It is critical to evaluate if/when a person will be eligible before filing the the Medicaid Application. If not, the information volunteered could result in a denial and longer period of ineligibility than necessary. As noted above, the Medicaid Application is extensive and should never be filed before seeking legal advice or representation.
As an example of the complexity, the application requires production of monthly financial statements for every account in which the applicant had an interest for the past 5 years and an explanation for any deposit or withdrawal over $1,000.00, information not readily available.
Applicants then learn of the "deeming rule" whereby all of the resources of both spouses are countable on the application for either spouse, even "second marriage" spouses. The deeming rule divides the spousal assets 50/50 to determine the amount of spend down for the infirmed spouse before Medicaid eligibility; however, the 50% share allowed to the non-infirmed (community) spouse cannot exceed $109,560.00 in 2011. Any amount beyond that gets added to the applicant spouse's spend down before Medicaid eligibility. Next there is a monthly income allowance for the community spouse of $1838 but no more than $2739.
Other little known, yet potentially devastating, Medicaid Application facts are:
- The cash value of life insurance policies beyond $1,500.00 face value is considered an available resource countable by Medicaid.
- Once Medicaid eligible, all income of the applicant must be signed over to Medicaid (unless there is a spousal allowance due to the community spouse).
- Both at home Medicaid (Global Options) and assisted living Medicaid have a monthly income cap of $2,022.00. If the applicant's gross income is $1.00 over $2002, the applicant is not Medicaid eligible.
- Either spouses' IRA's and their home (unless the community spouse resides there) are countable Medicaid resources which must be spent down before eligibility. An experienced Medicaid attorney can soften the impact of these harsh rules.
For a free initial consultation regarding Medicaid Applications, call us at 973-577-6010 or click here to contact us online.
