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Medicaid Planning

Texas Medicaid Planning: 4 things you need to know

In Texas, Medicaid is the primary program that assists with the cost of long term care. While the cost of Long Term Care varies from one nursing home to another, in this part of the state it usually exceeds $5,000 per month.

A patient who meets the Medicaid Eligibility requirements may be entitled to a substantial amount of assistance.  For a single patient the cost of care will not exceed their income. For a married patient the cost of care is typically lower, and, in some cases, no payment is required. Of source the results are determined by the facts of each case.

Medicaid and Medicare are NOT the same

Many people assume Medicare will pay for long term care. This can be an expensive misunderstanding. Medicare is the federal insurance program that may pay for nursing home care if the patient is receiving “skilled care” and certain other requirements are met. Even then, traditional Medicare will cover a maximum of 100 days of nursing home care and it only pays the full cost for the first 20 days. Medicare is simply not an alternative for those who need long-term nursing home care.

MEDICAID REQUIREMENTS

Nursing home Medicaid assistance is not available to everyone. Certain requirements must be met. The requirements fall info four broad areas.

 1. PATIENT STATUS:

The patient is

  • 65 years of age or blind or disabled,
  • a U.S. citizen or a qualified alien, and
  • Texas Resident
  • In a “Medicaid Bed”

2. MEDICAL NECESSITY

While the specifics can be complex, generally this means the state must determine the patient has the medical need for nursing home care.

3. INCOME LIMIT

Texas is an “Income Cap” state. This means the State has set a limit on the income a patient may have and be eligible for Medicaid assistance. For 2013 that limit is $2,130. If the patient’s gross monthly income exceeds that limit, this can be solved with a Miller Trust.

4. ASSET LIMITS

For Medicaid purposes, some assets count and some don’t. The primary asset that is usually not countable is the home. However, even a home that is not countable requires attention. If proper steps are not taken in advance, even an asset that was not countable might be subject to a claim for reimbursement by the state when the patient passes on.

Single: The “countable” assets of a single patient may not exceed:  $2,000.

Married: Medicaid has a stated maximum of $115,920 in “countable” assets, however this can be misleading. In some cases a smaller amount can be preserved and in other cases a substantially greater amount can be preserved.

Medicaid Planning, also known as Medicaid Asset Protection Planning, can be very complex. For a married patient one of the goals is to preserve as much as possible for the Spouse at Home (Community Spouse) so they can live with dignity.  For a single patient the goal is to preserve as much as possible for the patient’s care and loved ones.

Complex planning is not a “do-it yourselfer” and should be entrusted to an attorney who is experienced in this area of the law.

Mulder & Freedman has assisted hundreds of families obtain quality nursing care for their loved ones while preserving a lifetime of savings and their financial stability. 

            For guidance call Mulder & Freedman at (713) 721-5657. There is no charge for an initial assessment with an attorney. 

Mulder & Freedman, P.C.

 Competence with Compassion