Medicaid "Spend Down" and Long Term Care

The new Tax Reduction Act of 2005 mandated thatface value of all policies added together does not
seniors spend-down all of their combined assetsexceed $1,500. (If the total exceeds $1,500 in face
before the sick spouse can qualify into a nursing home.amount, the cash value counts and may need to be
The act requires a 5-year look back for any transfersspent down on long term care.)
by seniors designed to deprive the state of those- Cash: A small checking or savings account not to
available resources to pay for the nursing home.exceed the limit imposed by the state. Most of the
The Medicaid program requirements are actuallytime, a single Medicaid applicant may keep only about
established by each State. Whether or not a person is$1,500 to $2,000. A married couple who both need
eligible for Medicaid will depend on where you live.nursing home care may generally keep a slightly more
All states provide community Long Term Caregenerous amount. And a married couple in which only
services for individuals who are Medicaid eligible andone person needs Medicaid assistance can usually
qualify for institutional care. In order to qualify, you willkeep a larger Community Spouse Resource
have to effectively "spend down" your assets.Allowance.
Spend down is depleting private or family finances to-Burial space: Fully-paid burial plots, crypts, or
the point where an individual is sufficiently poor to meetmausoleums of any value do not count, for a client or
the eligibility criteria for Medicaid. Improperly followingimmediate family members.
the spend down guidelines can result in your family-Irrevocable Funeral Plan or Burial Trust: A prearranged
member's application for Medicaid benefits beingburial and funeral plan  does not count when the trust
deferred which means that he will not receive benefitscannot be revoked. The portion of an irrevocable
right away.funeral plan or burial trust that exceeds $7000 after
Once you are eligible for Medicaid, you have certainsubtracting the value of fully paid burial spaces may be
rights:considered a transfer of assets. Exempt items from
 You have the right to apply for any medicalthe $7000 limit include casket, marker, and vault.
assistance program of your choice.Prepaying your own funeral prior to SSI or Medicaid
 You have the right to timely and adequate notice.acceptance allows you to arrange and pay for the
 You have the right to a fair hearingfuneral of your choice:
 You have a right to fair treatment.WHAT TO BUY
With these rights, comes certain responsibilities:• Make sure the burial plan you purchase includes
 You are responsible for providing true and completeeverything that may be needed. The more you prepay
information about your circumstances,with money that will otherwise need to go to nursing
 You are responsible for reporting changes in yourhome care, the less your loved ones will need to pay
circumstances.or finance.
 If you have health or dental insurance coverage, you• Consider purchasing funeral arrangements,
must give the State of Georgia the rights to thesecasket, grave liners, opening & closing of graves,
payments.flowers, gratuities, limousines, police escort, obituaries,
Medicaid strictly limits the assets you can own. Eachhair styling, makeup, clothing, burial plots, crypts,
state has its own limit on this amount and its ownheadstones, including placement and engraving, and
guidelines for which assets count toward the total. Inexpenses of the wake.
general, however, the following assets do not countAs a Family Service Advisor, I work with families
against you for Medicaid eligibility, and are known asevery day who are dealing with loss.  Those who
"exempt assets."have not pre planned or have never even had a
-Your home: Your principal place of residence. In someconversation about how to deal with final expenses
cases, the nursing home resident may be required towhen a loved one dies are usually devastated. 
show some "intent to return home," even if that neverThere are 72 decisions that need to be made in the
happens. (Be aware, though, that second homes, suchfirst 24 hours of arranging a burial.
as vacation homes or condos, are not exempt 
assets.)By preparing for your final arrangements, your family
 -Household and personal belongings: Furniture,will have comfort in knowing that your final wishes are
appliances, jewelry, and clothing.-being honored. It will alleviate stress and allow them to
- One car: The state may limit the car's value.celebrate you and your life. Request a free "Medicaid
- Cash value of permanent life insurance policies up toInformation Pack" Email: linda.
$1,500: In most states, this asset is exempt only if the