We are going to share an important piece of timely information about Community Medicaid in this post. In order to understand the relevance, you have to digest some background information, so we will start with a brief explanation.
Long-Term Care Costs
Many elders require living assistance at some point in time. Medicare is the primary source of health insurance for most senior citizens in the United States, but this program will not pay for the custodial care that is provided in the home or in a residential setting.
This gap is a big deal, because these facilities are very expensive. They are high all around the country, but the costs in the Rochester area exceed the national averages.
The typical monthly charge for a private room in a nursing home in our area is $14,750, and the median cost for care provided by an in-home health aide is $5243 a month.
According to the Department of Health and Human Services, the average length of stay is one year, and 13 percent of people receiving paid care need the assistance for more than five years.
Medicaid is another jointly administered federal/state government health insurance program, and it is intended for people with significant financial need. Medicaid will cover long-term care, so many seniors that qualify for Medicare seek Medicaid eligibility late in their lives.
There are low income and asset limits, but it is possible to gain eligibility even if you have resources. To develop the right financial profile, you could convey assets into a Medicaid trust. With a Medicaid trust, you can retain full control over your assets, and even retain the economic enjoyment of the assets, but the assets will not be counted as yours for purposes of Medicaid eligibility.
The rules for creating such a trust to acquire Medicaid eligibility are complex and change frequently. Accordingly, you should only create such a trust with the assistance of a qualified elder law attorney.
Now that we have set the stage appropriately, we can explain the matter at hand. In the state of New York, Community Medicaid is potentially available to people that can receive the assistance that they need from paid caregivers in their own homes.
The income and asset limits are still in place, but traditionally, there has been no look-back period at all. As a result, you could divest yourself of assets when you decide to apply for Community Medicaid, and you would not be penalized.
In the State Budget that was enacted on April 2, 2020, there were provisions that impacted Medicaid eligibility. One of them installed a 30 month look-back period for Community Medicaid.
It was initially supposed to be implemented on October 1st, and that was pushed back to the beginning of 2021.
A provision contained within the federal Family First Coronavirus Response Act (FFCRA) that was enacted as a response to the economic impact of COVID-19 put changes like this on hold. As it stands now, the look-back will be imposed on April 1, 2021.
As a result, you still have a limited amount of time to submit an application for Community Medicaid for yourself or a loved one that needs living assistance.
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If you would like to discuss this matter or any other elder law or estate planning objective with a licensed attorney, we are here to help. You can send us a message to request a consultation appointment, and we can be reached by phone at (585) 546-1734.