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Medicaid planning consists of actions taken to reposition assets in an effort to promote the independence and quality of life for the Client, protecting the community spouse and family, while making sure that the Client is qualified for Medicaid payment for the Client's long term care. Medicaid planning can occur in advance of long term care needs or it can be done even after the Client has entered into a long term care facility. The Law Office of James C. Siebert & Associates helps seniors and their families prepare a comprehensive plan to deal with long term care while maximizing the financial resources available to community spouse and family.

See Medicaid Planning Facts & Myths.

See Medicaid Common Questions

How we can help?

The Law Office of James C. Siebert & Associates assists Clients in :

· Evaluation of the short and long term physical and financial needs of the Client, the Client's spouse and family.

· Evaluating the current situation and evaluating the options available to Client under the existing Medicaid laws.

· Reviewing options with the Client, the Client's spouse and family and making recommendation as to the best course of action to ensure the Client's qualification for M Medicaid payment for long term care while maximizing the financial resources which will remain available to the Client, the Client's spouse and family.

· Acting as a resource for referrals for various services available to the Client as well as to provide clarification in regard to the voluminous and often conflicting information provided to Client by various parties who do not always have Client's best interest at heart.

· Preparation of the various legal documents as well as the Medicaid application on behalf of Client, including detailed Exhibits outlining to the caseworker the specific provisions of the law that allow the Client's actions with the supporting documents attached.

· Representing the Client and advocating on his or her behalf with the State Agencies regarding the Client's application.

· Assisting the Client, the Client's spouse and family in post eligibility issues including estate planning designed to minimize the amount paid to the facility or Medicaid and maximize the amount available to the family at the death of the Client or the Community spouse.
















What is Medicaid Planning?

Medicaid is a joint federal-state welfare program that will pay for an individual's nursing home care, if the eligibility requirements set forth in the statutes and regulations are met by the individual. You must meet the income and resource guidelines in your state. Income is money you get from Social Security, a job, pension, or other sources. Resources are things you own, such as savings. But Medicaid doesn't count everything.

Generally, a Medicaid recipient's income, except for the exclusions must be paid to the long term care facility to contribute to the cost of his/her care. Further an individual is only allowed $2,000.00 of non-exempt assets. Since there is a limit of $2,000.00 in non-exempt assets individuals are frequently told that they must "spend down" their life savings on payments to the long term care facility prior to qualifying for Medicaid. While there is a limit of $2,000.00 in non-exempt assets, through the conversion of non-exempt assets into exempt assets The Law Office of James C. Siebert & Associates allows the applicant to benefit from their life savings while still qualifying for Medicaid payment for long term care.

The rules are slightly different for married applicants. The spouse of a Medicaid applicant is known as the community spouse. In addition to the applicant's assets, the applicant's resident spouse can have or receive from the applicant, an amount of non-exempt assets known as the Community Spouse Asset Allowance (CSAA) without affecting the applicant's eligibility, along with additional exempt assets which the Community Spouse can keep.

In addition, the community spouse is entitled to a contribution of monthly income from the resident spouse to bring the community spouse's monthly income up to a certain minimum amount. The amount of monthly income to which the community spouse is entitled is known as the Community Spouse Monthly Maintenance Needs Allowance (CSMNA). If the community spouse's income exceeds this amount, he or she may have to make a support payment be made on behalf of the resident. Typically the CSAA and CSMNA are adjusted annually.

Since Medicaid is a government benefit program, neither the applicant nor the applicant's spouse may give away their assets to avoid the spend down requirements. Asset transfers for less than fair market value during the "look-back" period preceding an application for Medicaid, by an applicant or spouse, will result in an ineligibility period. This ineligibility period or penalty period, is a time period during which Medicaid will not pay for the individual's care and therefore the individual must find another source of money to pay during that time.

Transfers of assets include any changes in the way an asset is held, including but not limited to: adding a name to a house deed, creating a trust, or closing a savings account. Thus, a transfer of assets made during the "look-back" period will result in a period of ineligibility equal to the number of months the individual could have paid for his/her own care at the private pay rate of the applicant's nursing home.

The law regarding Medicaid Eligibility was dramatically changed with the enactment of the Deficit Reduction Act (“DRA”).The DRA significantly changed rules governing the treatment of asset transfers. The look-back period is now 60 months and the penalty period resulting from transfers for less than fair market value is not imposed until the individual is in a facility and otherwise is qualified for Medicaid. This may result in some very harsh treatment for seniors where the penalty period does not begin until they have only $2,000.00 left and they have no money to pay for the long term care during the penalty period.

The Illinois Medicaid rules hold that certain types of assets and property held under certain forms of ownership are not to be counted against an applicant or community spouse's asset limit. The first step in long term care planning is to maximize the benefit of exempt assets and transfers. For a variety of reasons, most importantly the avoidance of spousal impoverishment, the government has designated certain assets and or transfers as exempt and therefore not included in the community spouse asset allowance. Further, certain asset transfers are allowed during the look back period. It is through the planned use of allowable transfers maximizing exempt assets and other Medicaid procedural rules that the Law Office of James C. Siebert & Associates is able to assist its Clients in qualifying for Medicaid, maximizing the community spouse and the family's financial future all while assuring the Medicaid applicant the highest level of care and quality of life possible.






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