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Paying for Long-Term Nursing Home Care

What is Medicaid?

Medicaid is a need-based program that helps nursing home patients pay for long-term nursing home care. If an individual qualifies, Medicaid picks up the monthly cost of nursing home care that exceeds the individual's monthly income. Currently, to be eligible for Medicaid the nursing home patient's assets must be below $8,000 (or $2,400 depending on monthly income). If the nursing home patient has assets in excess of $8,000 (or $2,400), Medicaid requires that the excess assets be used to pay for the individual's nursing home care before the individual will become eligible for Medicaid (referred to as "spend-down"). For couples, the at home spouse is entitled to keep one-half of the couple's assets, up to a maximum amount set each year, and the principal residence and one vehicle. This is in addition to the $8,000 (or $2,400) retained by the nursing home spouse. All other assets must be spent-down.

What is Medicaid Planning?

Medicaid Planning will help maximize the assets that are retained by the at home spouse and ensure that the at home spouse can continue to maintain a comfortable lifestyle. Medicaid Planning includes counseling and advice on the assets that should be retained and which assets, if any, should be transferred. As part of our Medicaid Planning, we walk clients through the eligibility process (completion of the Resource Assessment Form, submission of the Medicaid Application, and representation at the eligibility Hearing). We also help them collect the mountains of paperwork required by the Pennsylvania Department of Public Welfare. Most importantly, we ensure that the nursing home patient's care is adequately funded during any period in which he or she is ineligible for Medicaid benefits.

Why is Medicaid Planning Necessary?

Strict penalties result from uninformed Medicaid planning decisions. Transferring assets to meet the $8,000 ($2,400) requirement will result in an automatic period of Medicaid ineligibility if the transfer is made within five (5) years of the Medicaid Application. Legal advice can ensure the adequate funding of your long-term nursing home care.


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Owlett & Lewis, P.C.
One Charles Street
Wellsboro, Pennsylvania 16901
Phone: (570) 723-1000