Medicaid Attorney in Mentor, Ohio

Serving Northeast Ohio

The process of applying and qualifying for Medicaid is confusing. There are look back dates for transfers, protected and non-protected assets, and income qualifications with complicated formulas. However, with the help of your lawyer, you can qualify for Medicaid services and protect your assets as much as the law allows. 

When can you apply for Medicaid services?

You must be a resident of the State of Ohio to apply for Medicaid in Ohio. To qualify for long term care Medicaid coverage, you must be legally blind, disabled, aged, or have a limiting physical factor. You must also be institutionalized or needing home care services. There are various dates that determine the qualification date for the applicant. That can affect the look back period and the ineligibility period for the applicant. 

The State will complete an assessment of your needs called a PASSAR. Finally, you must meet the asset qualifications. For a single person, the asset limit is $2000, and for a married application(s) the asset limit is $3000. If only one of the married persons is applying for Medicaid, the community spouse (the spouse remaining at home) can keep half of the couple’s assets up to $123,600 for their care and benefit. 

That is money that does not have to be spent down or used to pay for the spouse needing Medicaid’s care. There is a certain amount of income the community spouse can retain – this could include some of the income ‘made’ by the spouse needing Medicaid. Some assets are exempt from being considered as an asset that has to be used by the Medicaid applicant for their care prior to qualifying for Medicaid coverage. 

Some of those assets include: 

  • The applicant’s primary residence.
  • Household goods and furnishings of reasonable value.
  • Wedding and engagement rings.
  • Automobile (some qualifications).
  • Business property essential for support.
  • Whole life insurance even with a cash surrender value if the face value does not exceed $1500.
  • Term life insurance.
  • Pre-need irrevocable burial and funeral contracts.

When you are thinking about applying for Medicaid it is wise to have a conversation with your attorney to determine the needs of each spouse and how best to spend down any assets to maximize the value to each spouse. 

How can I plan to protect my assets?

Medicaid is aggressive in seeking all available assets that could be used to pay for the applicant’s care prior to adding them to Medicaid coverage. There are some ways to protect your assets. However, planning is an important part of the protection strategy. 

Medicaid in Ohio has a look back period to determine eligibility of five years. That means that any transfer of an asset made within five years of the application for less than fair market value is considered not proper and will result in a period of ineligibility for the applicant. So gifts to your children can result in a period of ineligibility. 

The most common way to protect your assets from use to pay for your care prior to Medicaid coverage is a “Medicaid” trust. This is an irrevocable trust in which the applicant and or the spouse transfer assets into a trust of which they are neither the trustee nor the beneficiary. This means that the applicant must give up all control over their own assets and the right to benefit from them at least five years before the application for Medicaid coverage is made. 

Another option is long term care insurance that has a least a five-year coverage provision. This coverage will pay for the care of the applicant while he or she works with an attorney to dispose of assets properly. This type of insurance is very costly. There are some annuity tools and some income only trusts that can help protect some assets. The best planning tool is a conversation with your attorney. 

What about my spouse who remains at home?

When an application for Medicaid is made there is a “snapshot” made of the assets of the couple. The spouse remaining the community can maintain the home – up to a certain value, a vehicle, their income and possibly some of their Medicaid applicant spouses and half of the combined assets up to $123,600. 

There are ways to plan so that the assets are at a high point when the application is made to protect as much as possible for the community spouse. Further, proper expenditures made during the spend-down of the Medicaid applicant’s share of the assets can also benefit the community spouse. This planning is best done before the need to make the application arises as it gives each spouse more options. 

What about the assets retained by the spouse or individual when they die after receiving Medicaid coverage?

The State of Ohio has an aggressive policy of estate recovery of assets previously exempted from use for Medicaid upon the death of the Medicaid recipient. Once the individual on Medicaid dies the house, car and any other asset are subject to a claim by the State to recover up to the total amount the State paid out for the recipient’s care during their lifetime. 

The collection of certain assets cannot be made until the death of the community spouse or they are no longer needed by the community spouse – such as that spouse applies for Medicaid coverage. There are very specific exceptions to a claim by Medicaid on the house of the recipient. Medicaid recovery can even invade joint accounts with right of survivorship. Therefore, careful planning is required to avoid as much recovery by the State as possible. 

Medicaid Attorney in Mentor, Ohio

Moseman Law Office, LLC can help you plan for asset protection from Medicaid and Medicaid Recovery and can help you navigate the application process. Time is of the essence due to the strict look back and disqualification regulations in place.

There are options to plan to protect the assets of a future Medicaid applicant but these need to be started more than five years prior to the potential need to apply for Medicaid assistance. For assistance with Medicaid planning and navigating the application process contact Moseman Law Office, LLC for an appointment.