Medicaid look back rules are rules that can disqualify you from Medicaid coverage for a period of time. While many people are unfamiliar with these rules, they can have a profound impact on your financial security. Understanding what Medicaid is, what it covers, and what the lookback rules are is of vital importance when you are planning ahead to protect yourself in case of incapacity, to protect assets, and to protect your legacy.
The Law Offices of James A. Miller can explain what Medicaid look back rules are, why they matter, and how you can work within Massachusetts Medicaid laws to protect your assets. Give us a call today to speak with a Massachusetts Medicaid planning lawyer to find out why Medicaid coverage is important, whether you can get covered, and how to make a plan to get care if and when it becomes necessary for you.
What are Medicaid Look Back Rules?
Within the state of Massachusetts, many seniors rely on Medicaid to pay for certain types of medical care costs and health needs which are not covered by private insurance and which are not covered by Medicare. Nursing home care isn’t usually covered by any type of insurance other than Medicaid, unless you need only skilled medical care for a limited duration. Because most people seek nursing home care as a result of a need for custodial care, privately paying for care may become necessary since custodial care is not covered by insurance other than Medicaid.
Privately paying for nursing home care is extremely difficult because it costs many thousands of dollars a month to live in a nursing home. If you are forced to move into a nursing care facility and you do not qualify for Medicaid, it is likely your entire life savings will be spent in a matter of months. This is why getting Medicaid coverage becomes essential for seniors.
Unfortunately, some elderly individuals who need Medicaid are not able to get the coverage that they need because of strict rules determining Medicaid eligibility. The rules, according to the Massachusetts Senior Guide to Healthcare Coverage, restrict you from eligibility if your income exceeds permissible monthly limits and if you have more than $2,000 in countable resources as a single person or more than $3,000 in countable resources as a couple.
Some people try to simply transfer or give away their assets in order to get below resource limits. For example, if you have $100,000 in the bank, you may want to give $98,000 of that money to your children so you can get below the $2,000 resource limit. Of course, Medicaid does not want you to do this. Medicaid look back rules are aimed at stopping you from transferring your assets, giving away assets, or selling assets at less than fair market value for purposes of getting Medicaid coverage.
How Do Medicaid Lookback Rules Work?
Medicaid look back rules require a review of your accounts and financial assets over a five year period of time prior to trying to qualify for Medicaid coverage. An assessment is made regarding whether you transferred or gave away any items of substantial value over the course of the five years before you need Medicaid benefits for nursing home care.
If you gave away money or property, then you are going to be temporarily disqualified from being eligible for Medicaid coverage. The specific period of time for which you cannot receive benefits is determined by a simple mathematical formula.
You will need to add up the total value of transferred assets and divide this number by the average monthly cost of nursing home care in your local area. The results of this mathematical equation are equal to the number of months of Medicaid disqualification. For example, if you transferred $100,000 and it costs $10,000 a month to pay for a nursing home in your area, you would be disqualified for $100,000/$10,000 = 10 months.
Getting Help from A Massachusetts Medicaid Planing Lawyer
A Massachusetts Medicaid planning lawyer can provide you with advice on how the Medicaid look back rules will apply to you and can assist you in finding ways to work around look back rules and provide as much protection for assets as possible.
To learn more about the role of Medicaid planning in the estate planning process, you can download a free estate planning worksheet. You can also give us a call at 866-370-3888 or contact us online to speak with a member of our legal team about the process of asset protection will getting Medicaid to cover your nursing home care.
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