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Orlando Medicaid Planning Attorney

Dedicated Maitland & Orlando Medicaid Planning

Medicare covers the costs of doctor’s visits, outpatient care, hospital stays and prescription drugs (on certain plans). One of the largest health expenses seniors can face is long-term care, such as a stay in a nursing home or assisted living facility, but Medicare doesn’t pay for long-term care. With costs of $3,000 to $4,000 a month for assisted living and $7,500 a month for nursing home care, most people can’t afford long-term care without help. The government’s Medicaid program does pay for long-term care, but unlike Medicare, Medicaid is a needs-based program. Only people with low-income levels are eligible to receive Medicaid.

One way to get Medicaid to pay for long-term care is to spend down your assets until you qualify for Medicaid, but this method leaves you with nothing to live on after you leave the nursing home, or nothing to live on for your spouse and nothing to leave your children or grandchildren. Obviously, spending yourself into poverty so you can get long-term care assistance from Medicaid is not ideal. Also not ideal is engaging in nursing home planning after you are already admitted to a nursing home; this is crisis planning, and your options are limited. The better approach is to put a plan in place before you need nursing care – a plan that organizes and titles your assets in a way that protects those assets while at the same time protecting your ability to benefit from Medicaid.

Shea Fugate is an Orlando Medicaid planning attorney with decades of experience helping older adults and seniors with Medicaid planning and other elder law needs. Call the Law Offices of Shea A. Fugate, P.A. in Maitland and Orlando for smart, strategic advice and assistance in planning to protect your estate while ensuring the ability to obtain and pay for quality long-term care if it is ever needed.

What are some of the most popular Medicaid planning tools?

One option is to purchase a long-term care insurance policy. The drawbacks to LTC insurance are that it can be unaffordable or unavailable to those who do not buy it when they are younger and healthier. Also, you’ll want to carefully investigate the company to make sure you are getting a sound policy from a trustworthy carrier that will pay benefits when they are needed. Sources such as online reviews and the Better Business Bureau can help in this regard. Also, talk the matter over with your elder law or estate planning attorney to see how LTC insurance should fit into your overall Medicaid planning or estate planning.

Another route to Medicaid eligibility is to start gifting your property to others now rather than holding on to it and distributing your estate through a will. By gifting what you can and only retaining what you’ll need for long-term care and other needs, you may fall below the income threshold for Medicaid eligibility. Any funds you gift to others are taken out of your estate and don’t count against you when determining Medicaid eligibility.

Making gifts or transfers to get to Medicaid eligibility must be undertaken very carefully, however. You may have heard that you can make gifts up to $15,000 per person each year. This limit is only for the purpose of avoiding the estate and gift tax and does not have anything to do with Medicaid. When gifts or transfers are made for Medicaid eligibility, the government will look at those transfers very closely to see that they are not fraudulent. For instance, did you sell property to a friend or family member for less than market value? Medicaid will look at your financial transactions as far back as five years prior to your application for Medicaid. If they believe you engaged in any fraudulent transfers, you could get penalized by having those assets counted against your eligibility or being ruled ineligible to apply for a period of years.

Can I keep my home and still get Medicaid to pay for long-term care?

The answer to this question is complicated, and you should talk it over with your Medicaid planning attorney, but the answer is yes in many instances.

Although Medicaid can help pay the costs of long-term care, the government will want to recoup any costs it can from your estate after you have passed. In Florida, you are entitled to keep your homestead valued up to $572,000 and still qualify for Medicaid if you are otherwise eligible. If you enter a nursing home, you can still keep your house and maintain your eligibility, although you will want to draft an “intent to return home” statement to express your intent to move back into your home when you are able. If the government believes you will be living in the nursing home permanently, they may put a lien on your home, but they can’t force you to sell it. If you leave the house to your heirs, Medicaid may still have a lien on the property, but they can’t force your heirs to sell it either. The government may have a claim on the estate for the long-term care it paid for, but homestead property is meant to be safe from creditors in Florida.

Special Needs Trusts

If you are physically or mentally disabled and can’t work, you may need to rely on government assistance for housing, food and other basic necessities. This need may apply whether you are temporarily disabled for a short-term or long-term, permanently disabled, or were born with developmental disabilities. Government programs such as Medicaid and Supplemental Security Income (SSI) can cover some of these needs, but they are only available to low-income individuals. A special needs trust allows the individual or others to put assets into the trust to supplement public assistance without losing eligibility. When creating the trust, you can appoint a trustee who will help make sure trust funds are spent appropriately. Special needs trust funds can be used to buy a home or car, purchase home furnishings, get in-home care, obtain vocational or educational training, and other purposes. The money used for these expenditures is “non-countable” for purposes of federal income limits and Medicaid eligibility.

Medicare Set-Aside Trusts

A Medicare set-aside trust is a special form of supplemental needs trust meant to preserve money gained in a workers’ compensation or personal injury settlement, which you’ll need to pay medical expenses in the future. Without a Medicare set-aside trust, the settlement is considered the “primary payer” for medical bills under the Medicare Secondary Payer law, and Medicare won’t help out so long as you have settlement funds to spend on medical care.

Medical care after a serious injury may be needed in the long-term and may only get more expensive as time goes on. You shouldn’t be forced to squander your settlement funds and then rely on Medicare to take care of you. A Medicare set-aside trust helps you get help from Medicare now while ensuring you have the funds to help pay for a lifetime of care.

Help with Medicaid Planning in Maitland and Orlando

Medicaid planning is detailed and complex, but it’s an important part of elder law and long-term care planning to make sure you and your family are properly cared for. In Maitland and Orlando, call the Law Offices of Shea A. Fugate, P.A. for a free consultation on the ways Medicaid planning can benefit you.

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