Law Firm of Gallo & Spero, LLP - Staten Island, NY. We are Staten Island's premier Personal Injury and Elder Law Attorneys providing the best possible outcome for your accident claim and the best possible estate and medicaid planning protection of your hard earned assets.
What is Medicaid?
Medicaid is a government funded health-insurance program. The costs for Medicaid are shared by the federal, state and local governments. Medicaid should be distinguished from Medicare, a federal insurance program most frequently associated with receipt of Social Security benefits.

To be eligible for Medicaid while living in the community or nursing home, a Medicaid applicant may not have more than certain income/asset levels.

Medicaid should be distinguished from Medicare, a federal in­surance program most often associated with receipt of Social Security benefits. New York’s Medicaid program covers more than forty catego­ries of services. The more important Medicaid services for persons with disabilities tend to be those that are most expensive and often not covered by employer-funded insurance plans. These include inpatient and outpatient hospital care; nursing-home care; physician’s services; mental health counseling; home care, including personal-care services and private-duty nursing; physical therapy, occupational therapy, speech and language therapy; prescription drugs; and du­rable medical equipment.

Community Medicaid

To be eligible for Medicaid while living in the community (as opposed to living in a nursing home) a Medicaid applicant in 2017 may not have more than $14,850 in resources and a $1,500 burial account or irrevocable, prepaid funeral contract of any amount. In New York City, Medicaid permits the funding of a burial account and the purchase of a funeral contract. An individual may not have more than $845 per month in in­come.

If the individual’s monthly income exceeds the allowed income amounts, he or she is required to contribute the excess income, less any health-insurance premiums and out-of-pocket medical charges, to the cost of care.  You may be able to preserve all of the excess income with the implementation of a pooled income trust . Although there is typically no penalty period for transferring resources of any amount to receive Medicaid home care careful planning must be done by a qualified attorney as to the timing of the transfers and whether such transfers should be made to a trust or inidvidual. 

Nursing Home Medicaid

To be eligible for Medicaid in a nursing home, the same re­source limits as above apply. However, all of the individual’s income except health-insurance premiums and a $50-per-month personal-needs allowance must be paid to Medicaid to help cover the cost of care. If the applicant is married, the resource and income rules are enhanced to protect the spouse at home. 

Transferring Assets and Medicaid Nursing-Home Eligibility

Generally, when applicants for nursing home Medicaid transfer re­sources to trusts or to individuals, they incur penalty periods during which they are ineligible for Medicaid nursing-home services. There is an exception for applicants who are disabled and under sixty-five years of age. They may transfer their resources, including inherit­ances and personal-injury settlements, to special exempt trusts without a penalty period.

Although transfers between married couples (and certain other individuals) are generally exempt, the community spouse may still be subject to recovery by Medicaid.  If non-exempt assets are transferred to persons other than a spouse or certain specified indi­viduals within a period of five years, a penalty period will be incurred during which the applicant will not be eligible for Medicaid nursing-home services.   Typically, non-exempt transfers include any transfer of an asset for less than its fair market value.  This is commonly known as the "look-back period".  The penalty period will not begin to run until the Medicaid applicant "otherwise qualifies but for the implementation of a transfer penalty.”  The penalty will typically not end until all of the non-exempt assets are used for the care of the applicant/recipient thereby depleting the applicant/recipient's assets down to the qualifying levels. 

NOTE: You should NOT make any transfers nor should you apply for Medicaid without first hiring an experienced and knowledgeable attorney.
For further information,  please contact Mark Gallo, Esq. at (718) 761-6464 for a free consultation.
Law Firm of Gallo & Spero, LLP - Staten Island, NY Elder Law, Estate Planning, Personal Injury Accident Attorneys