Planning for Medicaid is one of the most important things to do as you get older
Seeing as Americans are living longer, it is essential to plan for life after retirement. This includes medical coverage and Medicare or Medicaid. Medicaid planning is an important part of life for older individuals.
Why Plan for Medicaid?
We all know that the cost of nursing homes is very expensive and it is costing more each year. The costs could range anywhere from $3,000 to $10,000 per month! Recent studies have revealed that people spend an average of 30 months in a nursing home. Many people pay for these nursing homes with their own money, often depleting their life savings. This is not always necessary. If you plan properly, Medicaid can help cut these costs, allowing you to leave money to your heirs instead of spending it all on nursing home costs.
Medicare and Medicaid: Nursing Home Care
Medicare Part A refers to hospital insurance which covers up to 100 days in a skilled nursing facility. However, Medicare has a restrictive definition of skilled nursing. Many times, nursing home care will not be covered under Part A. Medicaid is the only option that people have to help pay for the cost of a nursing home. Unlike Medicare, Medicaid is a program that is based on financial needs. You will be required to pass an asset and income test to become eligible for the Medicaid benefits. On the other hand, Medicare is available to anyone over the age of 65 and does not consider income or assets as part of the required qualifications.
Medicaid Eligibility Test
You must pass a three part test to meet Medicaid eligibility requirements. The test is broken into sections which includes your medical necessities, your age and disabilities and your financial situation. You must meet the requirement of all three sections to become eligible for Medicaid.
The medical need portion is based on any medical restrictions the individual may have. These restrictions must limit your ability to perform daily tasks. The requirements are that the individual must need daily care, skilled nursing, continuous observation, the need for a registered nurse and medical needs that are not typically offered by a hospital.
To be eligible, you must be over the age of 65 or have a disability. For example, if you are disabled and are only 60 years old, you will be eligible for Medicaid.
Your income and assets are an important part of eligibility. All individual assets and income will be considered when determining eligibility. The exact amounts will vary per state. Asset tests will vary depending on whether the individual is married or single. The amount of assets allowed will be determined by the marital status. The income cap per month also varies per state.
Medicaid Gap: Problems with Medicaid Qualifying Tests
The income test often presents problems when you are applying for Medicaid. If your monthly income level is over the specified amount, you will not be considered. Many times, that set amount is far less than the cost of monthly nursing home care. This often leaves individuals in a situation where they earn too much to get Medicaid, but not enough to pay for nursing home care. This situation is referred to as the Medicaid Gap.
Need for Medicaid Planning to Pass Eligibility Requirements
Since there are so many factors determining the eligibility for Medicaid, planning is very important. You must consider all factors and try to determine what your medical needs will be later in life. This can be very difficult. The financial aspect is also a difficult situation to deal with. Often times, people are forced to spend their life savings just to become eligible for Medicaid programs so they can receive nursing home care. Proper planning can alleviate some of these stresses.
You have one shot at submitting an application form to Medicaid. Do not submit it until it has been reviewed by an expert – it could cost you tens of thousands of dollars. Contact us for an expert evaluation process.
States typically offer online forms that you may download and print, however no states allow you to currently apply for Medicaid online and submit the form online.
Helpful resources: Readers often continue with Medicaid Irrevocable Trust, , and official Medicaid eligibility guidance before making final trust-planning decisions.
Questions that usually come up next
People exploring Medicaid Eligibility Planning often move next to the practical questions: when to act, what to fund, and how much control can stay with the original owner.
Details that often change the outcome
- Timing matters because transfers and look-back rules can change what is possible.
- Funding matters because a trust has to hold the right assets in the right way to work as planned.
- Control matters because Medicaid planning works best when the structure matches the family’s actual care goals.
What usually helps after the main answer
Many readers narrow the decision by comparing Medicaid Irrevocable Trust, Irrevocable Trust, and FAQ. When government rules shape the decision, many readers also review official Medicaid eligibility guidance.
