Medicaid Eligibility Case Study
Medicaid helps millions of older adults pay for long-term medical and health care needs. The government-sponsored program helps low-income seniors pay for doctor visits, hospitalizations, home health care and nursing home facilities.
However, qualifying for Medicaid is not as simple as just reaching the age of 65. There are several strict requirements that govern who can and cannot receive payments for these services.
Medicaid Eligibility
In order to qualify for Medicaid, a person must first be over the age of 65, blind, disabled, or make very little money. Children can also qualify for health care through Medicaid if they meet the criteria.
A person receiving Medicaid must be under certain income limits. In New Jersey, a person may be eligible …show more content…
Depending on the amount of the gifts and the length of time before the application was filed, a person may have to wait for months or even years before receiving their benefits. For that reason, it is important to discuss large gifts with an experienced elder law attorney who can help individuals plan out their long-term health care needs.
Medicaid Spend Downs
If a Medicaid applicant has countable assets in excess of the applicable limit, a spend down process will be necessary. During this process the applicant will have to spend down his or her assets on care or other personal expenses until the assets are below the required maximum. Generally, this spend down cannot include gifts or transfers of assets to others. There are some very limited circumstances where assets can be transferred to children who are totally disabled or who qualify for treatment as a “caregiver child.”
Married Couples
Medicaid does allow for certain protections for the spouse of a Medicaid applicant. Generally, title to the marital home can be transferred into the sole name of the other spouse. Additionally, a portion of the couples combined countable resources may be retained by the other spouse free from a spend down requirement. The protected portion is generally 50% but there are minimums and
However, qualifying for Medicaid is not as simple as just reaching the age of 65. There are several strict requirements that govern who can and cannot receive payments for these services.
Medicaid Eligibility
In order to qualify for Medicaid, a person must first be over the age of 65, blind, disabled, or make very little money. Children can also qualify for health care through Medicaid if they meet the criteria.
A person receiving Medicaid must be under certain income limits. In New Jersey, a person may be eligible …show more content…
Depending on the amount of the gifts and the length of time before the application was filed, a person may have to wait for months or even years before receiving their benefits. For that reason, it is important to discuss large gifts with an experienced elder law attorney who can help individuals plan out their long-term health care needs.
Medicaid Spend Downs
If a Medicaid applicant has countable assets in excess of the applicable limit, a spend down process will be necessary. During this process the applicant will have to spend down his or her assets on care or other personal expenses until the assets are below the required maximum. Generally, this spend down cannot include gifts or transfers of assets to others. There are some very limited circumstances where assets can be transferred to children who are totally disabled or who qualify for treatment as a “caregiver child.”
Married Couples
Medicaid does allow for certain protections for the spouse of a Medicaid applicant. Generally, title to the marital home can be transferred into the sole name of the other spouse. Additionally, a portion of the couples combined countable resources may be retained by the other spouse free from a spend down requirement. The protected portion is generally 50% but there are minimums and