Medicaid and the Treatments of Gifts by Medicaid

Medicaid will pay for long-term care in an “approved” skilled care facility.  In fact, Medicaid pays for most of the long-term care in this country.  To obtain Medicaid benefits in a nursing home, the nursing home placement must be medically justified and the individual must pass two tests:  a resource test and an income test.  To qualify for Medicaid, an individual must have no more $2,000.00 in “countable resources” which includes just about anything owned by or legally accessible to the Medicaid applicant.  In addition, an applicant’s income must be less than his/her monthly nursing home bill.

Medicaid is funded jointly by federal and state governments.  It is administered in Ohio by County Medicaid offices and in Kentucky by the Cabinet for Health and Family Services.  The eligibility rules and procedures are constantly being revised and when faced with long-term care, obtain advice immediately from a qualified Medicaid planner.

Treatments of Gifts by Medicaid

Any asset transferred within 60 months before filing a Medicaid application must be reported to the caseworker.  Medicaid will presume that the asset was transferred for the purpose of qualifying for benefits.  The applicant DOES have the right to try to prove that the transfer was for non-Medicaid reasons, but this is difficult.

However, certain transfers are permissible and will not be penalized:

  • The transfer of a home to a spouse or minor dependent child.
  • The transfer of real estate to a sibling with an equity interest who resided in the home for 1 year immediately preceding institutionalization.
  • The transfer of a home to a child who resided in the home for 2 years immediately preceding institutionalization where the child provided care which kept the parent out of the nursing home. This exception requires supporting documentation.
  • The transfer of any resource to or for the benefit of a spouse or a blind or disabled child.
  • Cases of undue hardship.
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    Edward D. Bender

    Ed practices primarily in the areas of estate planning, taxation and estate & trust administration. The estate planning area commonly includes planning for business owners, and Ed counsels them on their succession planning issues as well as their general corporate matters.

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