We realize that with the rising cost of long term care, many people are finding that they do not have the financial ability to tackle these high costs. Long term care planning is now becoming a necessity for those who perceive the need for long term care in the future.
Many people are unaware that government assistance is available in certain circumstances to pay for the cost of nursing home care. For others who are aware of the availability of government assistance, they simply are not aware of the process or the eligibility requirements. While early planning is one of the keys to effective planning, it is never too late to try to tackle the costs and other problems associated with providing long-term care for your loved ones.
Common Questions Regarding Long Term Care Include:
What types of government benefits are available to pay the cost of a nursing home?
The institutional care program (ICP Program) which is part of the Medicaid system pays the cost of nursing home care for aged and disabled individuals who qualify for benefits.
What is a “countable asset”?
The issue of what are “countable assets” is a determination made by the Department of Children and Families after considering which assets are available to the Medicaid applicant to cover the cost of their care. Determining whether assets are “countable” or exempt assets is a complicated task which should be left to a professional who is knowledgeable with the laws, rules and regulations regarding Medicaid eligibility.
What can I do if my “countable assets” exceed the asset limitation?
You should consult with a qualified professional who can review the person’s assets to determine if there are any measures available to reduce the amount of “countable assets”. There are several measures that can be taken to reduce the amount of countable assets, including the preparation of a personal services contract.
Can I simply give away my countable assets in order to be eligible?
No, absolutely not. Giving away your assets could cause the person to lose eligibility for a period of time. If the transfer is not a qualified transfer, then there will be a transfer penalty depending upon the amount of the transfer. The Department will look back for a period of 60 months prior to the date of application to determine if any gifts were made.
What is a personal services contract?
A personal services contract is a valid, binding contract between the applicant and his or her caregiver. The caregiver is often a family member or close friend who is caring for the applicant. The contract provides that the applicant will pay compensation to the caregiver for his/her services that are provided. Typically, the compensation paid by the applicant is in the form of a lump sum of money in advance. As to be expected, the Department closely scrutinizes the contracts to make sure that they are not an unauthorized gift of money. If the contact does not meet guidelines and is not approved, then the applicant could be penalized. If the contract is approved, then the funds paid are not considered a gift and are no longer “countable assets”. There are also tax consequences associated with this contract as well that should be discussed.
The individual must meet all of the following 5 criteria
1. Citizenship: Applicant must be a U.S. and Florida citizen.
2. Medically Needy: In order to be “medically needy”, the applicant must be unable to perform three out of five activities of daily living without major assistance. Those daily activities include: walking and standing by oneself, feeding oneself, bathing oneself, clothing oneself and doing toiletry by oneself. If the applicant is unable to do three of the previous five without assistance then they qualify for Medicaid benefits under the ICP program.
3. Income Limitations: In order to qualify for ICP benefits, as of January, 2014, the applicant can have no more than $2,163 of income per month. If a couple are both attempting to qualify for benefits, then the income cap is $4,326 per month for the couple. These income limitations change every year due to cost of living adjustments. Once eligible, all of the person’s income (except $35 for personal needs) must be paid to the facility. If the person has a spouse in the community (not in a nursing home) some of the income may go to that spouse.
4. Asset Limitations: A person can only have $2,000 in “countable” assets. The asset limitation is currently $3,000 in total assets for a couple, both attempting to qualify for benefits. If the applicant has a spouse living in the community who is not seeking to receive benefits, then the community spouse can only have $117,240.00 in “countable assets”.
5. Placement: The applicant must be placed in a Medicaid facility able to provide the level of care needed.
Can a person still qualify if their income exceeds the income limit?
Yes, if the total income of the applicant is above the income cap, an applicant can still qualify for Medicaid benefit through the use of a Qualified Income Trust.