Case Studies of Nursing Home Applications for Medicaid

Medicaid Eligibility Case Study

MARRIED-PERSON MODEL

In the following example, an elderly gentleman was admitted to a Nursing Home. Financial pressures quickly began to mount due to the high cost of his care. His spouse was worried that their life savings would be used up, she might not have enough money to live on and there wouldn’t be anything left to pass on to the children.

The mother and her children were very interested in our proven asset preservation strategies, but had many questions and concerns. We reassured them that every strategy we implemented was completely within Florida Medicaid guidelines, we began by learning about the father, mother and children to properly assess their situation. We obtained the following information about the finances of both mother and father:

Married Person Model for Website Case Study - Color

Our Recommendation:

Since the countable assets exceeded the spousal asset limit by $28,080 Medicaid Eligibility, Inc. helped the family coordinate with a Medicaid attorney. The family was advised by the attorney to implement the following strategies to help them reserve the excess assets: Burial Accounts were set up for both the mother and father, each at $2500, for a total of $5,000. Medicaid did not count these burial accounts as assets. However, the mother and father still had countable assets of $142,300, and needed to restructure assets to get below the maximum level of $119,220. To do this, CDs were cashed in, and a $23,000 Medicaid-friendly Annuity was purchased. We named the mother owner of the annuity to ensure that interest income from the annuity would go to her, not the nursing home. The mother is listed as the annuitant and owner, and their children are beneficiaries. Since Doris owns the annuity, there is no “gifting” of assets. Thus Medicaid’s “five-year look back” period does not apply to assets placed into the annuity. The annuity spouse is in some cases now allowed to receive a portion of John’s income as “spousal diversion” to enable her to meet her monthly expenses.

Results:

With a little help from (their friends at) Medicaid Eligibility, Inc. along with the experienced Medicaid attorney, the father, mother and their children were able to realize the following (value-added) benefits:

  • The father was immediately approved immediately for Medicaid.
  • The mother and father preserved virtually the entire amount of their excess assets or ($23,000.)
  • The mother receives interest payments from the annuity each month.
  • A portion of John’s income was diverted to Doris to help her meet expenses.
  • The children were pleased to have a little nest egg coming their way.
  • The mother, father and children stopped worrying about their finances.

This information is in accordance with regulations in effect prior to federal legislation that has been passed, but the State of Florida has not yet adopted at this time, but is subject to change without notice.

SINGLE PERSON MODEL

In the following example, the children of a Medicaid applicant placed their mother in a Nursing Home, and paid privately for her care for 3 months. They were searching for a way to preserve their mother’s assets without sacrificing the level of care she was receiving. That’s when they turned to Medicaid Eligibility, Inc. and spoke to one of our friendly and highly knowledgeable Medicaid eligibility specialists.

The children were very interested in our proven asset preservation strategies, but had many questions and concerns.

We reassured them that every strategy implemented with the coordination and advice from a Medicaid attorney was completely within Florida Medicaid guidelines, then began by learning about the children and their mother to properly assess their situation. We obtained the following information about the Mother’s finances:

Single Person Model for Website Case Study - color

Our Recommendation:

Since the mother’s funeral arrangements had been prepaid, all she had to do was sign an irrevocable designation form in order for the funeral contract to be excluded as an asset. In addition, asset restructuring was needed to get the mother’s excess assets of $58,800 below the $2,000 allowable asset level for a single person. A Medicaid-friendly annuity was then purchased in the mother’s name, with the mother listed as the annuitant and owner, and children as beneficiaries. Since the mother is the owner, there is no “gifting of assets”; thus Medicaid’s “five (5) -years look-back” period does not apply to assets placed into the annuity. If the mother was to die in the next few years, her children will receive a final balloon payment of $58,200 at the end of the annuity contract. They also have an option of receiving accelerated payments if they require access to funds before receiving the balloon payment.

This information is in accordance with regulations in effect prior to federal legislation that has been passed, but the state of Florida has not yet adopted at this time, but is subject to change without notice.