Medicaid Crisis Planning Attorney in Dunkirk, Maryland

Medicaid is a joint federal-state program that offers health care, dental care, and nursing home and assisted living services for those who qualify. Qualifications are based on income and assets. Assets are anything that can readily be converted to cash or cash already in a checking or savings account. Some assets are exempted in the calculation, usually your primary residence, car, and funerary trusts. 

Medicaid crisis planning refers to anticipating the potential need for Medicaid as you age and may require nursing homes or other services that Medicaid can provide. Since you will have to qualify under the asset threshold for Maryland Medicaid, you need to develop a strategy to meet the criteria, requiring solid planning in advance. In addition to the asset threshold, your income must not exceed the cost of nursing home care.  

No one really wants to leave their residence and enter a nursing home, but sometimes, that becomes a realistic prospect, so Medicaid crisis planning is an important tool to make sure you can qualify for Medicaid assistance. In other words, as part of your estate planning, you should also consider planning for a possible Medicaid crisis. 

If you’re located in or around Dunkirk, Maryland, contact us at the Law Offices of Julie A. Schejbal, CHTD to discuss how to prepare for a potential Medicaid emergency in terms of assets and income. We will review your financial situation with you and present you with the legal options available to meet Medicaid eligibility requirements while retaining as many of your assets as possible. Our firm also proudly serves clients throughout Calvert County, Prince George’s County, Charles County, and St. Mary's County. 

What Does Maryland Medicaid Offer?

As noted earlier, Medicaid is a joint state and federal program that offers a variety of services to those who qualify based on age (65-plus), income and assets, and disability. In terms of planning for a Medicaid crisis as you age, the two programs that are most applicable are Institutional/Nursing Home Medicaid and Medicaid Waivers/Home and Community Based Services (HCBS). The latter consists of assisted living arrangements, and since they are waiver-based, you may have to go on a waiting list to receive the services. 

For Nursing Home Medicaid, as a single person, you cannot have more than $2,500 in assets and your income cannot exceed the cost of the nursing home. The calculations get a little more complicated if you are married and both need nursing home care. In that case, assets cannot exceed $6,000 jointly, but that threshold falls to $2,500 per spouse after six months. If only one spouse is applying, the asset limit is $2,500 for the applicant and $148,620 for the non-applicant spouse. In all situations, income cannot exceed the cost of the nursing home care for the recipient. 

For Home and Community Based Services, a single applicant cannot have more than $2,000 in assets or more than $2,742 in monthly income. Income includes Social Security, retirement payments, dividends—anything received, basically. For a couple applying jointly, the income level remains the same, but the asset limit rises to $3,000. In the case of one spouse applying and the other not, the asset levels are $2,000 for the applicant and $148,620 for the non-applicant. The income threshold stays the same. 

As for assets, there are exemptions, including one’s primary residence, but there may be some qualifications you must meet for certain exemptions. One vehicle, personal property, and burial expenses are also exempt. 

The Five-Year Look-Back Period

Medicaid has what is known as a five-year look-back period to determine your asset values. If you, for instance, give a grandchild your car two years before applying for Medicaid, that can still be counted as an asset in your name. The same holds true if you sell your stock portfolio and give the money to your children for their personal use. 

Crisis Planning: Qualifying Under the Income Limit

If the Medicaid applicant’s monthly income exceeds the established limit, as detailed above, one way to qualify is by establishing what is called a Qualified Income Trust (QIT), also known as a Miller Trust. The applicant’s excess income is funneled into the QIT to be used for medical and associated expenses not covered directly by Medicaid. The trust is irrevocable, meaning it cannot be canceled or altered in most circumstances. 

Maryland Estate Recovery Efforts

Maryland Medicaid can place a lien on a beneficiary’s home after six months to help recover the costs of nursing home services provided. If a spouse or disabled child is still living in the home, however, the state might approve a hardship exemption.  

The purpose of the lien is to collect from the proceeds of a possible sale. These recovery efforts apply only to beneficiaries 55 or older who receive nursing home or other institutionalized services, not to those receiving home health care.