Medicaid When You Have Income

*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 everyone to answers for elders radio network. And as the summer goes on and we’re in the the year two and it’s so many things are happening in our world today and we’re very, very fortunate to have our wonderful Jim Koewler, attorney at law, elder law attorney, and Um, Jim, I am so glad to have you back. We’ve missed you. Thank you, sorry, I know you have been. I know you have been. There’s a lot of stuff going on with seniors right now. Obviously, Um, a lot of move-ins, move-outs and senior living seems to be like they’re heavy, you know, busy time of year. Um, a lot of things happening with fiscal years, you know, fiscal years for companies, especially in our Um Industry, and certainly working a lot in, you know, just different areas of just families being on vacation and things like that. But there’s and and I’m sure Jim you know, as in this time of year, in the summer months, families are getting together and they’re seeing that maybe mom or dad need a little bit more help than they you know, than they anticipated when they’re around. So you might be getting a few phone calls these days, I’m sure, around that. So well, I’m so glad you’re back and I know that the last time we were together we talked a lot about Um spend down Medicaid, um how to qualify. That is like a huge um scenario and you know, I had several people comment on your you know, I think it’s one of the most confusing things in the world. But you know, as you and I spoke after Um I’m very interested. Obviously there’s a lot of seniors that get income the rest of their lives and I would love an opportunity to kind of visit with you of how that’s handled with Medicaid and or, you know, other types of long term care type situations. Okay, yeah, so welcome. Thank you. Thank you, Hey, it’s good to be back. Of course, the last time you were over together we were drinking wine. So I know I was in Seattle for a special Leeds conference that we got together. Thank you for entertaining me. By the way, had a great I loved it. I loved it. We had the best time together and, you know, getting to know you was really one of the not that I haven’t known you forever, but it was just really, really fun to have you here in my city. So, yeah, yeah, it was a good time and it’s a great conference. And then I had to go to Phoenix the next week for the older law conference. Well, there you go, you’ve just been a busy guy. Yeah, my takeaways are specialties, lawyers and other law attorneys are very friendly and they tend to drink their sorrows away and we had plenty of wine and you and I too. Yeah, I enjoyed bringing you out to the the winery. I enjoyed bringing you out to some of our Seattle staples like, uh, you know, Dukes and Um raised boat house and like that. It was really great. Yeah, so thank you for coming. Glad to be here. Yeah, so fill me in about this whole income stuff, because here I am going like I don’t know what this all is and it’s so confusing. That’s why we need people like you. Well, thank you. Okay, so to revisit some of the definitions. Under Medicaid terminology resources is what you have. Let’s say you’re the applicant of the spouse. Resources is what you have at the beginning of the month that was held over from last month. So on July one you’ve got a hundred thousand dollars and on August thirty one you’ve got a hundred thousand dollars and that hundred thousand dollars is your resources for the purposes of August. Okay, so you’re so security arrives in July. That’s income because it wasn’t there before. It’s new this month and it remains income until you get to the end of July and then whatever you haven’t spent from it during July is now a resource in August. So you had a hundred thousand dollars at the beginning of July and your income arrives and you you spend most of it, but you have five hundred bucks you didn’t spend. Now your resources in August will be a hundred thousand five hundred dollars. Okay, that’s so income is what arrives during a month, whatever part of it’s still there. After, after the month, in dual into the next month, it becomes a resource, but during the month it stays income. So so security, retirement benefits or income. So secreed disability benefits are income. Um, you’re no one’s ever getting both of those the same time, by the way. Spouses might, but not one person getting both of those. UH, pension benefits or pension payments are income. Of v a pension payments, what most people call aid in attendance, our income, but they’re handled very differently because really there for long term care, just like Medicaid for long term care is for long term care. Um. So those are all income. If you have an annuity payment, that’s income. Okay, if you have a nuny withdrawal, it’s income, but it’s not the same every month necessarily. But if you have a nuty payment, you turn the annuity on and the contract just send you with taking money out of your four ohek withdrawal from a four oh one K withdrawal from an I ra. But before we get too far into the details of retirement funds, that needs to be a different podcast because with Obamacare, granted, Obamacare is now, what ten years old, the states are still sorting out what it means in the long term care world. Okay, Ohio, for example, you know where I practice. Two years ago they said, Oh, we we treat retirement funds uh, this way and we’ve always done that. We’ve always done it. Part was BS. No, they hadn’t always done that, but they switched it. Claimed we had always been doing it and they opened a cannon worms and they got ahold of one worm and all, they say, for two and a half years until, oh, when did it come out about? They finally wrangled most of the rest of the worms and said this is how we’re going to deal with the other retirement fund issues. Okay, so retirement funds. I raised form in case four, three, B seps, roths. All those are a whole different issue. Money that comes out is income, so we’ll talk about that as income. But the retirement fund itself is a whole new body of older law topic, but we will get to that in a few your installments of our podcast. Okay, so, uh, income is what arrives in one month and and what someone is on Medicaid, not the application process, but on Medicaid then, Um, the Medicaid rules pretty much say we’re every dollar that income goes Um, a certain amount gets to stay with the Medicaid recipient for their what’s called a personal needs allowance, at least in Ohio, and I think that’s consistent across. Not very much. No, no, Oh, no, no, no, in Ohio and fifty bucks. In Iowa, I understand it’s thirty. Um, goodness. Yeah, I think in California. I heard it was a quote me on that. I think in Washington. Yeah, in Washington as sixty and they’re kind of all in that ballpark. Okay. Well, California, by the way, has done a big overhaul and resources. They may have tapped income at the same time. I’m not ready to talk about that and won’t be for a while. We’ve got enough national stuff that we’ve got to deal with. But California did a huge overhaul with medical and I don’t I have no clue at my colleagues in California are doing it. There’s any work for them at all right now in the Medicaid world. Uh, but UH. So income that arrives in a month, even if it’s inheritance, by the way, your uncle died, it’s income the month that arrives. Okay. Now, granted, you’re planning not going to spend the entire inheritance in one month, assuming it’s not. Okay, uh, but so a lot of it may turn into resources the end of the month and we could talk about what happens with those and another future installment. What to do with money that arives once you’re on Medicaid. Surprise, surprise money, surprise money. Okay, Um, but this the stuff that arrives routinely. A systematized withdrawal from an IRA for a one K. That will call income. We won’t have to get to all the retirement fund details as long as we stick to systematized pretty much the same withdrawal all the time. Will just include that Inter income discussion right now. Okay, uh, so, security benefits don’t change, except when they do the cost of living adjustments. Retirement Benett, I’m sorry. Pension benefits rarely changed. Employment Pension benefits rarely change. Very few of them have a cost of being adjustment, but a few do. Very few. Um, yeah, my husband gets a very small pension. V A. V A pension is income. That’s the a intennis thing and it does have a cost of living adjustment via compensation benefits. And we have not talked to compensation benefits in detail yet. That’s at least two or three podcasts. Will Get to that in the future. But if you have that coming in from V a compensation, that’s via disability, you got injured while you’re in the military, Um, then those are income. So money that is coming in routinely income. Let’s say you you still have a rental house. For whatever reason, your spouse, you have a spouse. The spouse is able to keep the rental house. The rental income is income for Medicaid purposes. Okay, it may be the spouse’s income and well, that’s that’s probably in our second or third installment we’ll talk about spouse and income. Okay, but that’s the big thing. People all too often, and I see this in my own clients, tell me what they’ve gotten the bank. Oh, I’ve got so security coming in. That’s not at the bank yet. Okay, that’s that. I’m talking about what I ask. I’m talking about resources and uh, we’ll talk about income second okay, and just to confuse the world, okay, because you heard you mentioned assets. Some member of Congress back in the nineties sixties, when Medicaid was being created along with Medicare, decided that income is an asset. So that’s why you have always heard me talk about the stuff in the bank from one month to the next as resources. Got It, because resources and income together are assets. Just so, bureaucrats don’t speak the same language as everyone out in the real world. Thank you. They make it so complicated. Well, that is why I have a job. But yes, they do make it complicated. Bureaucrats speak is gibberish. Okay, I mean there’s there’s one and again we’re not gonna get into it, but there’s one that just came out in Ohio with this I ra thing that did in May that’s supposed to clarify what they blew up two years ago. Okay, where it says you’re required to say called the maximum. So as long as you take out your minimum, according to the I R S, that’s your maximum. So we have a maximum meeting on equaling a minimum right now. That’s bureacratic gibberish. Okay. So the asset thing, including resources and income, yes, that’s simply more bureaucratic gibberish. So, Jim, in our next segment, what are we going to talk about? So in our next segment we’re gonna be talking about if you are a single medicaid applicant, what happens to your income. Wow, and almost every dollar of it is accounted for in the Medicaid rules. And where can you expect that to go? Fabulous, and Jim and I will be right back in the next segment. State of Ohio. Residents, you have a friend to help you navigate long term care while protecting your assets. You can reach Jim at protectingseniors.com, or just email him at  [email protected]  [email protected],