Graham-Cassidy Proposal Puts Medicaid Coverage at Risk

Senate Republicans continue to push for legislation to repeal and replace the Affordable Care Act. The Graham-Cassidy bill is sponsored by Senator Lindsey Graham, from South Carolina and Senator Bill Cassidy, from Louisiana. Although the bill is still lacking 50 votes needed, it is important to understand the effects it may have on health care. Continue reading “Graham-Cassidy Proposal Puts Medicaid Coverage at Risk”

A Pooled Income Trust May Be The Best Option For Those With Excess Income

For an individual to be eligible for Medicaid services at home, he or she must be over 65 and disabled. In addition, the applicant must meet certain income and asset criteria in order to qualify, because Medicaid eligibility requires a means based test. As of 2017, an applicant is allowed to have $845.00 in income. It is possible that Medicaid may take any income in excess of this amount. For many individuals, turning over these excess funds to Medicaid is not a viable option because it would leave them without the means to pay certain expenses. Continue reading “A Pooled Income Trust May Be The Best Option For Those With Excess Income”

Community Medicaid and Chronic Medicaid

To qualify for Community Medicaid an applicant may have no more than $14,850.00 in assets. Community Medicaid provides coverage for at home care. It does not have a look back period and allows an individual to be eligible for benefits within one month. In addition, the $14,850 does not include qualifying retirement accounts, where the individual is taking monthly required distributions. Continue reading “Community Medicaid and Chronic Medicaid”

Medicaid Financials At A Glimpse

New York Medicaid eligibility

Medicaid is a program that entitles individuals who meet certain income and asset criteria to benefits for Chronic Medicaid or Community Medicaid. Chronic Medicaid is care that is provided in a skilled nursing facility, whereas Community Medicaid is care that is provided in an individual’s home by a home health aide. In 2017, Medicaid applicants may have up to $14,850.00 in resources to qualify for Chronic Medicaid. A Medicaid applicant may also have retirement accounts, such as IRAs, as long as the applicant is taking the minimum monthly distributions. In addition, a pre-paid burial account is an exempt asset. Continue reading “Medicaid Financials At A Glimpse”

What to Consider Before Choosing a Nursing Home

Today, as many as 1.3 million Americans live in nursing homes. Choosing a nursing home for a loved one can be difficult and there are many factors that need to be taken into consideration before making a decision. Although every elder’s needs are unique, there are common criteria that may serve as a guide when choosing the best nursing home for a loved one’s needs. These important factors include method of payment, location, quality, and specialized services. Continue reading “What to Consider Before Choosing a Nursing Home”

Which Trust Helps Me Qualify for Medicaid?

Through conscious Medicaid planning, New York residents may be able to preserve some of their assets for their children or other heirs while still meeting Medicaid’s income requirements. One means of achieving this is through the establishment of a trust. By placing assets into certain types of trusts an individual can eliminate their countable assets for Medicaid eligibility purposes. However, only certain trusts may be useful in qualifying for Medicaid. Continue reading “Which Trust Helps Me Qualify for Medicaid?”

Common Long-Term Care Planning Misconceptions

Many people share common concerns as they reach retirement age: Will they have the ability to remain independent in their homes without intervention from others? Are they going to be able to maintain good health and receive adequate health care? Will they have enough money for everyday needs and not outlive their assets and income? Despite the fact that thousands of Americans are concerned with these aspects of aging, many have failed to develop adequate long-term care plans that specify which services they will need and how they will pay for them. Unfortunately, many Americans also share common misconceptions about long-term care planning that may be factors in why individuals fail to establish a properly executed long-term care plan prior to when they need the services. Continue reading “Common Long-Term Care Planning Misconceptions”

Chronic Medicaid vs. Community Medicaid

In New York, Community Medicaid helps cover the cost of home care and Chronic Medicaid pays for all or part of nursing home care. However, there are certain income and asset requirements that apply to these Medicaid programs because they are need based. Continue reading “Chronic Medicaid vs. Community Medicaid”

How Can a Special Needs Trust Protect My Eligibility for Medicaid?

Supplemental or Special Needs Trusts (SNTs) are legal tools that individuals can utilize to protect their ability to receive New York Medicaid and Supplemental Security Income (SSI) benefits. Originally, SNTs were set up to allow parents of children with developmental disabilities to provide financial assistance for them as they grow up without negating their ability to receive public benefits. SNTs are structured in a way that they supplement the disabled individual’s public benefits, rather than replace them. Continue reading “How Can a Special Needs Trust Protect My Eligibility for Medicaid?”

What is Managed Long-Term Care and What are My Available Options?

Managed long-term care is an option utilized by those who are disabled or chronically ill and need assistance with activities of daily living (ADL), but wish to remain within their homes and communities. Managed long-term care can be provided through the Program of All-Inclusive Care for the Elderly (PACE) and managed long-term care plans.

PACE is a little-known Medicaid and Medicare program that provides comprehensive health care services to eligible members 55 years and older who are otherwise eligible to be admitted to a nursing home. PACE is available through 110 programs in the United States, eight of which are located in New York State.

According to AARP, PACE provides coverage of in-home care, checkups, doctor and dental services, hospital and nursing home stays, as well as prescription medication and some transportation. PACE is open to those enrolled in Medicaid and/or Medicare; some may need to pay a monthly premium based on coverage. All applicants are screened by a team of doctors, therapists and nurses who will determine whether an individual’s level of health and disability requires the level of care typically provided in a nursing home.

Managed long-term care plans provide long-term care services, such as home health care, nursing home care, ancillary and ambulatory services and are funded through Medicaid. Medicaid members can use their Medicaid and/or Medicare cards to pay for services rendered by their primary physicians. To be eligible for a managed long-term care plan, the individual must qualify for nursing home admission. Most enrollees must be 65 years or older to qualify for a managed long-term care plan; however, there are several plans in New York State that will accept younger applicants.

P&P Medicaid provides assistance to those who are seeking a home care program to meet their needs or the needs of their loved ones. We offer a comprehensive in-home assessment conducted by our case manager, who, with the assistance of a nurse, can help determine program eligibility. Together, the case manager, the client and their family caregivers can develop a comprehensive long-term care strategy that is reassessed on a regular basis.

For those seeking qualification for Medicaid, P&P Medicaid will handle the entire application and document acquiring process and appear on the applicant’s behalf for all interviews with the Department of Social Services (Medicaid). For more information about home care evaluation, Medicaid application or any of our other services, please call us at (516) 541-4770 for a consultation.