Questions about Planning for Medicaid Part 2

Older couple on a hill

Disclaimer: Since Medicaid rules and insurance regulations are updated regularly, past blog posts may not present the most accurate or relevant data. Please contact our office for up-to-date information, strategies, and guidance.

  1. What appeal rights are available?

If your client has been denied Medicaid benefits, they have a right to file a “Reconsideration Application.” If they still receive a denial, they can request a fair hearing due to “undue hardship.” If you purchased a product through our office, we offer complimentary expert testimony and litigation support.

  1. What options exist for long-term care insurance (LTCI)?

If you have a client where one spouse still resides in the community, the community spouse may be able to purchase a long-term care insurance policy. The spouse that currently needs care will not be able to obtain long-term care insurance as, most likely, they will not pass the underwriting process.

If the community spouse does purchase long-term care insurance, they then can have peace of mind knowing they get to choose where they receive care; many policies allow the owner to choose a nursing home, assisted living or in-home care. They will also be able to preserve many of their assets as there are more planning options when they are able to pre-plan.

  1. What are the relevant considerations when reviewing an LTCI policy?

Depending on the type of policy desired, your client will want to look at the benefits they will receive and the premium amount they will have to pay in. They will also need to look at the elimination period before receiving benefits, what type of care the policy covers (nursing home, in-home, etc.) and if there is any specific coverage for Alzheimer’s and related diseases.

  1. What strategies exist regarding asset protection?

Medicaid Compliant Annuities help your client protect a large amount, if not all, their assets if they are part of a married couple where one spouse will remain in the community. With MCAs, the community spouse would fund all their countable assets over the Community Spouse Resource Allowance into this annuity which would then make the institutionalized spouse immediately eligible for Medicaid benefits.

Irrevocable Funeral Expense trusts can also be purchased to help spend down while also preparing for final costs. In some cases, your client can purchase them for their children and their children’s spouses.