best interest. Once deemed incapacity by the court a private guardian can be hired and similarly be an intermediary between you and your mother. see more
Initially, I would suggest contacting and hiring a Certified Geriatric Care Manager (GCM) in her area to do an evaluation and determine her competency and her needs. A talented GCM may be able to create a trusting relationship with her and be the intermediary between the two of you.
If mom does indeed lack capacity to make decisions for herself, and if she refuses to cooperate with the GCM, then you may wish to proceed to guardianship. You do not have to be the guardian if you feel it would not be in your best interest. Once deemed incapacity by the court a private guardian can be hired and similarly be an intermediary between you and your mother. see more
Question
Do we need to continue the Medicare supplement and Plan D Rx insurance?
runragged... Part D takes effect the month of Medicaid eligibility. The applicant may have to private pay until the enrollment in Medicaid... runragged...
Part D takes effect the month of Medicaid eligibility. The applicant may have to private pay until the enrollment in Medicaid goes through at which point the Medicaid recipient will be sent a check to reimburse for premiums paid.
Let's clarify:
You said that mom has supplemental coverage that includes prescription costs except for a co-pay. Are you looking to drop the supplemental Rx coverage (not the supplement itself) and substitute Part D or are you looking for Part D to cover the co-pays not covered by the supplemental Rx coverage?
I don't believe you can have Rx coverage from a private plan AND Part D but I am not sure. Perhaps the business office at the facility can give you the answer to whether you can have both plans simultaneously. If they are not sure, or you want to double check, 1-800-MEDICARE does a great job answering questions of this nature.
I do know, however, that most states will allow the Medicaid recipient to pay for recurring unreimbursed medical expenses from their income BEFORE the nursing home is paid. In Florida, this is called the "Uncovered Medical Expense Deduction" and is based on the expenses of the last six months and is re-evaluated every six months. So, if you wanted to keep the supplemental Rx, which you might want to do if, for instance, if the supplemental formulary has drugs that the Part D plan may not, you could have the co-pays covered by mom's income with no penalty to her.
(Part D for a Medicaid recipient falls under the "Low Income Subsidy" (LIS) program. The premium is paid by the state and each state has a maximum premium they will pay for an LIS plan. Because these are generally the lower cost plans, it is possible that the formulary may be limited in some respects. I suggest asking the facility which Part D plan they recommend for their Medicaid recipients as they will have to administer the program. You can then go to Medicare.gov and check the formulary of the plan against your mother's Rx needs.) see more
Part D takes effect the month of Medicaid eligibility. The applicant may have to private pay until the enrollment in Medicaid goes through at which point the Medicaid recipient will be sent a check to reimburse for premiums paid.
Let's clarify:
You said that mom has supplemental coverage that includes prescription costs except for a co-pay. Are you looking to drop the supplemental Rx coverage (not the supplement itself) and substitute Part D or are you looking for Part D to cover the co-pays not covered by the supplemental Rx coverage?
I don't believe you can have Rx coverage from a private plan AND Part D but I am not sure. Perhaps the business office at the facility can give you the answer to whether you can have both plans simultaneously. If they are not sure, or you want to double check, 1-800-MEDICARE does a great job answering questions of this nature.
I do know, however, that most states will allow the Medicaid recipient to pay for recurring unreimbursed medical expenses from their income BEFORE the nursing home is paid. In Florida, this is called the "Uncovered Medical Expense Deduction" and is based on the expenses of the last six months and is re-evaluated every six months. So, if you wanted to keep the supplemental Rx, which you might want to do if, for instance, if the supplemental formulary has drugs that the Part D plan may not, you could have the co-pays covered by mom's income with no penalty to her.
(Part D for a Medicaid recipient falls under the "Low Income Subsidy" (LIS) program. The premium is paid by the state and each state has a maximum premium they will pay for an LIS plan. Because these are generally the lower cost plans, it is possible that the formulary may be limited in some respects. I suggest asking the facility which Part D plan they recommend for their Medicaid recipients as they will have to administer the program. You can then go to Medicare.gov and check the formulary of the plan against your mother's Rx needs.) see more
Question
Mom's house is paid off but Medicaid is trying to take or put lien on it? What can I do?
So sorry to hear of your loss. Unfortunately your question is a bit to vague to answer. Please elaborate: 1. Was your mother receiving... So sorry to hear of your loss.
Unfortunately your question is a bit to vague to answer.
Please elaborate:
1. Was your mother receiving Medicaid benefits for long-term care?
2. Did her husband?
3. What state do you live in?
4. Do you live in the home currently?
5. Have you lived in the home for the past two years and were you taking care of your mother?
6. How is the house titled?
Answering these questions will help me to help you. see more
Unfortunately your question is a bit to vague to answer.
Please elaborate:
1. Was your mother receiving Medicaid benefits for long-term care?
2. Did her husband?
3. What state do you live in?
4. Do you live in the home currently?
5. Have you lived in the home for the past two years and were you taking care of your mother?
6. How is the house titled?
Answering these questions will help me to help you. see more
Question
My Dad is a disabled Vietnam Veteran his wife is in the advanced satges of Alzhiemer's. What assistance is ava...
What is available will depend in part on the compensation currently being received. There are two cash benefit programs available from the... What is available will depend in part on the compensation currently being received.
There are two cash benefit programs available from the VBA; Compensation (aka Disability) and Pension.
Compensation is service connected where the veteran, as in this case, was injured or disabled as a result of service. A disability rating is assigned and a check paid for the balance of the veteran's life.
Pension is a non-service connected, needs based benefit. The only service connected is 90 days of service one of which was during wartime, and a least a general discharge.
Both benefits are always based on the veteran's health needs unless a survivor's benefit is being sought.
If the veteran is not rated as needing Aid and Attendance Improved Pension then the maximum award for the couple will be $1381 per month in 2014.
If the veteran is rated as needing Aid and Attendance the maximum award will be $2,085 in 2014.
To receive the maximum pension in either case, net income for VA purposes (IVAP) must be $0. IVAP is arrived at by starting with household gross income and subtracting unreimbursed medical expenses including the cost of home or assisted living care. If IVAP is below the respective maximum award amounts above, a partial award may be granted. If subtracting eligible expenses = $0 income then a full award may be granted.
Assets (not including the house, automobile, and personal effects) will also be considered in determining an award. see more
There are two cash benefit programs available from the VBA; Compensation (aka Disability) and Pension.
Compensation is service connected where the veteran, as in this case, was injured or disabled as a result of service. A disability rating is assigned and a check paid for the balance of the veteran's life.
Pension is a non-service connected, needs based benefit. The only service connected is 90 days of service one of which was during wartime, and a least a general discharge.
Both benefits are always based on the veteran's health needs unless a survivor's benefit is being sought.
If the veteran is not rated as needing Aid and Attendance Improved Pension then the maximum award for the couple will be $1381 per month in 2014.
If the veteran is rated as needing Aid and Attendance the maximum award will be $2,085 in 2014.
To receive the maximum pension in either case, net income for VA purposes (IVAP) must be $0. IVAP is arrived at by starting with household gross income and subtracting unreimbursed medical expenses including the cost of home or assisted living care. If IVAP is below the respective maximum award amounts above, a partial award may be granted. If subtracting eligible expenses = $0 income then a full award may be granted.
Assets (not including the house, automobile, and personal effects) will also be considered in determining an award. see more
Can my Mom change the name on her CD's to mine before it is up for renewal?
Certainly qualify for Medicaid is one of them as most states have adopted federal law which requires that most assets transferred by a Medicaid applicant within five years of application be considered as countable for eligibility purposes.
In the case of transfer to an individual it is important to creditor status. Understand that assets that are gifted to another become the property of the the donee and therefore become subject to the donee's creditors. We always ask before a gift is made if the donee has creditor issues, whether they are in a litigious provoking profession, or if their marriage is unstable to avoid unexpected diminution of the funds.
Income tax (gift tax is discussed below) may also be an issue in that any earnings generated by the asset transferred are now taxed at the the donee's highest marginal income tax rate. The difference can be appreciable. Many elders pay no taxes or are in very low tax brackets whereas an adult child may pay ordinary income tax rates of almost 50% (between federal, state, and sometimes city, income taxes).
One consequence that is NOT typically at issue, however, is gift tax. The Unified Federal Estate and Gift Tax exempts each individual from paying Federal Estate or Gift tax on the first $5.42 million dollars gifted or bequeathed to any other individual or entity (in 2015). Naturally, there are very few elders who have this kind of wealth and, therefore, there is no "gift tax" consequence when most gifts are made. (As an aside, in most cases gift tax returns and gift taxes, when due, are paid by the donor, not the donee).
In addition to the estate and gift tax exemption mentioned above, there is the "annual exclusion" which for 2015 $14,000 as it was for 2014. The annual exclusion permits each individual to gift up to $14,000 per year to as many individuals or entities as they wish without the gift being subject to gift and estate tax or the lifetime exemption.
Although there is never any tax due for gifts of up to $14,000 per year, a gift tax return may have to be filed for gifts over that amount even if there is no tax due (again, except in rare circumstances, this would be filed by the person making the gift, not the person receiving the gift).
Very important, too, is to not conflate Federal Estate and Gift Tax rules with Medicaid rules. For instance, I am often asked "Can't my mother gift her three children $14,000 each to qualify for Medicaid?" The answer is no as such a gift would indeed be a penalty inducing transfer for Medicaid eligibility purposes.
Before transferring anything that belongs to an elder you may wish to consult with a professional familiar with Medicaid, estate transfer, and income tax rules. see more