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Navigating Medicaid

When it comes to navigating Medicaid’s rules and regulations, many seniors and their families find the process confusing, frustrating and stressful. The application process is one of the biggest hurdles that families face, and with regulations varying by state, it can be difficult to even know if you’re eligible.

Do Your Assets Put You Over the Exemption Limit?

“Your assets drive the Medicaid application and approval process and it depends whether the Medicaid applicant is married or single,” Furman explains, “so the planning is finding the “sweet spot” which minimizes the spending of resources and maximizes the Medicaid payments,” he says. “For example, in some cases it may be better to claim more income for the Medicaid recipient knowing it will be part of the co-payment in exchange for allowing more resources be kept for the spouse. Sometimes you need to adjust income to minimize your overall expenditures.”

Other common roadblocks that can cause trouble on your Medicaid application include:

  • Becoming a co-owner on your child’s home to help them qualify for their home loan

  • Having made gifts to family members

  • Not being aware of all your assets and reporting them incorrectly

  • Not creating proper trusts

  • Not having effective Powers of Attorney, with the necessary authority, if you’re applying on behalf of a parent

  • Not knowing the necessary asset and income information, or where to find that information, if you’re applying on behalf of a parent

Some potential issues that could jeopardize your existing Medicaid coverage include:

  • Leaving the long-term care community to go home, or to the hospital

  • Moving from a long-term care community in one state to another

  • Not completing the re-certification application properly (you must fill this out every year as Medicaid looks for any new assets and income)

  • Making a false claim on your application (even if it’s unintentional)

  • Not being aware of changes to Medicaid

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