Medicaid-opoly – Here Are the Answers
Last week I challenged readers’ knowledge of Medicaid rules in a game of “Medicaid-opoly”. As promised, this week I am publishing answers to the “true or false” and multiple choice sections. Readers should compare what they considered to be the answers to the actual answers below. Readers might also hold on to last week’s and this week’s columns to question financial advisors, estate planners, caseworkers and others working with the system on their understanding of the rules. We all learn new information every day.
Qualification Answers –Answer True or False.
- Question: Medicaid is only available to persons 65 years old and older. False. Medicaid benefits can be received at any age by an applicant who qualifies medically and financially.
- Question: Medicaid benefits can be received in the home under certain circumstances. True. The Pennsylvania Department of Aging waiver program, for instance, is a Medicaid program at home.
- Question: All states in the U.S. have the same Medicaid rules because Medicaid is a federal program. False. Medicaid is a joint federal-state program and some rules vary from state to state.
- Question: If a recipient is receiving benefits under Medicaid in Pennsylvania and moves to another state, she does not have to reapply for benefits because benefits follow her to the other state. False. Requirements vary.
- Question: All persons receiving SSI (Supplemental Security Income) in Pennsylvania also receive Medicaid. True. If an applicant qualifies for SSI which is a form of welfare, in Pennsylvania, he also qualifies for Medicaid.
- Question: Only government operated nursing homes accept Medicaid as payment for care. False. Private skilled nursing homes that are Medicaid certified also accept Medicaid.
Spousal Answers. Multiple Choice.
- Question: If a husband in Pennsylvania needs to move to a nursing home, his wife who remains at home: (c) can keep their home during her lifetime and there is no claim against her estate even if her husband goes on Medicaid unless she dies before he dies. Note other issues,however, if his wife dies first or if she sells the house. For estate purposes, Deeds should be retitled and Wills probably rewritten. Whenever dealing with the family home, get expert advice.
- Question: When a spouse who is receiving care in a Medicaid certified facility applies for Medicaid, his spouse at home might keep: c) all of their exempt assets, about half of their non-exempt and available assets up to a maximum and no lower than a minimum, all of her income, and sometimes, depending on circumstances, some or even all of his income. Get help to know the details so that all appropriate claims are made.
Gifting Answers – Answer “Yes,” “No,” or “It Depends”
- If a father gives $12,000 to his daughter and another $12,000 to his daughter’s spouse in 2008 and then suffers a stroke in 2009 causing him to need nursing care, will he be able to qualify for Medicaid in 2010 assuming that he has paid for his care up to that time, his assets are low enough, and he otherwise would qualify for Medicaid? Answer: It depends. However, if the reader answered “no,” this would be understandable. One school of thought says that, if father was not thinking of Medicaid when he made the gifts, the transfers would not be penalized. Another states that the transfers would be counted as disqualifying gifts regardless. Stay tuned.
- If a mother, after her husband’s death, adds her daughter’s name to the title of her house, is this counted as gifting such that she could be prevented from receiving Medicaid if she applies for benefits three years later? Answer: “Yes” or “it depends.” Usually, the answer is “yes” and this would be counted as a gift with all of the related penalties. However, if her daughter lives with mother for at least two years and cares for her (caretaker child) or if daughter is classified as disabled under SSI or Social Security Disability, exceptions may apply.
- Question: The most important change that resulted from the Deficit Reduction Act effective February 8, 2006 is that it changed the lookback period to five years. Answer: No. The most important change is the requirement that the penalty run from the time that the person would “otherwise qualify” for Medicaid. In other words, the penalty begins to run when the person who needs care has run out of money to pay for the care. Whether and how payment might be made when funds are gone and how to return gifts without further penalty are answers for another column and another day.
About the Author Janet Colliton
Esquire, Colliton Law Associates, P.C. Janet Colliton has practiced law for over 38 years, 37 of them in Chester County, Pennsylvania, a suburb of Philadelphia. Her practice, Colliton Law Associates, PC, is limited to elder law, Medicaid, including advice, applications and appeals, and other benefits planning including Veterans benefits, life care and special needs planning, guardianships, retirement, and estate planning and administration.