To professionals
dealing with seniors
Allowable Transfers
Qualified Income Trust
Report Changes
Paying for Private Room
Medicaid Changes and Planning Opportunities
Financial planners and
other professionals dealing with the elderly need to know that Medicaid
regulations are constantly changing. We specialize in understanding the
complicated and confusing Medicaid program and offer you our asset
protection ideas.
If you are working with
an elderly client who faces long term nursing home care, your planning
takes a different slant. Although we recommend long term care insurance
for those who are able to pass underwriting requirements, many seniors are
unable to buy the insurance because of health or financial problems.
Medicare offers limited nursing home coverage. So we find that Medicaid is
the only program offering long term nursing home coverage.
We want to work with you
and your clients to preserve assets and peace of mind when long term care
is an issue. Our recommendations are specific for each client's
circumstances. Our experience and technical tools enable us to make
optimal recommendations for the client. Call us if you want our valuable
assistance in planning with Medicaid in mind.
We hope you will find
the following updates interesting and valuable. Please feel free to use
this information as you see fit to enhance your client service.
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A transfer of assets for
less than value may cause a disqualification period for Medicaid benefits.
There are exceptions to this rule. Do any of your clients fit the
following exceptions?
1) Homestead property
may be transferred without penalty to:
- A child under 21 years
of age
- A blind or
permanently disabled adult child
- A sibling who has
equity interest in the home
- An adult child who
has lived in the home for at least two years before the individual was
institutionalized
2) Any assets may be
transferred without penalty to:
- A child under 21
years of age
- A blind or permanently
disabled adult child
- A spouse
- A Qualified Under 65
Disabled Trust or Pooled Trust
3) A life estate may be
transferred without penalty.
Back to top Qualified
income trust
Florida Medicaid law
requires a Qualified Income Trust (QIT) for anyone who has income above
$2,022. We find that the QIT is a major trap if not administered
correctly.
No exceptions to denial
of Medicaid coverage when Qualified Income Trust (QIT) is not funded or is
not funded correctly.
Numerous fair hearings
have been held in which an individual in a nursing home (the petitioner)
has argued that the Department of Children & Families (DCF) caseworker
did not give correct instructions on how to administer the QIT. The
petitioner always loses Medicaid coverage for each month that the QIT is
not funded correctly.
The QIT process is so
complicated that we administer the QIT for the first year as part of our
services.
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Report change in
circumstances
Any change in
circumstances of Medicaid recipient must be disclosed immediately. The
designated representative for a Medicaid recipient can be held criminally
liable if changes in the institutionalized individual's income or assets
are not reported to Department of Children & Families (DCF) within 10
days.
DCF is now enforcing the
10-day change-reporting requirement. Any person or designated
representative who knowingly does not report a change in circumstances in
order to continue to receive benefits is guilty of a crime and will be
punished as state law allows. Back to top
Paying to upgrade from a semi-private to a
private room
- The nursing facility
may only charge the difference between the facility's private room rate and the facility's semi-private room rate.
- The facility may not make the additional payment a requirement of admission or continued stay in the facility.
- The facility may not charge an additional amount if the private room is medically necessary.
- The facility is not required to move the
Medicaid recipient to a private room if the family member or friend
chooses not to pay the additional amount for a private room.
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