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”
Medicaid is a federal and state funded program that provides health coverage to those, including the elderly and disabled, who meet certain income and resource eligibility requirements. Personal care services (PCS), or home attendant services, are provided by a personal care aide to individuals who require nutritional and environmental support as well as assistance with personal care functions. Through New York Medicaid, eligible individuals can receive PCS to maintain their health and safety in their own homes. Continue reading “New York Medicaid Personal Care Services”
With changing healthcare and increased longevity, it is important to acquire long term care insurance, because both State and Federal budgets are threatening certain Medicaid benefits. An adequate estate plan should include measures to protect against devastating healthcare costs. One solution is long term care insurance. Continue reading “Protect Yourself With Long Term Care Insurance”
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”
In the United States, the elderly population who require the assistance of a caregiver will grow substantially by 2018. In the future, the number of elderly persons may even begin to exceed the number of available caregivers. There have been efforts made throughout the United States to retain a dwindling number of caregivers who have been leaving the field. For many individuals who cannot afford a caregiver, the responsibility may fall on a family member or friend that is close to the elder. This responsibility can have physical, emotional and financial effects on the individual caring for their loved one. Continue reading “Compensation Available for Family Members Acting as Caregivers”
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?”
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”
Effective June 1, 2016, New York State Medicaid fee-for-service (FFS) and Medicaid Managed Care (MMC) will begin covering breast ultrasonography following a patient’s diagnostic mammogram with an abnormal or suspicious finding. Additionally, those enrolled in New York Medicaid FFS and MMC with breast cancer diagnoses will receive their mastectomy and lumpectomy procedures at high-volume facilities. According to research, five-year survival rates increase for women who have their breast cancer surgeries performed at high-volume facilities and by high-volume surgeons.
Breast ultrasonography, also known as ultrasound, is an imaging method that uses sound waves to evaluate breast tissue. It is non-invasive and may aid in distinguishing normal findings like simple cysts or fat lobules from suspicious breast findings that may require a biopsy.
Once the New York Medicaid’s new program initiative comes into effect, breast ultrasonography following a diagnostic mammogram will no longer require an additional order from the primary provider when performed in a hospital setting. Instead, a note in the radiologist’s report will fulfill this requirement.
High-volume facilities that will be able to perform mastectomy and lumpectomy procedures associated with a breast cancer diagnosis for New York FFS and MMS patients are defined as averaging 30 or more all-payer surgeries annually over a three-year period. Low-volume facilities will not be reimbursed for breast cancer surgeries provided to Medicaid beneficiaries. This policy is an ongoing effort to reform New York State Medicaid and to ensure the purchase of cost-effective, high-quality health care and better outcomes for its beneficiaries.
Medicaid is a federally funded program run by the state and the county which provides medical insurance and long-term care for middle- to low-income persons, including the elderly and disabled. P&P Medicaid Consulting Inc. specializes in preparing applications for Medicaid eligibility, guiding you through the document acquiring process and will appear on your behalf at all interviews with the Department of Social Services (Medicaid).
If you are interested in learning more about applying for Medicaid or any of our additional services, call (516) 541-4770 or visit www.ppmedicaid.com.
A trust is a way to distribute assets to a beneficiary where a trustee, or the person in control of the working trust, is assigned. There are different types of trusts that are set up for specific purposes. One type of trust is a special needs trust, which is created for beneficiaries with disabilities. Under a special needs trust, there is what is known as a pooled trust, also called community or master trusts.
A pooled trust is where the trust assets of multiple individuals are combined, and then distributed proportionately. Some pooled trusts are created in order to care for the disabled beneficiaries, and others are set up just to manage money properly. Typically, these trusts are run by a nonprofit organization, and no two are identical. When setting up a pooled trust, an individual contract is written to reflect individual circumstances.
When it comes to Medicaid, a pooled trust is a way to enable an individual to qualify while still being able to use their income to pay bills. Typically, to qualify for Medicaid, and individual must “spend down” their income to $825.00 for singles and $1,210.00 for couples, after a $20 income disregard. Any money above these amounts must be paid back to Medicaid, or to other medical bills. The issue with this in New York is that the cost of living is so high, individuals are unable to pay basic bills, such as rent and electric, on the Medicaid allowed spend down amount. This is the reason why many people are unable to afford to go on Medicaid, or why they do not qualify.
With this in mind, pooled trusts offer a solution. A qualifying disabled individual can participate in a pooled trust by depositing the amount of their spend down/overage amount. This can then be used to pay necessary bills, allowing the individuals to use all of their money in some fashion. There is an initial fee of $300.00, and a monthly banking and yearly fee, but all-in-all, a pooled trust can allow for Medicaid coverage without a spend down.
There are some other advantages in choosing a pooled trust. One, a trustee is not named as in a regular trust. There are directors of the trust who likely have experience in the area, but not a specific trustee. Sometimes it is difficult for family members to choose a trustee, and this alleviates the pressure of having to do that. Another advantage is that a pooled trust does not require individuals to have a large amount of money as regular trusts require. Lastly, with a pooled trust, the organization is well versed on agency law and how social security insurance and Medicaid programs work. This knowledge can help the beneficiary fully understand how the programs and the trust intertwine.
There are some disadvantages to a pooled trust as well. A few of the basic drawbacks include the inflexibility of the pooled trust, infrequent distribution of funds, and limitations on the types of investments it allows. However, these issues are generally specific to the pooled trust in which you choose to participate.
Understanding the advantages and disadvantages thoroughly and consulting with an experienced advisor is essential to ensuring access to care while protecting your assets. P&P Medicaid Consulting, Inc. has been helping clients structure pooled trusts so that there is a reduction in monthly income overages. P&P Medicaid provides Medicaid application services. The company also provides a full range of geriatric care management services to help individuals and their families make decisions about and supervise their long-term care needs. Please contact P&P Medicaid Consulting, Inc. at (516) 541-4770 for more information.