12Law Arrow 12Law Arrow  Easy Questions  
12Law Arrow 12Law Arrow Instant Legal Documents
 
 
FINANCIAL & MARITAL

Cohabitation Agreement coming soon!
Separation Agreement coming soon!
No-Fault Divorce coming soon!
Bankruptcy coming soon!
 
 

Rules of Eligibility on Medicaid in Zip Code 92572

Rules of Eligibility on Medicaid in Zip Code 92572


You don't get to choose how you're going to die, or when. You can only decide how you're going to live.
 
- Joan Baez


Medicaid, which is distinct from Medicare, provides health coverage to nearly 60 million children, families, pregnant women, the elderly, and people with disabilities. Medicaid covers US citizens and eligible immigrants and is generally provided for low income citizens.

Medicaid can pay for nursing home costs for senior citizens with few assets and low income. In some cases, this applies to senior citizens who have already spent almost all their savings paying their residential facility or home care and cannot sustain the expense.

In the case where one spouse lives at home and the other in a long term care facility, Medicaid can allow more assets to be retained while still qualifying for Medicaid. Planning plays an important role so that Medicaid can pay the nursing costs of for an elderly patient in a medical facility.

When does Medicaid Pay for Assisted Living or Nursing Home?

Medicaid provides for people with low income and limited assets. The program is a joint project by the state and federal government to assist senior citizens in terms of their assisted living care or nursing home needs. The state administers the program and has certain requirements for an elderly to qualify for the benefits.

Long Term Care Requirements

Long term care consists not only of medical care but also personal services for people who are ill and disabled.

State Provided Medicaid

Medicaid recipients will avail of the nursing facilities provided by every state for free. The state will also pay for the home health care services of the recipients who qualify for nursing home care. Medicaid funding can be used by the state to provide long term care services like health aides to those who are not qualified for assisted living facilities and in-home services.

Facilities Accepting Medicaid

Since Medicaid has certain mandatory federal requirements, not all nursing home or assisted living facilities accept Medicaid payments. There are facilities that accept Medicaid and they are subject to periodic inspection to make sure they meet the federal standards set by the state. You need to check with the facility to determine if they take Medicaid patients.

Medical Eligibility

Seniors are not the only persons assisted by Medicaid. Adults and young children who have needs for a nursing home care are also medically eligible for Medicaid after satisfying the requirements of the state. As long as it is proven "medically necessary" for a patient to be placed in a nursing home or health care facilities, and you meet the asset and income criteria, Medicaid will shoulder the expenses.

Financial Eligibility

Depending on the state where you are residing, Medicaid eligibility is set by the federal SSI (Supplemental Security Income). SSI also set the income limits.

Income Limits

Flexible medical guidelines are available in most state for long-term Medicaid reimbursement. These income guidelines depend upon the type of the long term program being applied for and used.

"Medically Needy" Guidelines

"Medically needy" refers to those people who have high income and assets yet their medical expenses are also very high. This means that their income is reduced. In Medicaid terms, this is referred to as "spending down".

Resource Limits

A person who has "spent down" would be eligible to qualify for Medicaid assistance. This is after a person's assets are higher than the Medicaid resource limit.

Asset Transfer

You can diminish your assets or do whatever you like while you are "spending down", getting below the qualifying asset criteria for Medicaid. However, you may not give away assets for less than market value. Medicaid will track your finances for the past five years to determine if your transferred assets in order to qualify for Medicaid. If they determine that you have done so, you will be ineligible to apply for Medicaid for a certain period. Penalty charges may also apply, even after restrictions are lifted and you will legally qualify for Medicaid assistance.

Contribution to Cost of Care

Before Medicaid pays for your care, they expect your available income would go to the long term medical care at a nursing home or other healthcare facility and you will only be allowed to keep a small fixed amount for your "personal needs allowance". The amount that you will be allowed to keep will depend on state laws and the arrangement you made with your healthcare facility. Arrangement can also be made for persons with more than what is allowed for Medicaid eligibility assets to put it in a trust in order to qualify for Medicaid. When the person dies, the trust proceeds will be paid to any long term medical care that was provided for by Medicaid. The rest, which may not be much, will go to the heirs.

Spousal Improvised Protection

Married couples who have one member needing a long-term care services will not be required by Medicaid to give up assets and income in order for the other who need health care to qualify for Medicaid. The healthy spouse is still allowed to live in the community and keep assets ranging from $22,000 to $110,000 depending on the state rules.

Future Medicaid Claim against Your Estate

Medicaid will claim your estate only if:

• You are 55 year old and receiving long-term medical care

• You are permanently institutionalized before you turn 55 year old

• If you pass away, Medicaid will have a claim on your estate for the amount they have spend to care for you (Medicaid estate recovery)

Medicaid will only claim your estate after your remaining spouse dies and you have not left behind any minor or disabled children.

 
Personalize & Print a Free CA Living Will Create This Document
Page 1
Page 2
Page 3
Page 4
Page 5
Page 6
Page 7
Page 8
Related Legal Services near Zip Code 92572
Anderson John H
105 E Mariposa
San Clemente, CA 92672
(949) 492-9944
General Practice Attorneys, Attorneys
Currington Christina H
526 1st St # A
Rodeo, CA 94572
(510) 799-9777
Estate Planning Attorneys, Attorneys, Family Law Attorneys, Divorce Attorneys, Legal Service Plans
Hooper Lisa K Esq
100 S Ola Vis
San Clemente, CA 92672
(949) 487-9549
Attorneys, Divorce Attorneys, Family Law Attorneys
Perez Shawn R
107 Avenida Miramar # C
San Clemente, CA 92672
(949) 492-9545
Attorneys, Legal Service Plans
Clinebell Donald R
110 E Avenida Palizada
San Clemente, CA 92672
(949) 366-9394
Business Law Attorneys, Attorneys, General Practice Attorneys
LaCalle Professional Services
350 Bohemian Hwy
Sebastopol, CA 95472
(707) 874-9144
Attorneys Referral & Information Service, Attorneys
Diran & Grey
153 Lake Ave
Rodeo, CA 94572
(510) 799-9000
Attorneys Support & Service Bureaus, Attorneys, Legal Service Plans
Birnie Tate
7182 Healdsburg Ave
Sebastopol, CA 95472
(707) 823-8593
Arbitration Services, Attorneys, Legal Service Plans
Lokewalsh Tien-Li
881 Alma Real Dr # 118
Pacific Palisades, CA 90272
(310) 454-7920
Immigration Law Attorneys, Attorneys
Gurney Glade Sarah
130 Petaluma Ave # B
Sebastopol, CA 95472
(707) 823-6500
Attorneys, Legal Service Plans
Turner Keith J
17383 W Sunset Blvd
Pacific Palisades, CA 90272
(310) 454-6190
Insurance Attorneys, Attorneys, Legal Service Plans
Bernard A Allen Law Offices
160 Avenida Granada
San Clemente, CA 92672
(949) 492-6111
Attorneys, General Practice Attorneys, Business Law Attorneys, Real Estate Attorneys, Estate Plannin
Attorney A1 Referral Svc
1802 N El Camino Real
San Clemente, CA 92672
(949) 485-5793
Attorneys Referral & Information Service
Damm Lawrence H
15200 W Sunset Blvd # 209
Pacific Palisades, CA 90272
(310) 459-5784
Estate Planning Attorneys, Attorneys, Tax Attorneys, Wills, Trusts & Estate Planning Attorneys
San Clemente Bankruptcy Attorney
501 North El Camino Real
San Clemente, CA 92672
(949) 203-3845
Bankruptcy Law Attorneys, Business Bankruptcy Law Attorneys
Minnott John M
503 Via Deseo
San Clemente, CA 92672
(949) 492-3459
Attorneys, Estate Planning Attorneys
Western Auto Clearance
105 Avenida De La Estrella # 3
San Clemente, CA 92672
(949) 361-1999
Collection Law Attorneys, Collection Agencies
Coffman Ellen
874 Gravenstein Ave # 5
Sebastopol, CA 95472
(707) 829-1567
Mediation Services,  Attorneys,  Arbitration Services,  Legal Service Plans
Du Bovy Jane
881 Alma Real Dr # 309
Pacific Palisades, CA 90272
(310) 573-1430
Bankruptcy Law Attorneys, Attorneys, General Practice Attorneys
Jenni Gustafson
PO Box 945
Soulsbyville, CA 95372
(209) 532-1421
Attorneys, Family Law Attorneys, General Practice Attorneys, Estate Planning Attorneys, Legal Docume
O'Brien Scott
2453 Burnside Rd
Sebastopol, CA 95472
(707) 829-0522
Attorneys,  Mediation Services,  Arbitration Services,  General Practice Attorneys,  Legal Service P
Levin Richard
130 S Main St
Sebastopol, CA 95472
(707) 824-0440
Attorneys, General Practice Attorneys
12Law.com   |  NASHVILLE, TN USA   |  CONTACT US