Elder Law Attorneys

LONG TERM CARE – NEED HELP QUALIFYING FOR MEDICAID?

If you need assistance qualifying and applying for Medicaid, please call 503-641-6262 to schedule a complimentary Medicaid planning consultation.


Medicaid is a joint federal and state program that pays long-term care expenses for individuals who qualify based upon medical and financial need. There are several benchmarks that an individual must pass in order to qualify for long-term care coverage through Medicaid.

In order to qualify for benefits, an individual must pass income and asset qualifications and show medical need. As a result, you will need to plan carefully how best to spend down your income. This is especially true for couple or individuals that have less than $400,000-$500,000 in savings. These “spend down” decisions will have a lasting effect and must be analyzed carefully. For example, not every asset counts against the Medicaid asset limit. Some assets, like a primary residence, are exempt up to a certain limit and do not count towards financial disqualification.

WHY MEDICAID MATTERS

We all desire to avoid the costly mistakes that could expose us to unnecessary expenses. Concerns over not having enough to pay for our care is the primary concern of retirees today. Long-term care is something that we all know we should plan for but there are always financial surprises and the costs can be more expensive than we anticipated. With proper planning those that qualify for Medicaid can benefit from the following:

  • In-home care
  • Assisted Living, memory care, and foster care
  • Assistance with supplemental needs that Medicaid will not provide
  • Support for disabled children (both minors and adult)
  • Preserve retirement assets for a healthy spouse
  • Avoid triggering Medicaid disqualification through impermissible gifting of assets
  • Preserve assets for the family through family serviced in-home care support
  • Avoid unnecessary claims against your estate for Medicaid reimbursement

WHEN SHOULD YOU START THINKING AND PLANNING FOR MEDICAID?

There are two possible contexts for your planning. Long-term care needs can be addressed through both planning for an immediate need (“Immediate Planning”) and planning in advance (“Advanced Planning”). Immediate need planning occurs with the expectation that Medicaid qualification may be required in the next 4 years or less. Advanced planning takes place five or more years prior to any Medicaid need.

Long term planning includes hoping not to need Medicaid, but we can never be certain about the future, so we plan for funds to supplement our needs should Medicaid become necessary. Advanced planning for long term care can include Long term care insurance, but it might also mean setting aside assets prior to the Medicaid five year look back period.

OTHER ISSUES TO CONSIDER WHEN PLANNING:

  • Income Cap Trusts – enables qualification when income is the only disqualifying factor for qualification.
  • Employed persons with Disabilities (EPD program)
  • In-home care, where you get to choose who you hire through Oregon’s Independent Choice Program.
  • Providing for a disabled Child through a supplemental needs trust while spending down for Medicaid
  • Staying in your home as long as possible without disqualification from Medicaid.
  • Having funds available to pay for burial and other needs after you have spent down your assets to qualify for Medicaid.

THE NEXT STEP:

Please contact our office for more information on Medicaid planning and if it is right for you and your family.  We offer complimentary Medicaid Planning consultations!