What do we mean by a Medicaid crisis?  It is when a person has already been admitted to a convalescent facility, or will be placed in one in the near future, and has too many assets to qualify for Medicaid benefits.

For example, let’s say Marjorie recently had a stroke and is recovering in the hospital.  Due to extensive paralysis, she cannot return home.  She is not wealthy, so, unfortunately, her income and assets will be depleted if she has to pay for her care without assistance.

Proactive planning is for people who are currently healthy but want to prepare for the possibility of incapacity and protect their life savings against the devastating costs of nursing home care.

Let’s consider this example: Sam and his wife Maria, ages 72 and 71, have been married for 40 years.  Maria has started to have memory lapses; Sam is worried that if Maria’s condition worsens, he won’t be able to keep her safe in their home.  And who will care for Maria if Sam becomes ill or dies?  Sam wants to make sure he and Maria have the proper paperwork in place in case he or his children need to make financial or healthcare decisions for Maria.

Here at the Law Office of Antoinette Bone, we do both crisis and proactive Medicaid planning.  We can help Marjorie ensure her hard-earned wealth are not depleted by Marjorie’s care expenses, and we can make sure Sam and Maria have the instructions and the legal tools in place for Sam to act for Maria if Maria gets to the point that she can no longer do so.

To qualify for Medicaid in Texas, you must:

• • • Be 65 years of age or older, or blind or disabled;
    • A U.S. citizen or a qualified alien;
    • A resident of Texas;
    • Have “countable” assets/resources of only
      • $2,000 (Individual),
      • $3000 (couple applying at the same time)
        • Countable Assets/Resources:  bank accounts (CDs), vehicles, stocks & bonds, cash, life insurance policies, annuities, mineral rights
    • Have monthly gross income lower than
      • $2,199 (individual),
      • $4398 (couple applying at same time) ;
    • Require institutional care as determined by the state; and
    • Reside in a Medicaid-certified facility that provides the required level of care.

In most cases, Medicaid does not pay the entire cost of nursing home expenses.  To the extent that you have income, you have to pay your “share of cost” — all but $60 of that income — each month to the nursing home.

The Medicaid rules recognize that a “well spouse” — that is, an individual married to someone who needs convalescent home care — needs money and other assets to live.  Texas and the federal governments have rules to make sure a well spouse is not impoverished if the ill spouse receives Medicaid benefits.  At a minimum, the well spouse is entitled to $119,220 in “countable” assets, as well as a minimum income allowance.

With good planning, you should be able to protect far more than the minimums allowed by Medicaid to provide for your spouse.  However, once, again, the rules are complicated and, if handled incorrectly, the well spouse may lose the right to keep some of all of the wealth you’ve worked so hard to accumulate.  Don’t prepare a Medicaid application without consulting with a qualified elder law attorney.

The most important advice we can give you about applying for Medicaid is:  don’t file on your own unless you are absolutely certain you qualify.  Why?  Once you apply, you may lose the flexibility to protect your assets.  If your Medicaid application shows you have too many assets to qualify for Medicaid benefits, you will be required to spend down those assets before you qualify in the future.  And, you may be disqualified from Medicaid benefits for up to five years.

This circumstance is so unfortunate and unnecessary!  Don’t lose the chance to qualify.  Let your Fort Worth, Bedford Medicaid planning attorney develop a preservation plan you and your family.If you think you need Medicaid benefits, please call your Fort Worth Medicaid planning attorney today (817.462.5454) before you file your application.