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IS MEDICAID AN OPTION FOR LONG-TERM CARE?

By:   Kimberly A. Soyer
Sandra L. Clapp & Associates, P.A.

Long-term care needs are on the rise in the United States.  Living longer often comes with an increase in physical restrictions, dementia, Alzheimer’s, and other illnesses requiring skilled care.  With an ever growing population of elderly requiring long-term care, the ability to pay for skilled care becomes more important.  One option is the Medicaid program.

The Idaho Department of Health and Welfare administers the Medicaid program and provides services for nursing home care.  The Home and Community Based Services, or Aged and Disabled Waiver are available for qualified individuals age 65 or older, and provide general medical care, skilled nursing, assisted living, and in-home care services.

To be eligible for Medicaid in Idaho a person must be age sixty-five (65) or older and must: (1) have a medical need; (2) be income qualified; and (3) be resource (asset) qualified. 

Medical Need.  To meet this requirement a person must either need now or be likely to need long-term care services for a period of at least thirty (30) consecutive days.

Income Test.  The monthly income to qualify for Medicaid in 2014 is limited to $2,163 per individual.  Income is broadly defined, including anything that can be used to pay for food and shelter.  Cash, pensions, rent, dividends, and interest can all be considered income. 

Resource Test.  In 2014 a person can have resources (assets) with a combined value of no more than $2,000.  A resource is any asset that can be used to pay for long-term care or can be liquidated to pay for long-term care.  Certain assets owned by a person are considered exempt for Medicaid eligibility purposes.  These include, but are not limited to: (1) a home with equity up to $750,000; (2) a single vehicle; (3) burial funds up to $1,500; (4) burial plot or irrevocable contract for burial services; and (5) household goods and personal effects.  If you have too many non-exempt assets to qualify (like money in a savings account or more than one car) you may have to consider spending down some of the assets before you will qualify for Medicaid.  Many people pay for long-term care out of pocket for a while and apply for Medicaid only when they have few enough resources to qualify.

If you do not meet the Medicaid eligibility requirements it may still be possible to receive Medicaid benefits with careful planning.  It is important to talk to an experienced attorney about long-term care planning as there can be tax implications and penalties imposed by Medicaid if you simply gift away your assets.  To learn more about Medicaid and the eligibility requirements contact the Idaho Department of Health and Welfare at 1-877-456-1233.
This article is not intended to replace legal advice applicable to your situation and should be used only for informational purposes.  Because of the complexity of the law, please consult with your attorney for proper guidance. 

Ms. Soyer is an associate attorney with the firm of Sandra L. Clapp & Associates, P.A. and can be reached at ksoyer@clapp-legal.com or (208) 938-2660.

 

 
 
 
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