In late April, the Centers for Medicare and Medicaid Services (CMS) published the final rules for remaking Medicaid managed care, starting a huge reform process that will impact the majority of Medicaid recipients. The rules, proposed in fairly similar form a year ago, set new mandates for the states to develop rules for managed care plans serving Medicaid recipients. As of 2013, 46 million — almost three-fourths — of Medicaid beneficiaries had all or part of their benefits in managed care, according to the CMS. The Government Accountability Office in December said that as of fiscal 2013, 39…
Many middle-income people have too much money to qualify for Medicaid but can’t afford a pricey long-term care insurance policy. In an effort to encourage more people to purchase long-term care insurance, the Deficit Reduction Act of 2005 (DRA) created the Qualified State Long Term Care Partnership program. The program offers special long-term care policies that allow buyers to protect assets and still qualify for Medicaid when the long-term care policy runs out. The program authorized by the DRA expands to all states the partnership programs that were previously available in only four states: California, Connecticut, Indiana and New York….
The state Medicaid office owes medical providers nearly two years worth of back payments for poor, elderly patients, an expense that will increase past and future costs, according to the state budget office. The state has not been properly paying providers for patients who use both Medicare, the federal government health insurance for the elderly, and Medicaid, the government health insurance for the poor. Providers have been complaining since the state first started using a new Medicaid payment system called NCTracks in July 2013 that they were being underpaid, but the state did not start making those payments until March…
In order to be eligible for Maryland Medical Assistance (Medicaid), applicants must have no more than $2,500 in “countable” assets (the dollar figure may be slightly more, depending on the state). Applicants for Medicaid and their spouses may protect savings by spending them on non-countable assets. The following are examples of such expenditures: prepaying funeral expenses paying off a mortgage making repairs to a home replacing an old automobile updating home furnishings paying for more care at home buying a new home In the case of married couples, it is often important that…
The Centers for Medicare and Medicaid Services has released its Spousal Impoverishment Standards for 2015. The official spousal impoverishment allowances for 2015 are as follows: Minimum Community Spouse Resource Allowance: $23,844 Maximum Community Spouse Resource Allowance: $119,220 Maximum Monthly Maintenance Needs Allowance: $2,980.50 The minimum monthly maintenance needs allowance for the lower 48 states remains $1,966.25 ($2,457.50 for Alaska and $2,261.25 for Hawaii) until July 1, 2015. Home Equity Limits: Minimum: $552,000 Maximum: $828,000 David Wingate is an elder law attorney, and practices in Frederick County, and Montgomery county, Maryland.
One of the greatest fears of older Americans is that they may end up in a nursing home. This not only means a great loss of personal autonomy, but also a tremendous financial price. The average nursing homes cost, in our area, is approximately, $10,000 per month, that’s $120,000 a year, and the average stay in a nursing home is 4 years, that’s $480,000. For many people this will wipe them out financially. Most people end up paying for nursing home care out of their savings until they run out. Then they can qualify for Medicaid to pick up the…
The decision to move a family member into a nursing home is one of the toughest and most difficult decisions you can ever make. Over time, caring for an aging or disabled love one can deplete your energy, time and finances. The legal and financial ramifications can cost you plenty. Your income, assets and financial security can be a serious risk. Stop, before it’s too late. If you and your family are overwhelmed or confused by all the decisions you have to make. If you want to know your individual rights, or this is an urgent matter, please call us…
In order to qualify for Medicaid, in Maryland, you can't have more than $2,500 in assets. Many people forget about life insurance when calculating their assets, but depending on the type of life insurance and the value of the policy, it can count as an asset. Life insurance policies are usually either "term" life insurance or "whole" life insurance. If a Medicaid applicant has term life insurance, it doesn’t count as an asset and won't affect Medicaid eligibility because this form of life insurance does not have an accumulated cash value. On the other hand, whole life insurance accumulates a…
DON’T GO BROKE PAYING THE NURSING HOME Do you have over $500,000 to pay the nursing home? Our FREE Report “NINE QUESTIONS TO ASK THE NURSING HOME” is Available to Seniors and families to Help Pay the Cost of the Nursing Home. The average cost of a nursing home facility in Maryland is approximately $10,000 PER MONTH, that’s $120,000 PER YEAR. Also, the average length of stay at a nursing home is approximately 48 months, that’s $480,000. Unfortunately, spouses and their families use all their hard earned lifetime savings, sell their home, to pay the nursing home, and now they…
The notice must also provide instructions on how to appeal the decision made by the Medicaid agency. In some states, the first step in the Medicaid appeal process is an administrative hearing, commonly known as a "fair hearing." Other states, however, provide for a local "evidentiary hearing," which may then be appealed through the fair hearing process. The notice should tell you how to request a hearing. You may request a hearing whenever either your application for Medicaid has been denied or your existing Medicaid benefits have been reduced or terminated, and you believe the state Medicaid agency is mistaken…
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