Call us for a free consultation: 1-855-S-PLANNING (1-855-775-2664)
Medicaid (Title, 19), the joint Federal and State program that provides health coverage to nearly 60 million Americans is quite naturally governed by an ever evolving labyrinth of rules, regulations, exceptions, and exceptions to those exceptions.
To the uninitiated, the application process is unduly frustrating and complex, and when compounded with the emotional anxiety and angst that so often accompanies the decision to commit a loved one to a skilled nursing facility, families often find themselves in a crisis. The exorbitant costs associated with long term care are staggering, and a denial in Medicaid coverage can result in gargantuan financial losses.
Senior Planning Services is a professional organization that focuses exclusively on helping families navigate Medicaid’s murky maze and achieve maximized coverage and benefits. Experts in the industry with thousands of approved Medicaid applications under our belt, we have the entire process streamlined down to a science. From the initial consultation through the final approval, Senior Planning Services is there every step of the way, completing forms, gathering documentation, assisting in the spend down procedures, and following up with the exclusive contacts within the Department of Social Services.
At Senior Planning Services we go beyond just providing our clients with information and helping them understand the eligibility requirements, personalized case managers walk the families through the entire planning and application process until the best possible outcome is achieved. Professional and proficient, Senior Planning Services is the stepping stone to expedited and ensured Medicaid Coverage.
The Medicaid program was instituted in 1965 as a safety net to assist seniors with the financing of their long term care. A stay at a skilled nursing facility can cost upward of $11,000.00 a month, and with the ever increasing life expectancy, it has become quite difficult to adequately prepare. For those with limited assets, Medicaid will cover the cost of high quality care, however, because of the sheer size of the organization, and the fact that is a joint Federal and State program, there are myriad rules and regulations governing Medicaid eligibility.
Before all, Medicaid looks to establish three fundamentals.
• Financial status
• Medical need
• Citizenship status
To qualify for Medicaid one must be a 65+ and/or disabled US citizen or qualified alien.
CT Medicaid Financial Requirements
Assets: To qualify for Medicaid in Connecticut, an individual must spend down his/her assets to a total of $1,600, with a few allowable exclusions. Spousal Case: The formula when one spouse is getting onto Medicaid and the other is not, is a little more complex. The community spouse is allowed to keep a minimum of $23,844.00 or up to 50% of the joint liquid assets. However, the assets may not exceed the maximum of $119,220.00. If the 50% portion exceeds $119,220.00, the monies need to be spent down until the assets reach a total of $119,220.00. The assessment of joint liquid assets is performed from the day the institutionalized spouse enters a facility, generally referred to as the snapshot date. It is important to note that there are specified expenses that can be deducted from one’s assets during the spend down. Simply gifting or transferring funds will not only not work, but Medicaid will impose a penalty of ineligibility corresponding to the monies gifted.
Income: In Connecticut, an Individual on Medicaid must use all his/her income toward payment for care, with Medicaid picking up the difference. Income includes Social Security, pensions, and any money coming in on a regular basis. Some deductions that can be made include:
• A personal needs allowance (PNA) of $60.00, that the Medicaid recipient can choose to use for whatever he/she wishes.
• A supplemental health insurance premium to allow the policy to remain active.
• some scenarios in which a community spouse or dependent child may retain some or all of the income
• Additional household upkeep expenses in the event that an individual is only scheduled to stay at the skilled nursing facility temporarily (6 months or less) and plans on returning home.
Medical Eligibility When an individual is admitted to a skilled nursing facility, and it is determined that they may be in need of Medicaid, the facility will begin the process of opening the Ascend. The Ascend will assess an individual’s Medical need. The process is taken care of by the skilled nursing facility or hospital.
What Senior Planning Can Do At Senior Planning Services we are intimately familiar with every intricate aspect of the Medicaid application process. This is what we do, all day, every day, and as such, have unparalleled expertise when it comes to working the Medicaid system. We do not just give advice. We implement it from start to finish. During this particularly hectic period in your lives, Senior Planning Services steps in and exchanges anxiety and confusion with clarity and direction.
When you engage in our services we:
• Offer a free Medicaid Consultation
• Assist in obtaining 60 months of bank and financial statements from financial institutions back offices.
• Assist in obtaining verifications from banks regarding checks, deposits, and cash withdrawals
• Guide families through the spend-down process
• Assist families in utilizing excludable resources
• Assist clients in the process of liquidating life insurance policies, annuities and stocks etc.
• Obtain missing documentation from Vital Statistics, if necessary
• Update client on status on a constant basis
• Interact with the Department of Social Services caseworker regularly
• Submit complete application to the correct DSS Regional office
Senior Planning Services is just a free phone consultation away. The Medicaid process….Simple. Give us a call at Toll Free at 1855-775-2664