If you need assistance paying for healthcare and you are considering applying for Medicaid, here are some things you need to know about the program and about Medicaid eligibility, specifically. Medicaid is a government assistance program providing healthcare coverage to low income individuals, regardless of disability or age. Patients with Medicaid coverage are typically not required to pay anything for qualifying medical care, except possibly a small co-pay. Here is what you need to know about Medicaid eligibility.
Kentucky Medicaid eligibility requirements
If you are a resident of Kentucky and you have questions about the basic eligibility requirements, here is what you need to know. Children up to age 1 with a family income of no more than 195 percent of the federal poverty level and children ages 1 to 18 with family income of no more than 159 percent of the federal poverty level are eligible for Medicaid.
When the family income is too high to qualify for Medicaid, the child may still be eligible for the Kentucky Children’s Health Insurance Program, as long as the family income does not go above 213 percent of the federal poverty level. Pregnant women with family income up to 195 percent of the federal poverty level and parents and other adults with incomes up to 133 percent of the federal poverty level are also eligible for Medicaid. The elderly or disabled may also be eligible, so ask your attorney about Kentucky Medicaid eligibility requirements.
How Medicaid determines the amount of an applicant’s resources
In determining Medicaid eligibility, assets are generally divided into two categories — either countable or exempt. Countable assets are those that could be used to provide for your care. Countable assets include cash, bank deposits, IRA’s, Keogh plans, pension funds and annuities, securities and the cash surrender value of life insurance policies. Exempt property usually includes your residence, up to a certain value, household items, burial policy or a certain amount of cash saved for burial expenses, automobiles, and personal Items like clothing and jewelry. Although these types of property may not be counted toward Medicaid eligibility, they may nevertheless be subject to recovery after your death.
Medicaid planning is important
If you are not familiar with Medicaid, the program is managed by both the state and federal government. It only pays for medical services that have been deemed medically necessary by a physician. There are limitations on the amount of financial resources a recipient is allowed to have because Medicaid is considered a “need-based” program. It is still quite easy to spend all your savings before Medicaid will start paying for necessary long-term care expenses. Medicaid planning is necessary in order to prevent that from happening.
Kentucky seniors should be prepared
Most of us already recognize that nursing homes can be very expensive, even if we don’t already know someone living in one. Unfortunately, the reality is that most private health insurance policies do not cover nursing home services. Even seniors with Medicare coverage may not receive sufficient benefits to make a nursing home affordable. Therefore, when it comes to the possible need for nursing home care, Kentucky seniors must be prepared by planning ahead.
Medicaid coverage for nursing home services
While Medicaid coverage is generally limited to “medically necessary” care, that does include nursing home services. That means Medicaid will only pay in situations where it has been determined that the requested services are reasonable and necessary to protect life, to prevent significant illness or disability, or to alleviate severe pain.
You may be able to “spend down” your assets in order to attain Medicaid eligibility
In cases where an individual is not initially eligible for Medicaid, they may be allowed to “spend down” their assets in order to attain Medicaid eligibility. However, this is an issue that you should discuss with your Medicaid attorney first. Spending down essentially refers to using your countable assets to pay off certain debts or expenses. This process must be accomplished in a very particular way in order to avoid the potential penalty period for fraudulent transfers.
Medicaid trusts are a valuable strategy to consider
A Medicaid Trust is a unique type of trust used primarily to protect a Medicaid applicant’s property so they can maintain Medicaid eligibility for benefits. A Medicaid Trust must be an irrevocable trust that makes you the income beneficiary, while identifying residual beneficiaries who will receive the trust property after your death.
Attend a FREE seminar! If you have questions regarding a trust, or any other estate planning matters, contact Gersh Law Offices, P.S.C. for a consultation either online or by calling us at (502) 423-7023.