Medicaid exempt assets: What Federal and State Laws grant

by GarySpicuzza » Tue Apr 22, 2008 09:19 am

Medicaid, the State and Federal Government program pays for health services and nursing home care for the elderly in your home. This program has been designed for individuals with low income and if you have limited assets. An added advantage of Medicaid is that it also pays for some long-term care services at home.

How would you choose long-term care?

This is an important decision that you need to make. When choosing long-term care you need to plan out your health care needs in the future. How much you would pay for such care depends on the type of policy you buy. Experts say that if you have the savings for long term care you may not consider buying a policy. But, if you do not have then maybe you could consider buying one. The cost of treating chronic illness can be expensive and this is when a policy like this can be very advantageous.

Usually, LTC recipients of Medicaid are usually those who are aged or from the disabled group, but there are only a handful who receive SSI and yet opt for LTC.

What are the assets exempted under Medicaid and LTC?

There are certain Medicaid asset exemptions made by the Federal and state laws when determining eligibility. As an applicant you would first have to use all of your assets in excess of the exempt amount in order to pay the cost of nursing care facilities before you can qualify for Medicaid. If you are married, your spouse’s assets would also be combined to determine eligibility.

The following are Medicaid exempt assets:
  • A house but only when you (the applicant) are likely to return home. Your home may also be among Medicaid exemptions if your spouse, or a child under the age of 21 years or a child over the age of 21 years but disabled, or a brother/sister owning part of the house and having resided there for at least 1 year continues to live in that house.
  • Essential items like furniture, appliances etc.
  • Personal items like jewelry, clothing etc.
  • Burial plots
  • Funds for burial up to $1500 each in case you are married and $1200 if you are a single applicant.
  • A cash surrender value in a life insurance. This is possible only when the face value of the policies together is less than $1500. However, term life insurance does not have a cash surrender value and hence is totally exempt.

Related readings:

Exempt assets from Medicaid with Long Term Care insurance. (LTCi)

There are 25 states with Long Term Care Partnership Programs.

This is significant legislation as a person can now LEGALLY exempt their assets from nursing home and Medicaid spend down by simply obtaining Long Term Care insurance.

Click HERE to read Florida Statute 409.9102.

(b) Provide a mechanism to qualify for coverage of the costs of long-term care needs under Medicaid without first being required to substantially exhaust his or her assets, including a provision for the disregard of any assets in an amount equal to the insurance benefit payments that are made to or on behalf of an individual who is a beneficiary under the program.

(4) The Department of Children and Family Services, when determining eligibility for Medicaid long-term care services for an individual who is the beneficiary of an approved long-term care partnership program policy, shall reduce the total countable assets of the individual by an amount equal to the insurance benefit payments that are made to or on behalf of the individual.



States with Partnership Legislation:

Arkansas
Iowa
NorthDakota
Colorado
Maryland
Ohio
Florida
Massachusetts
Oklahoma
Georgia
Michigan
Pennsylvania
Hawaii
Missouri
Rhode Island
Idaho
Montana
Virginia
Illinois
Nebraska
Washington
New York
Indiana
Connecticut
California

Total Comments: 113

Posted: Mon Apr 16, 2012 07:01 pm Post Subject: medicaid

If I apply or medicaid in Indiana will I have to give up my car? My car is the only way I have of getting anywhere even to the doctor. I am 63 years old and on Social Security, I rent my apartment, I have a checking account so that social security can deposit my funds.I have no other assets

Posted: Mon Apr 16, 2012 07:01 pm Post Subject: medicaid

If I apply or medicaid in Indiana will I have to give up my car? My car is the only way I have of getting anywhere even to the doctor. I am 63 years old and on Social Security, I rent my apartment, I have a checking account so that social security can deposit my funds.I have no other assets

Posted: Tue Apr 17, 2012 05:49 pm Post Subject:

The Medicaid spenddown rules permit the retention of one automobile. So nothing to worry about when it comes to your car being taken away. Go ahead and apply if necessary.

Posted: Mon Oct 15, 2012 11:29 pm Post Subject: Medicaid Lien

Daughter had a trust and the house is in the name of the trust. Daughter died and medicaid is to be refunded the lien for medical services the decedent received while living. Can the lien be put against the property while the mom and minor sibling live in the home? This would allow the mom and her child the opportunity to stay in home. Does the mom have to sell the home right away?

Posted: Tue Oct 16, 2012 02:16 am Post Subject:

If the home has been in the trust longer than 60 months prior to applying for Medicaid, the home is a non-assessable asset, and Medicaid cannot put a lien against it.

If there are no other assets available to satisfy the lien, Medicaid is out of luck when it comes to asset recovery.

So the all-important question is: How long has the home been in the trust?

Also, if I'm not mistaken, asset recovery should only apply if the decedent was age 55 or older, and I get the impression that this person was younger than that.

Additionally, when Asset Recovery was instituted in OBRA 1993, this is was it was intended to do:

States must pursue recovering costs for medical assistance consisting of:

Nursing home or other long-term institutional services;
Home- and community-based services;
Hospital and prescription drug services provided while the recipient was receiving nursing facility or home- and community-based services; and
At State option, any other items covered by the Medicaid State Plan.

At a minimum, states must recover from assets that pass through probate (which is governed by state law). At a maximum, states may recover any assets of the deceased recipient.


Anything in a trust is a non-probate asset, and it is not an asset of the deceased recipient. But originally, the time in the trust was 36 months. A few years ago it was increased to 60 months (obviously to make it harder to hide assets and escape asset recovery).

Additionally, there is also this discussion:

Recoveries may only be made from the estates of deceased recipients who were 55 or older when they received Medicaid benefits or who, regardless of age, were permanently institutionalized. However, states may exempt recipients if their only Medicaid benefit is payment of Medicare cost sharing (i.e., Medicare Part B premiums).

If a state has elected to impose TEFRA liens on recipients’ homes, then it must also recover from the estates of those recipients. States may impose liens on property of Medicaid recipients of any age if they are permanent residents of a nursing home or other medical institution, and if they are expected to pay a share of the cost of institutional care.


Finally,

States are prohibited from making estate recoveries:

During the lifetime of the surviving spouse (no matter where he or she lives).
From a surviving child who is under age 21, or is blind or permanently disabled (according to the SSI/Medicaid definition of “disability”), no matter where he or she lives.
In the case of the former home of the recipient, when a sibling with an equity interest in the home has lived in the home for at least 1 year immediately before the deceased Medicaid recipient was institutionalized and has lawfully resided in the home continuously since the date of the recipient's admission.
In the case of the former home of the recipient, when an adult child has lived in the home for at least 2 years immediately before the deceased Medicaid recipient was institutionalized, has lived there continuously since that time, and can establish to the satisfaction of the State that he or she provided care that may have delayed the recipient’s admission to the nursing home or other medical institution.


Hopefully, the answer to your specific situation may be in these statements.

You can read more from this article at http://aspe.hhs.gov/daltcp/reports/estaterec.htm

Posted: Tue Oct 16, 2012 02:33 am Post Subject:

There are four other companion articles which may also be of value to you:

http://aspe.hhs.gov/daltcp/reports/liens.htm
http://aspe.hhs.gov/daltcp/reports/hometreat.htm
http://aspe.hhs.gov/daltcp/reports/spouses.htm
http://aspe.hhs.gov/daltcp/reports/MAliens.htm

Posted: Wed Nov 07, 2012 04:10 am Post Subject: medicaid exemption

In Wyoming when my health became increasibly worse, I qualified for a medicaid exemption. I receive medicare but need medicaid to help me with medical expenses. I have reduced lung capacity and have had an electric stimulus implant for chronic pain. But I need someone to do the deep cleaning.

Posted: Mon Mar 18, 2013 08:31 pm Post Subject: Law in NM, can Mom keep house in Fl as exempt?

My Mom's house in Fl, is worth about 65K, she is needing caregivers 7-8 hrs a day, since 7/11. She is running out of her funds, as her income is only $1770, and caregiving is costing $2800/mo. Plus her household and living expenses! She has SS, and spousal VA benefits. She is frail, 88yrs old. She probably has to move to NM, where the bulk of her family now is. Her family is confused as to whether they should sell her house. Can she keep it as an asset, and rent it for more caregiving funds? The sale proceeds won't be enuf to pay for assisted living only 2 years, then she's broke. Any advice?

Posted: Sat Apr 27, 2013 01:22 am Post Subject: 401k assets

I am on SS disability. When I became SS eligible after 24 months I received Medicare. I applied for Medicaid eligibility for my Part B benefits and prescriptions..it was granted,but I did not know a 401k was an asset.It doesn't ask about a 401k anywhere on the form. Now I find out it is an asset. I have received those benefits for 2 years..This has nothing to do with LT care. But what do I do now that I am aware of the fact it is an asset and have been getting benefits. It isn't much, only 12K, but obviously over the threshold..I am in Fla. What are my liabilities ? Thanks in advance

Posted: Wed May 22, 2013 03:34 pm Post Subject:

Your 401(k) account is an exempt asset until you begin withdrawing money from it. You cannot be forced to take money from an IRA or 401(k) or other retirement plan. If you are over age 55, however, the state will keep track of the Medicaid expenses which are attributable to long-term care, if any, and has a right to "asset recovery" following your death.

But at your death, if you have named a beneficiary of your retirement plan assets, that asset becomes the beneficiary's property, and remains exempt from the state's reach. If the money ends up in your estate, that's a different matter.

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