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The Bright Side of Aging
Vol. XX, Issue XI
has an income of $2,700. If her calculated monthly income allowance, including excess shelter expense is $2,357, then she would get $1,537 of her husband’s income to get to $2,357. His monthly Medicaid co-pay would be the remainder minus $60 for his personal needs and enough to pay any monthly medical insurance premium.
If his monthly insurance premium were $303 a month, his co-pay would be $700. (Medicaid calls the co-pay the “patient pay amount.”)
3. The nursing does not tell the family about “retroactive” application.
Families are not told that instead of paying the nursing home they may “spend down” and apply the next month for Medicaid. Medicaid’s rule is if you complete the spend down by the end of the month you are eligible the whole month.
Example: Mr. Smith’s Medicare rehab ends on the 10th. The nursing home tells the spouse they want a check for $14,000 to pay to the end of the month and for the next month. What should Mrs. Smith do? Write no check and inform them she will apply for Medicaid to pay his bill. She would then proceed to do the spend down in number 2 above. After she got all the paper work together she could submit a Medicaid application the next month along with a “retroactive application” (a separate form) and have Medicaid pay the entire bill except his monthly co-pay. She would write a check to cover his co-pay. In 2 above it would be $700 and the next month it would be another $700.
4. The family is told they need to spend down by paying the nursing home. (False)
While it is true that a resident is responsible for getting his bill paid, that duty may be satisfied by applying to Medicaid for payment. As relayed above, Medicaid requires “spend down” of assets until the resident is eligible. That spending can be anything for the resident or spouse. It need not be for the nursing home. It could be for prepaying the funeral. It could be to fix up the house so that it could sell for a better price. Almost
all homes of elders could use a ‘refreshing.” It could be for the purchase of a new car.
5. The family is not told the resident may pay nothing to the nursing home if he will return to home within 6 months.
As relayed above, the resident’s spending not only includes spend down of assets, but also a monthly co-pay. That monthly co-pay can be waived if a doctor certifies the resident is likely to return to home within 6 months.
6. Bonus! This article is not legal advice. (Don’t rely on articles like this. Verify your situation. Get advice
Thank you, Jim Schuster.
from an attorney!)
MORAL: Medicaid is such a
complicated program that very few people know the allowances it makes for the applicant and family.
Get advice, save your hard-earned money for those you love and get your benefit from all those taxes you paid for decades.
And, of course, give us a call if you want to be sure you are saving as much as you can,
(Hint: 248-356-3500)
This entry was posted on Jim Schuster’s website on Wednesday, Dec. 26th, 2018. You can contact Jim directly at: jimschuster.com.
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