In this hour, Elder Law and special needs attorney Jim Koewler talks about Medicaid, specifically in the long-term-care process as we’re aging. This segment focuses on more of the criteria that would allow someone to participate in Medicaid, in particular the ideas of resources and spend-down.
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*The following is the output of transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors.
The following podcast is by Mr Jim Koewler, elder law and special needs attorney, helping and protecting those who need long term care and welcome to the answers. I’ll podcast network and we here here with Jim Koewler from the Koewler Law Firm. Jim Is an elder law attorney and we are proud to have him on our platform and Jim and I have been talking this hour. We’re in our second segment here talking about Medicaid and we gave in our first segment a little bit about what is it. And you know the statistics is overwhelming that it’s the largest provider, obviously of long term care. But, Jim, obviously it’s not. You just don’t choose to go on Medicaid. There’s a lot of things that people are say. Well, if my mom sells our house or gives me your house, than she can go on Medicaid. Doesn’t work that way, does it? Know? No. So, okay, first of all we’re talking about long term Care Medicaid here right. Other forms of Medicaid, Obamacare, agelind disabled, our income driven. Okay, in theory, if Warren Buffett built his companies so that he didn’t get any current income out of them. He simply owned them, okay, right, and didn’t get current income. He could, in theory qualify well, if he weren’t over a hundred sixty five and on medicare he could get it. Obamitare because he would have low income. Right, Long Term Care Medicaid has an income test, but it’s different. But the biggest thing about long term can medicated is has a wealth test or a spend down or what Medicaid calls a resource test or what most people an asset test. I’d love to be able to call it an asset test, but some congressman forty years ago said income is an asset. So just confuse the conversation. So we call the resources. Okay, so we’re in this segment. We’re going to talk about resources and spend down. We’ll talk about income separately at some point in the future. One cannot get long term Care Medicaid. A single person cannot get long term care Medicaid if they have more countable resources than two thousand dollars. Now that’s Ohio and I think that’s most states. That’s the federal guideline. There may be some differences. For example, before two thousand and sixteen. The federal guideline was two thousand and Ohio was only fifteen hundred. Okay, so there may be some small differences in there, but we’re still in the Ballpark, somewhere in the ballpark of two grand, and it’s a hard limit. If you have per month or is all that? That’s how much you have in the bank at the end of the month. Oh, okay, got it. This is not income, this is wealth. So resources are let’s do income first. Just the definition. We’re not talking about qualification, just the definition. Okay, income is money that arrives during the month kind of routinely. So an inheritance is not income. Okay, hitting the scratch off lottery is not income. So security is income, pension is income, annuity payments are income. Got It. Anything that comes in during the month that is kind of one of those routine payment is income. Remains income until the end of the month. Otherwise we just be chasing our tail midmonth on how many resources you have. Okay, Medicaid works and coundar months just to keep us from all going even more nuts than we already are. So income arrives during the month, bills get paid during the month, whatever’s left at the end. We’re taping on October. So let’s just say at the end of October, as Halloween rolls over midnight into All Saints Day on November. One right very Catholic reference there. Then the whatever is left in the bank at that point. Pill bills have been paid, bills haven’t been paid, doesn’t matter. Whatever rolls over with whatever’s in the bank. And wherever else you’ve got your money? Maybe it’s, you know, in your personal count the nursing home. Add all ways together. If theft over twozero and dollars, you are ineligible for Medicaid. Okay. Now, if you’ve been on Medicaid for a while, they’re not looking at you every month. They don’t have that kind of time. But if you’re trying to get Medicaid for October, your application is not going to be finished before October thirty one, at least in most states, certainly not all. Takes about two months, easy, piece of cake. Okay, that it’s that. It’s two months. I think we have a party in Ohio if we got one done in two months. Anybody attorneys every time sakes. But I’ve always tell people at least two months at least two months. Okay. So if you’ve got to medicate, application pending, you’re doing it yourself or social workers doing it for you, or you’ve wisely sought out an odle law attorney. And that’s the other thing is I’d go through another little lot of tourney. I always suggest that I’d be like putting food on my table. Well, it’s just you make one you answer one question not correctly, it will be kicked back in. It will take you sometimes, I’ve seen years. Yeah, easy. So if you’re over to Grand Sing, you’re in two thousand limit state. You’re over to grand as October rolls in, in November, your application is going to get denyed. Yeah, okay, at least for October. Right. And they’re not, at least the states that I know of, are not going to say, oh, but we’ll look at you in November. Now they’re looking at the time you the time you applied. Yeah, so if you are over resourced at the end of October, you got a problem. So you want to spend down. If you were below two thousand beginning of the month, you make Darn’t sure that all your bills get paid. And if you know when Halloween arrives. You’re over, find something to buy by ten pillows, by a television, by something. Okay. If you’re over by thousands of dollars, now let’s talk to a note La Attorney, and it didn’t going to be done that day, by the way. Okay. But if you’re over by a few bucks higher, an older law attorney with your spend. Yeah, but they need to catch the time to day. Okay. Yeah, use a certified check because it has to be out of the bank by the end of the day. So two thou is the hard limit. So let’s say, okay, this isn’t the month you’re applying, but okay, so that’s that’s the two tho limit, the resource limit. Okay, to qualify. So let’s say your first getting into this, you’d like to qualify for a long term Care Medicaid, but you’ve got more money. You figure out how to spend it down the key as far as Medicaid is concerned is spending it down right. Medicate doesn’t want you giving it to your children. That’s an improper transfer. If you had the money and you gave it away, Medicaid rules and Medicaid law says we shouldn’t have to cover you because you’ve made yourself artificially poor. They don’t use that term artificially for but that’s theory. You make yourself artificially poor. So but they want you to spend it, and spending is okay. So let’s say you’re tenzero over. In theory you could go buy tenzero televisions and now you qualify. Now you can’t go get the televisions away because that would being proper transfer. So you got ten, ten televisions in your room at the nursing home. Other than your roommate being mad at you for taking too much space, you would theoretically qualify for Medicaid. But that’s a stupid way to do it. Okay, you’re burning money on ten televisions. Now, if you’re just a sports fanatically actually got to all go in the off fine, go for it. Okay, but I’m not that much of a sports fanatic. So I might now thinking about my uncle. Probably would be, now that I think about it. Yeah, my uncle was just he he had four TV’s in his living room because he could not go without watching all the games on the same time. And this is before cable. So so spending it is okay, but there are wiser ways to spend it, and some of them will really surprise you. Now even more, maybe emotionally important. There are ways to make improper transfers, to make yourself artificially poor. The key is to balance what you improperly transfer with putting money in a place where it can pay for your care correct for the time that Medicaid won’t. Okay, Medicaid wants you to believe that if you give anything away, they’re not covering you unless you gave it away more than five years ago. Both Five Year lookback period. Okay, well, that’s not really the rule. The rule is for every amount of money you give away, and the amount of money’s in different in different states, but it’s what each state’s determines as its average private pay rate for the kind of career seeking. Or the state. You know, Ohio, we simply got one average private pay rate for nursing home and it applies if you’re an assisted living, applies if you’re at home, no matter what kind of lunch there medicad you’re seeking. This penalty devis or the average private pay rate for nursing home is what they use. So in Ohio it’s six thousand nine hundred five dollars. Let’s call it seven thousand so they can talk about it without losing ourselves in the minutia. For every seven thousand dollars you give away, Medicaid will not pay for one month. See, they don’t tell you that then, which is that? Oh, you give something away, you got to wait five years now, and I know you don’t. If you can give away seven grand to your child because you want to, you can find a way to pay for one month of Nursing Home Care. All the law attorneys do this all the time, all the time. So the reason it’s emostly satisfying is some of your life savings is going to a place of you’re choosing, rather than going to your nursing home or your assisted living. Now, if you want to go to your nursing home, our sisters living, that’s fine. I got no bones about that. It’s your money, do with it what you want, but many people would rather see it go to their kids and grandkids then have it go to their costs of care. And that’s the emotional satisfaction. And when you need long term care, emotional satisfaction is huge because so many other things about your day are sad. Yeah, so that’s what I want to be able to provide to people and it probably on our next segment will talk about some more conventional spend down methods. To keep in mind, spending is what Medicaid want you to think. If you’ve got enough money to make it work, we’re talking, you know, maybe fifty, sixty seven thousand dollars. If you’re in New York, Pie has to be a hundred thousand dollars, okay, if you’re in Kentucky it may be forty. Well, it’s interesting to like here in Washington State, we always tell people you should probably have assets if you want to live and assisted living, you know, a major community something like that. It’s going to and you have to obviously think about the progression of your health, you know, to decline, which will cost more. We always say to have enough assets for about two years. Yeah, I see an assisted living at least in Ohio, and I hope this mirrors other other states. Just so I’m not talking Ohio only. Right now the assistant living community can say you must private pay here at aout our rate of choosing any time for a certain period of time. Yep, I’ve seen it as three months. I’ve seen it as high as five years, which is the entire Medicaid look back period, and I’ve seen some that say you need to tell us exactly what you’ve got and you got to spend it all here before we leave. Benser, a Medicaid for you. Yeah, and some of them want to buy in of all your assets up front. That’s to continue cancy, C arc yeah, and that’s a slightly different animal as well. Right, because, especially under Medicaid, if you if you have to make a deposit. Yeah, and if you move out you can get any of that back. Yeah, that deposit is now, at least in some states, and it isn’t, Ohio, acountable resource, even though you can’t get access to it without moving out and risk losing it all. Yeah, you see, RC’s continued to care. Retirement communities are really tricky. In some states they are that deposit. But the nice part about it is is it you never get kicked out either. So that’s the other that’s a good side. But the bad side is they got you in because of their independent living, which may be awesome. HMM. There assisted living may not be quite so good. It may be awesome as well, but if it’s not so good. You’re already bought in. You paid your deposit. Yeah, and if you have home, if you have a need of specialization of care and they don’t offer it, then you’re stuck. So or very interesting. Even more common the CCRC gets sold to new company that doesn’t try as hard. I know they still have your deposit. Yeah, a big time to tell. I’m not a huge being of CCRC’s. Yeah, well, I hear you on that one. So, anyway, we will be back. We’re going to discuss a little bit more about the spend down about Medicaid, and Jim will be right back right after this. State of Ohio residence, you have a friend to help you navigate long term care while protecting your assets. You can reach Jim at www dot protecting seniorscom or just email him at j Koewler afe. That’s j Taylor AFE at protecting Seniorscom.
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Originally published October 24, 2021