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Medicaid Myths

 
LOUISIANA MEDICAID MYTHS
 
  1. Giving away everything I own is the only way to get Medicaid.In fact, giving everything away can sometimes prevent you from receiving Medicaid!   But you do not have to be destitute to qualify.  You can own a home, a vehicle, some life insurance and personal property, and a limited amount of resources.

  2. I will not qualify for Medicaid until 36 months after donating or transferring property.  Medicaid rules do penalize some transfers of property and the “look-back” period for transfers is 36 months.  However, the length of the penalty period of ineligibility depends on the kind of transfer and the value of what was transferred. (Recent legislation on the national level (Deficit Reduction Act signed by President Bush on February 8, 2006) has increased the look-back period to 60 months or five years.  Louisiana is expected to adopt this policy on the state level.)

  3. he Medicaid office will answer all of my questions regarding Medicaid eligibility criteria before I apply. Most of the time, they will not.  They usually provide you with income and resource guidelines that are factually correct but very misleading because of nuances in their practical application.  Sometimes they encourage you to apply to see if you are eligible even though application at the wrong time could result in unnecessary periods of ineligibility.   They sometimes tell you to spend down all of your money before applying when this is not always the best strategy.

  4. Once I am in a nursing home it is too late to protect any assets. While you may have lost the opportunity to use some of the easier strategies, it is never too late to protect some if not all of the remaining assets.

  5. I can give away up to $11,000 per year without any negative consequences from Medicaid.The $11,000 refers to the federal gift tax rule that has nothing to do with Medicaid law.  This gift will trigger a Medicaid penalty, however short-lived. (The Deficit Reduction Act signed by President Bush on February 8, 2006 changes the start date of penalty periods to the date when application for Medicaid is made.  Therefore, if Louisiana adopts this legislation on a state level as it is expected to do, any donation could result in a significant delay in benefits.)

  6. Medicaid rules that applied to my neighbor when he went into a nursing home will also apply to me. Medicaid policy is based on federal guidelines that are interpreted by the states and are ever-changing.  Income and resource limits can be adjusted each year. (Medicaid policy is changing all the time.  The Deficit Reduction Act signed by President Bush on February 8, 2006 includes major changes in Medicaid policy.)
  7. The state will take my house if I qualify for Medicaid.  Home property is an exempt asset as long as the Medicaid recipient and spouse are still alive.  However, estate recovery rules allow for recovery of Medicaid dollars under certain conditions after the death of both the Medicaid recipient and spouse.

  8. he care received by a Medicaid recipient in a nursing home is substandard to that received by a private-pay patient.   As regulated by federal and state guidelines, there are absolutely no differences in the level of care received by private-pay patients and that received by Medicaid recipients.

  9. LouisianaMedicaid honors the terms of a prenuptial agreement in determining resources for a married couple.  Medicaid considers the total resources of both spouses, regardless of the terms and conditions of the prenuptial agreement.
  10. There are no negative consequences to applying for Medicaid before I am eligible.  If you apply for Medicaid too early in the process, you could be subjected to extensive periods of ineligibility that could be totally avoided if you had waited to apply at the “right” time.

  11. It is possible to apply for Medicaid and determine whether you are eligible before you enter a nursing home or receive waiver services.  Most regions of the state of Louisiana require that you already be a resident of a nursing home before you apply for Medicaid.  This practice often results in the family finding out that the applicant is not eligible for Medicaid only after services have been received and payment for services is due.  In the case of waivers, the applicant can wait several years for services only to find out that they were never financially eligible to receive them. 
  12. The nursing home will provide guidance in Medicaid application.  This is not always the case.  Because of high employee turnover and lack of adequate training, many nursing home staffs are not knowledgeable of Medicaid policy.  They can even create problems for the family by quoting misinformation or referring all applicants to Medicaid regardless of income and resource levels. 

  13. If I do not reveal all my resources to Medicaid, they will never find out.  It may take several years but decisions to “hide” resources or other information from Medicaid can come back to haunt you.  The receipt of ineligible payments directly resulting from fraudulent information or misrepresentation can result in legal charges and/or the need to make restitution

  14. Nursing home care is the only type of long-term care covered by Medicaid.  Louisiana Medicaid also covers personal care attendants in the home and adult day healthcare through the waiver program.  However, the waiting period for personal care attendants is presently 2- 3 years and for adult day healthcare is 6-12 months.  Nursing home care is generally available on demand as long as the patient meets the disability requirements.  There are some new programs partially covered by Medicaid that provide a living environment similar to assisted living.

  15. Medicare pays for nursing home care.  Medicare only covers a portion of the care costs in specialized medical units within the nursing facility and for very limited periods of time.  The vast majority of nursing home patients do not fit the medical criteria for any Medicare payments.

  16. I can depend on my children to care for me so I will never need long-term care services.    Adult children have families of their own, careers, and other responsibilities that may limit the time that they have available to care for disabled parents.  They also might be unable to provide the type of specialized care needed for the parent(s).  Regardless of the children’s ability and willingness to care for their parents, consideration must be given to the level of burden placed on family caregivers.

  17. I have long-term care insurance so I will never need Medicaid.  It all depends on the daily benefit amount, waiting or elimination period, and maximum benefit period.  Some long-term care insurance plans only provide coverage for a limited number of years or have daily benefit amounts less than the cost of care.  Some will only cover nursing home care while others cover home health and assisted living facilities.  It is good practice to completely understand the terms of your policy before making planning decisions.
 
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