Some programs provide “Home or Community-based Services” (HCBS) for those who would require nursing home care but for the program. Assisted living costs and nursing home costs are covered under a Medicaid waiver program.
Most Medicaid Planning looks to the resources of the individual (and the spouse ). Not all resources are counted although all resources are disclosed. “Countable Resources” can be converted to “noncountable resources”. Some assets are noncountable resources because they are exempt such as: One automobile, the family home if the applicant “intends to return home”, property used in a trade or business, property used for self-support or employment and personal effects and household goods up to $2,000, an account of $4,000, wedding and engagement rings, life insurance with a face value of $1,500 or less. Certain income producing property is also exempt. “Qualified” assets such as an IRA are not countable assets. The “community spouse” who still resides at home is entitled to a “Minimum Monthly Maintenance Needs Allowance (MMMNA)”. In October, 2011 it was raised to a maximum of $2,841 per month and a minimum of $1,828.75. The MMMNA may be increased at a “Fair Hearing”. The Community Spouse Resource allowance (the CSRA) provides for the pooling and division of the resources of husband and wife and allows the “community spouse” to retain a share of the couple’s countable resources. This is composed of countable resources only. The new minimum CSRA in Rhode Island is $22,728 and the new maximum is $113,640. This is in addition to the $4,000 that the institutional spouse may retain. The minimum and maximum home equity limits used by Medicaid have increased to $525,000 and $786,000, respectively.
The Medicaid “look-back period” for transfers of assets is 60 months if the transfer occurred after February 8, 2006. In cases where it is too late to transfer assets there are transfer strategies used by Medicaid planners. There are risks and costs also when assets are irrevocably transferred so it is wise to consult an expert before transferring any asset. There are exempt transfers from the period of ineligibility such as transfers of the family home in certain circumstances, transfers to the community spouse, transfers to a blind or permanently and totally disabled child. There are transfers for value not subject to penalty such as: the purchase of an annuity; a “self-cancelling Installment Note (SCIN), the sale of a remainder interest in a home, modification of a child’s home for the parent before the need for a nursing home, reimbursement of a pro rata share of expenses, compensation for caregiving services and cost of other living arrangements. Medicaid planners also consider the use of a reverse mortgage or a family reverse mortgage and non-negotiable promissory notes.
The foregoing list is not exhaustive and any person or family who wishes to begin planning with reference to Medicaid should remember: “The sooner the better!”
The Law Offices of Howe and Garside LTD are staffed by Rhode Island Medicaid Planning Attorneys serving clients in RI towns surrounding Newport, RI such as Middletown, Portsmouth, Jamestown, North Kingston, South Kingston, Wakefield, Tiverton, and beyond.