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COVID-19 Stimulus Checks and Medicaid

By Uncategorized

Will my COVID-19 Stimulus Check impact Medicaid Eligibility?

The Coronavirus Aid, Relief, and Economic Security Act, also known as the CARES Act (passed on March 27, 2020) is a $2 trillion economic relief package intended to help offset the huge financial crisis caused by the Coronavirus (COVID-19) pandemic. As part of the CARES Act, the majority of Americans, including those who are elderly and on fixed income, will receive a one-time stimulus check from the Internal Revenue Service (IRS).

Many Medicaid beneficiaries who live at home, assisted living, adult foster care, or nursing homes are concerned the money will put them over the Medicaid income or asset limit, and therefore, disqualify them from Medicaid benefits. In addition, Medicaid applicants express the same concern that the additional money will cause them to have income or assets over Medicaid’s limits, and as a result, prevent them from becoming eligible for Medicaid.

Stimulus checks will not be counted as income and therefore will not impact Medicaid beneficiaries or applicants. However, should the stimulus money not be spent within 12 months, it may be counted as an asset, and therefore could impact eligibility in the year ahead. Therefore, make sure you spend the funds as soon as possible on eligible purchases in accordance with Medicaid regulations (DO NOT GIFT IT).

Nursing Home Residents

he receipt of a stimulus check by Medicaid beneficiaries who reside in nursing homes will not impact these individuals’ Medicaid benefits. Stated differently, the receipt of the check will not disqualify them from Medicaid nursing home care. This is because Medicaid will not count the money as income, which means it cannot push one over Medicaid’s income limit, and hence, result in the loss of Medicaid benefits.

United States Treasury stimulus payment for Coronavirus CoViD-19 outbreak disease.

While Medicaid-funded nursing home residents are required to surrender all of their income except for a personal needs allowance and a monthly maintenance needs allowance for a non-applicant spouse (if applicable) to Medicaid, the money from the stimulus check will not have to be surrendered to Medicaid. This is because, as mentioned above, the stimulus check is not considered as income by Medicaid. Rather, it can be thought of as a tax refund.

Furthermore, the stimulus check will not count as assets, given the money is spent within 12-months of receiving it. So, within this time frame, a nursing home Medicaid recipient can have possession of the money and it will not impact one’s Medicaid eligibility. However, it is imperative that the money, in its entirety, be spent within one year. If not, the money will count towards Medicaid’s asset limit and can potentially push one over the limit, resulting in Medicaid disqualification.

The money can be spent by nursing home residents in a number of ways. For example, one might buy new clothing, purchase a television for his / her room, stock up on extra snacks, or purchase an irrevocable funeral trust. What one does not want to do is to buy assets that are counted towards Medicaid’s asset limit. For instance, collectors coins would most likely be considered an investment and the value of them would be counted towards the asset limit, potentially causing one to be over the limit and lose Medicaid benefits.

The stimulus check will either be directed deposited in the nursing home resident’s bank account or be mailed to the address on one’s 2018 or 2019 tax return. To further clarify, if a refund was issued via direct deposit for one’s tax return, the stimulus check will be directed deposited in the same bank account. If not, the check will go in the mail. Persons who do not have to file tax returns, such as Social Security recipients, will receive stimulus checks in the same manner in which they receive their Social Security benefits. Therefore, if one receives his / her Social Security payment by direct deposit, the stimulus check will automatically be received via direct deposit also.

Spouses of Nursing Home Residents

Spouses of nursing home residents on Medicaid (called Community Spouses), who are not on Medicaid themselves will receive a stimulus check. The receipt of this check will not impact their spouses’ Medicaid eligibility in any manner. First, and foremost, the money from the stimulus check is not considered income by Medicaid, and even if it were, the income of a non-applicant spouse is not considered in the continuing Medicaid eligibility of his / her nursing home spouse.

For Medicaid beneficiaries, the entire check needs to be spent within 12-months of receiving it or the remaining funds will count as assets towards Medicaid’s eligibility. However, the same rule does not hold true for community spouses. To be clear, there is no time limit in which a spouse of a nursing resident must spend his / her stimulus check. Furthermore, non-applicant spouses can spend the stimulus check in any manner they choose, such as paying rent or mortgage, utility bills, food, or even on a splurge, such as a pricey piece of jewelry.

No matter how long it takes for the community spouse to spend the funds, and regardless of how they are spent, it will not impact the institutionalized spouse’s Medicaid eligibility. In other words, a community spouse can be rest assured that it will not cause the nursing home resident to lose his / her nursing home Medicaid benefits. This is because the assets of the non-applicant spouse are not considered for the continuing Medicaid eligibility of his / her Medicaid beneficiary spouse. (The community spouse’s assets are only considered when determining initial eligibility).

The community spouse will receive the stimulus check either via direct deposit or in the mail. Exactly the manner in which it will be received will be based on one’s 2018 or 2019 tax return and how a refund was issued. For instance, if one received a refund via the mail, the address on file will be used and the stimulus check will be mailed to that address. For those who are not required to file tax returns, such as recipients of Social Security, the check will be received in the same way in which their monthly Social Security benefit is received. This means that if it is deposited directly in one’s bank account, the stimulus check will also be directly deposited.

Please note that the institutionalized spouse will also receive a stimulus check. However, at this time, it is not known if the check will be issued separately from his / her community spouse’s check. It is our assumption that if 2018 or 2019 tax returns were filed jointly, the couple will receive one check (couples who filed joint tax returns are eligible for double the amount of a single filer), while if tax returns were filed separately, each spouse will receive an individual check. Again, for persons on Social Security, there is no need to file tax returns. In this case, checks will automatically be received in the same manner in which Social Security benefits are received.

How Much Will the Stimulus Check Be?
The amount of the stimulus check, also called an economic impact payment or recovery rebate, may be for as much as $1,200 / person.

• Individuals who earn up to $75,000 / year will receive a $1,200 check.
• Married couples, filing jointly who earn up to $150,000 / year, will receive a $2,400 check.
• Individuals who earn up to than $99,000 / year will receive a check, but it will be for less than $1,200.
• Married couples, filing jointly who earn up to $198,000 / year, will receive a check, but it will be for less than $2,400.

Payments will be based on one’s tax returns from 2018 or 2019. Please note that for disabled persons and seniors who receive Social Security payments, it is not necessary for a tax return to be filed. (Persons who receive Social Security benefits generally do not have to file a tax return). Rather, the IRS will automatically send out economic impact payments to these individuals.

Checks will be received either via direct deposit or in the mail.

SOURCE: American Council On Aging 

Co-pays proposed as part of $166M in Medicaid cuts

By News, Uncategorized

Co-Pays and Not Changes to Eligibility Proposed

Gov. Gina Raimondo has proposed balancing next year’s $9.38-billion budget with nearly $166 million in cuts to Medicaid. None of the changes will affect eligibility or benefits, officials said. Co-Pays and other cost reducing strategies will be implemented.

A plan to “rebalance” long-term care and nursing home services would account for another $18.2 million in savings. That includes “modernizing” the eligibility process for long-term care. The budget also calls for a 1-percent increase to nursing home reimbursement rates. In recent years, those rates have seen as much as a 3-percent increase.

Asked if he expected backlash from the nursing homes, Beane said, “I think, frankly, the nursing homes will be pleased to see that some part of the COLA is going to be included here. That’s the first time the governor’s proposed budget has included an increase. She has said in her cover letter to this budget that if revenues are up, this is an area she’d like to see more investment.”

Source: Co-pays proposed as part of $166M in Medicaid cuts

As the long term care insurance market continues to struggle with its future, knowledge as to the rules of Medicaid eligibility that will pay for long term skilled nursing is critical. Individuals can only have $4,000 of countable resources to qualify for Medicaid. Your home, car and personal property is not a countable resource and is protected. Under the proposed budget, those rules appear to remain unchanged. However, what are you to do with savings, investment accounts, a second home or investment property? Will you be forced to liquidate those assets and spend them down on my long term nursing care below $4,000 before I qualify for Medicaid? Without  a plan and proper advice, the answer is likely yes for most. However, with a proper plan, these assets can be protected for yourself, your spouse and your heirs. Contact us to discuss how.

The 6 Biggest Challenges To Protecting Assets From Nursing Home Expenses

By Uncategorized

Protecting Assets and Nursing Homes – Knowing The Issues

Protecting assets from the costs associated with a nursing home usually causes people to run into 6 major problems:

Problem 1: The 60 month Look Back: On February 8, 2006, President George W. Bush signed The Deficit Reduction Reconciliation Act of 2005. The changes make it more difficult than ever to qualify for Medicaid eligibility.

The look-back period for transfer of assets is now 5 years (instead of 3 years) prior to applying for Medicaid coverage.

Problem 2: Gifting: Giving money away can frequently be more expensive than keeping it and finding other ways to protect it. Though each long-term-care-pic1person can gift $14,000 to a person per year, these gifts are disqualifying transfers for Medicaid. In addition, both federal and state gift tax laws (imposed in a number of states) must be considered.

Problem 3: Too much Income: Even if you do manage to effectively give away all of your assets (spousal impoverishment provisions allow the non-confined spouse to keep all financial assets up to a maximum of $119,220 in 2016 and a minimum monthly needs allowance of $1,991.25 and maximum of $2,980.50). The at-home spouse can keep the primary residence, a car, personal and household effects, and a small amount for burial. Many individuals have too much income to enable them to qualify for Medicaid. The income of the community spouse is not counted in determining Medicaid eligibility.

Problem 4: Loss of Independence: Most individuals who embark on Medicaid Planning use Income Only Trusts, which require the cooperation of the Trustee of the Trust when individuals seek to sell a property and change living arrangements or would like to access the Trust assets.

Problem 5: Ensuring Control of Assets: Once one gives money away, legally it is no longer his. Attorneys have numerous, sometimes heart wrenching, stories of parents who have given assets directly to children who have subsequently sqGrandparent walking babyuandered those dollars through drug abuse, gambling, etc. Even the “best” and “most loving” children are still subject to bankruptcy, divorce, law suits, etc. Sometimes children die before their parents and the parent’s money sometimes does (and sometimes does not) return to the parents. When couples seek to protect their assets, they must transfer the assets to proper vehicles and trusts to ensure loss of control is avoided or minimized.

Problem 6: Choice of Nursing Facility: Many individuals have discovered all too late that “money talks.” Many nursing homes accept both private pay and Medicaid patients; the nursing homes however, are generally reimbursed at a far lower daily rate for a Medicaid patient than a private pay resident. As a nursing home owner or admissions officer, if you had two individuals requesting a bed in your home -one who could pay privately at the full daily amount and one who had (or claimed to have) no money and would need to depend on Medicaid, whom would you prefer (and give preference to)? Many of the finer nursing facilities require that the prospective resident be able to pay privately for six months, a year, two years, or even longer, before the application is even considered. A properly drafted and planned estate will anticipate this possibility and provide couples with the flexibility to address this situation.

Conclusion: After analyzing these six potential pitfalls of disposing of one’s assets (and being prepared to use Medicaid if long term care becomes a necessity) it becomes apparent that only through proper planning can these pitfalls be avoided. Many of these challenges can be avoided if discussed and planned in advance. The use of Income Only Trust are critical in the planning and execution of these goals. Couples will rely on the skill and experience of their attorney in planning and drafting a plan that can and will work for them.

Want to discuss a plan that is customized to you and your specific goals?  CoCouple walking bannerntact our office for a no-cost consultation.