skip to Main Content
Midway, PA (724) 796-3040 Erie, PA (814) 315-0123 Franklin, PA (814) 209-4699

3 Myths You Should Know About Medicaid

Medicaid is a complex benefits program created by the federal government and administered by each state for its residents. There are several different elements of Medicaid, and most of them offer health care coverage to individuals who meet income and personal asset guidelines.

Nursing home care in Pennsylvania costs thousands of dollars per month. Such costs can quickly use up any assets or savings a person may have, leaving virtually nothing for the patient’s family. With careful planning, a person can qualify for Medicaid benefits for long-term care expenses while preserving assets for future generations.

You might have a spouse or loved one that needs long term care. Are you worried you will have to sell hard-earned possessions and be left destitute in order to secure Medicaid or care for a loved one? Misconceptions about Medicaid are everywhere and it’s important to arm yourself with facts.

Myth #1: My Income Prevents me from Qualifying for Medicaid

You might be surprised to discover that with the help of an elder law attorney, there are strategies that can be implemented to help you qualify for care while protecting your money.

The earlier you start your planning, the more options there are to protect your assets and qualify for care. Most people think they have to spend down all of their assets, but Medicaid has exemptions that will allow you to keep your assets and still qualify.

Our firm can properly assess your finances and life situation to figure out what you or your loved one can keep and how to best utilize funds over the countable asset limit.

Myth #2: Once I am in A Nursing Home, It’s Too Late to Qualify   

It is never too early or too late to begin planning for Medicaid. If you did not plan before entering a nursing home, there is still a possibility assets could be protected. With proper planning, our firm can help save some of your assets and secure Medicaid.

You might be worried about your current situation and facility and if you could switch to Medicaid and the possible repercussions. When someone enters a nursing home, they cannot be discharged because they change from private pay to Medicaid. It is important to check with the facility to see if they accept Medicaid.

Further, each spouse’s income is considered separate property. A couple’s income treatment by Medicaid can get complicated, so it’s important to start planning now.

Myth #3: I Have to Wait 5 Years After Giving Anything Away to get Medicaid  

Your Pennsylvania Medicaid agency will examine your financials for the five years before your application for benefits. But five years is not necessarily the length of time you will be disqualified from getting Medicaid. However, you may not have to wait five years before qualifying for benefits. Five years is the “look-back” period, not the penalty period.

How long you have to wait to qualify for Medicaid is based on the value of the property and the average monthly cost of nursing home care in your state. The waiting period begins to run on the date you apply for Medicaid. Medicaid will look back at gifts made within five years, also. If a transfer has taken place during the lookback period, then penalties for the asset transfers may be imposed. The rules in this area have changed before and could change again, so it’s important to consult with an elder law attorney.

Our firm can help you navigate these often complex rules and guide you to a resolution for you and your loved ones. Our team can:

  • Advise families on how to pay for long-term care, and if appropriate, guide families in the steps necessary to qualify for Medicaid
  • Advise families on the options to protect assets that otherwise may be exhausted on long-term care expenses, including the complex rules on giving away assets
  • Advise families on an individualized long-term care plan for a spouse or parent that looks at all care models and how to pay for care, including Medicaid benefits, Aid and Attendance benefits from the Veterans Administration, long-term care insurance, and withdrawals from retirement accounts
  • Assist with the Medicaid application process
  • Advise families on how to protect property from a Medicaid lien if a spouse or parent is receiving Medicaid benefits
  • Include special needs trust provisions in Wills for married couples to protect assets
  • Prepare powers of attorney and health care directives to plan for incapacity and death properly
  • Advise clients on strategies for applying for Social Security benefits
  • Review continuing care retirement community agreements and caregiver contracts
  • Advise trustees and attorneys-in-fact designated in a power of attorney on how to preserve eligibility for a beneficiary’s Medicaid benefits

The rules surrounding Medicaid are complicated and often confusing. Please schedule a consultation with our firm today to avoid any missteps in your Medicaid application and planning.

Back To Top