What’s a Medicaid expert?

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A Medicaid specialist, sometimes called a Medicaid consultant, is a person who helps people qualify for Medicaid without depleting their resources and assets. Medicaid, a government insurance program funded jointly by the US federal government and state governments, is designed to pay the health care costs of the poor, but it is also the insurer of last resort for long-term care. It is primarily in this area that Americans may seek the services of a Medicaid specialist to help them navigate the sometimes complex rules, as well as the asset and income limitations imposed on applicants for this government insurance.

In the United States, the cost of medical services for those who cannot afford it and who do not have health insurance is generally paid for by Medicaid. In general, the average American who cannot afford medical services or health insurance has no problem qualifying for Medicaid, and there is no need for a professional advisor to help with the application process. Long-term care, however, is not medical care – only about 5% of the care provided to these patients is medical in nature, with the remainder being custodial tasks such as bathing, dressing and eating. Generally, it is the elderly who most need long-term care, but since it is not medical care, only a small part of these expenses is covered by Medicare, the American medical insurance for the elderly.

The affluent can usually cover the costs of long-term care, either from their own resources or from long-term care insurance. The poor are usually already eligible for Medicaid; therefore, if they need long-term care, they are already covered. The middle class, however, generally cannot afford long-term care insurance, whose premiums are usually reasonably expensive, but their savings and other resources may not pay for an extended period of care, especially if a nursing home is necessary. A Medicaid specialist can help these people qualify for Medicaid without “burning out” all of their assets in the process.

When determining assets for the purpose of qualifying for Medicaid, some are considered “countable” and some are considered non-countable, according to rules that vary from state to state. In 2010, for example, a person can generally have assets not exceeding $2,000 (USD) and monthly income of $50 or more. When considering a couple, however, the spouse who doesn’t need long-term care — the “community spouse” — can keep all of their income and can retain half of the couple’s assets up to about $110,000, plus a home. , automobile and other personal possessions such as clothing and jewelry. Anything above those thresholds, which are adjusted annually for inflation, must pay for medical or long-term care under a program called the “low-spend” process. The Medicaid specialist will review the couple’s assets and income and formulate a plan to spend the least amount of money necessary in this process, thus preserving as much of the couple’s property as possible.

Many Americans think that as they get older, they simply transfer their assets to other family members. The problem with this approach is that Medicaid is legally entitled to a five-year “lookback” period, allowing it to reverse those transactions made in the five-year period before the Medicaid application or to hold the couple financially responsible. the value of these transactions. A good Medicaid specialist, however, will know how to reclassify assets and even income – legally – to minimize the impact of an expense and help preserve ownership.

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