Navigating the Uncertainties for Long-Term Care Needs

Garden City Medicaid trust lawyerMedicare is a Federal program enacted in 1965. It is an earned-benefit program for those that are aged 65 or older or disabled. It consists of parts A, B, C and D. Part A is for hospital insurance coverage, as well as limited stays in nursing homes and some rehabilitative services such as physical, vocational, and speech therapy. Usually, there is no co-pay for Part A coverage. However, it is $167.50 per day for skilled nursing facility visits in excess of twenty-one days.

On the other hand, Medicare Part B covers outpatient services including physician office visits, medical devices, and some rehabilitative services. Usually, there is a $134.00 premium for Part B. However, this may vary depending on a person’s income. Part C is for the Medicare Advantage program and Part D is for the prescription drug program. It is worth noting that a person must apply for Part A and Part B through the Social Security Administration.

Unlike Medicare, Medicaid is a cooperative program between the Federal and State governments. The Medicaid program provides assistance to low-income individuals, which may include the elderly and those with disabilities. To qualify for the Medicaid program there are certain income and asset requirements. New York State offers two distinct programs:

  • Community Medicaid and
  • Chronic Care Medicaid.

Community Medicaid is at home care, whereas Chronic Care Medicaid is care that is provided by a skilled nursing facility.

To qualify for Community Medicaid a single applicant may have no more than $15,150 in assets and $845 in monthly income. Qualifying retirement accounts where the individual is taking monthly-required distributions are considered exempt assets. Also, the primary residence and an irrevocable pre-paid funeral are considered exempt assets. Community Medicaid does not have a look back period, therefore, a person may be entitled to benefits within one month from the date of eligibility.

Unlike Community Medicaid, Chronic Care Medicaid has a five-year look-back period, therefore, any transfers made out of a recipient’s name within five years from the date of entering the skilled nursing facility imposes a penalty period. However, it is worth noting that some transfers to a spouse or disabled child may be exempt. For this reason, it is important to preplan for your loved one’s future.

If you or a loved one requires long-term care, it is imperative to seek the guidance of an estate planning lawyer that may help navigate any uncertainties. The Long Island lawyers at Blodnick, Fazio & Associates PC handle all aspects of estate planning, including the creation of trusts to qualify for long-term care coverage through New York Medicaid. With an office conveniently located in Garden City, Nassau County, the firm is dedicated to providing high-quality legal representation at reasonable costs. Contact our Long Island estate planning lawyers at (516) 280-7105 to arrange a free consultation.

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