I need Medicaid right now to cover my $7,500 Nursing Home bill.

Medicaid Crisis Planning

Medicaid Crisis Planning refers to the situations where someone is in the nursing home now and they need Medicaid immediately. Nursing home bills range from $6,700 to $8,500 on average around the surrounding counties. Let’s see if we can get this paid for you!

Living in Georgia, these are the numbers that we are working with:

$6,768.00 Divestment Penalty Divisor
$2,349.00 Income Cap
$2,000.00 Individual Resource Allowance
$70.00 Monthly Personal Needs Allowance
$128,640.00 Community Spouse Resource Allowance
$3,216.00 Monthly Maintenance Needs Allowance
$3,000.00 Resource Allowance for a Couple (Husband and Wife both reside in a facility)

Now that we are done with the numbers, let’s put it all together.

This type of planning has big differences when you have a single person versus a married couple. With a married couple, we can save 100% of the assets. With a single person, we come up with a way to save as many assets as possible. Worst case scenario, we can save 50% of the assets. This type of planning is very case specific as there are many planning techniques we can use.

Here are a few examples using approximate number for presentation:

Single Person – Eligibility

In order to be qualified for Medicaid, a single person is allowed to have the following assets:

  • House
  • Vehicle
  • $2,000
  • $1,500 Face Value of Life Insurance

If a single person has more assets than this, there is still planning options for them.

Planning Option – Half Loaf

Half Loaf Planning refers to a special Medicaid planning technique for single persons only. The attorneys at Ansari Firm start by sitting down with the family and determining all assets and, usually, we will end up consolidating them. Then, the attorney will discuss with the family and spend-down items; such as, pre-paid funeral contract, home improvements, hearing aids, personal items, etc. The money can be spent down on any items for the person in the nursing home. Gifts are not allowed. The key here is to spend-down on things that you will have to eventually pay for anyways. You do not want to spend money just to spend the money. It is not necessary.

Once it is determined if there is a need to spend-down any assets, the attorney will come up with the amount of assets that will go into the half loaf plan. The half loaf plan is a very case specific, mathematical calculation that gifts away a portion of the assets, which will create a penalty period in which medicaid will not pay for the nursing home stay. The other part of the equation is to retain the correct amount of assets and loan, not gift, them away so that the loaned assets can pay the nursing home bill over the penalty period. Now, we know that was a lot to digest, how about a case study?

Case Study

Mom is single and 84 years old. She was living on her own until she recently had a fall. She went into the hospital, was admitted for 3 days, and then was transferred to a nursing home to do rehab. She did rehab for 3 weeks when the family was told she had “plateaued” and she would be discharged within the next few days. The family then decided that Mom was not safe to come home and live on her own anymore, so they notified the nursing home that Mom would be staying there long-term.

Now that we know Mom will have to stay in the nursing home long-term, they come into Ansari Firm. We determine that Mom has a house and $70,000 in the bank. First, we need to talk about any spend-down items. Is there anything in the home that needs to be done in order to eventually sell? Does Mom has a pre-paid funeral contract? We factor any of these in off the top of the plan. Lets assume we did not need to do any spend-down. Here is the half loaf plan:

We gift approximately $35,000 away. By away, I mean into someone else’s name, usually a child. This gift will trigger a penalty period ($35,000/$8,469) of 4 months. The other $35,000 if loaned away, usually to a child. The child then signs a Medicaid compliant promissory note. This note says that this amount was not a gift and the child will then pay back Mom over the 4 month penalty period and Mom will then use that money to pay the nursing home. At the end of the 4 months, the loan is repaid, and the penalty period is over and Mom then goes onto Medicaid. This illustration is at its simplest form. The individuals exact monthly income and the nursing home’s actually monthly cost also has to be factored in.

Married Couple – Eligibility

For married couples, the asset limit is different. The at home spouse can keep 1/2 of the assets up to $126,420. If their assets are below $25,284, they are automatically asset qualified. These asset limits do not count the principal residence (as long as it is not owned by a trust), one vehicle, and $1,500 Face Value of Life Insurance.

If a married couple is over the asset limit there is planning they can do to become qualified. Some people have things to spend the assets down on; such as burial expenses, home improvements, or even a house or car. If they do not want to spend down assets, they can either Petition the Probate Court to increase the Spousal Resource Allowance or they can take the assets over the asset limit and put them into a Medicaid Compliant Single Premium Immediate Annuity (SPIA).

In a nutshell, I have tried to put a decade of Medicaid planning experience into a short synopsis. Call our office and we will send you an asset spreadsheet for completion and then we will start a review of your case.

Mansoor Hussain AnsariReviewsout of 15 reviews
Ansari Law Firm, Tax Attorney, Alpharetta, GA

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Ansari Law Firm

2650 Holcomb Bridge Road
Suite 110
Alpharetta, GA 30022

1744 Roswell Road
Suite 100
Marietta, GA 30062

8530 E FM 1960
Suite 204
Humble, TX 77346

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Call (678) 400-4485