Medicaid Planning Attorneys in Chesterfield, MO, Providing Guidance to Clients Dealing With Medicaid Eligibility Matters

Medicaid is a needs-based program that covers care deemed medically necessary for those who need help paying for medical assistance. In Missouri, the program is called MO Healthnet. It offers coverage for a variety of eligible individuals and can also cover nursing home care. However, it is important to understand how you may be eligible for Medicaid benefits and how to protect your assets without being disqualified from the program. Our attorneys explain how Medicaid planning works and why getting legal help may make the process easier.

Why Do I Need Medicaid Planning if I am Covered by Medicare?

Both Medicaid and Medicare are healthcare programs provided by the government, but they are designed to do different things. Senior citizens who are 65 or older may receive short-term coverage for illnesses, prescriptions, medical equipment, and other healthcare conditions. However, Medicare is meant only to provide healthcare resources for up to 100 days – for example; you may be covered if you need to visit urgent care for a stomach virus, then receive treatment and follow up with your primary physician, and make a full recovery.

On the other hand, if you find out that you have a chronic or terminal illness that requires hospitalization, ongoing care, or long-term nursing care, Medicare will only cover your medical treatment expenses for a total of 100 days. After that, the patient will need to pay out of pocket. That is where Medicaid plays a role. Medicaid may provide coverage for long-term care for qualifying individuals, covering an extended stay at the hospital, receiving in-home care, or extended care at a nursing home.

Who Is Eligible for Medicaid?

In order to be eligible to receive Medicaid benefits in Missouri, you must be 65 or older. In addition, you must be pregnant, blind, or disabled or have a disabled or blind child, parent, or spouse in the same household. You must also be a U.S. citizen or permanent resident and a resident of the state of Missouri.

In addition, you must be in need of healthcare assistance, and your household must meet certain income requirements. For example, if you have two people in your household, your annual income must not exceed $26,228.00 a year. These numbers are often updated and may vary according to the type of Medicaid plan you may be receiving, so be sure to check for the most recent guidelines.

Medicaid may also look at an individual’s assets to determine income-based eligibility. Certain assets such as cash, bonds, stock, investment accounts, bank accounts, and real estate (not including a primary residence) are considered countable assets, and their value is calculated against Medicaid’s asset limit. This is important because the total value of a person’s countable assets affects their eligibility to receive Medicaid benefits.

Medicaid also has a 5-year look-back period for certain plans, which is meant to ensure that an individual has not sold, gifted, or transferred assets below market price in the five years prior to the application date with the goal of reducing the size of their estate to receive benefits. For these reasons, planning your estate in a way that allows you to protect your assets while remaining eligible for benefits is crucial.

Does Missouri Have Medicaid Estate Recovery?

Another reason to include Medicaid as an estate planning goal is a program called Medicaid estate recovery. Unlike other healthcare programs, all medical expenses covered by Medicaid must be paid back after the Medicaid recipient passes away. In order to recoup funds, Medicaid can seek reimbursement by going after any portion of the estate that remains, including assets that were previously considered non-countable. That means unless the decedent’s spouse is still living in their primary residence, Medicaid may put a lien on the decedent’s home and any other assets in order to fulfill the value needed for repayment of care.

That may sometimes mean that an individual may end up with little to no assets to leave to their beneficiaries. However, with proper planning and the right tools, it is possible to ensure you can receive the care you need while still leaving a legacy for your loved ones, and a Medicaid planning lawyer can help.

What Can I Do to Protect My Assets and Still Be Eligible for Medicaid?

There are many options to protect your assets from Medicaid recovery. As always, it is best to work with a Medicaid planning lawyer and start the planning process well before a healthcare crisis arises. By starting early, you will have better chances of preserving your estate and still being eligible to receive care when needed later in life.

Each situation is unique, but many Medicaid planning strategies include either spending down or transferring your assets (preferably in a manner to avoid a penalty due to the look-back period rules). One of several ways of achieving this is calculating the total value of your countable estate assets, then using an irrevocable trust to transfer the amount in excess of the Medicaid qualifying threshold. Many choose to open an irrevocable funeral trust, which can cover funeral costs while remaining as a non-countable asset. This strategy may not be right for everyone, so it is best to seek the advice of a skilled Medicaid planning attorney.

How Can an Attorney Help?

Whether you are planning for the future or need help qualifying for Medicaid to provide immediate care for a loved one, a Medicaid planning attorney can provide the legal knowledge and strategies to help you make the right decisions. Medicaid rules can be hard to understand, and it may feel overwhelming, especially when you are faced with a crisis situation and need to secure nursing home care or specialized care for your loved one.

By seeking the help and knowledge of a professional, you can better navigate the process of applying for Medicaid benefits while protecting your estate and ensuring you have enough assets to cover all your healthcare needs. Your attorney can assess your situation and suggest short and long-term strategies to help you qualify for benefits and minimize your exposure to Medicaid asset recovery.

At Mid-America Law Practice, LLC, our Medicaid planning attorneys have helped countless clients and their families in the Chesterfield, MO, area and are ready to assist you with all your Medicaid planning matters. We understand you may be going through a difficult time, and we are here to help you make the right decisions for you and your family while simplifying the process of securing the benefits you need. You do not need to try and figure it all out by yourself. Reach out to our office by calling (314) 347-3567 and requesting a free consultation to discuss your situation and learn your options. We look forward to assisting you.