Ensuring Medicaid Eligibility
If you were denied full coverage under the Medicaid program, but received a notice that you must “spend down” to be eligible for Medicaid, we can help. If you have a low income but were denied coverage, it may be in your best interest to work with a professional to challenge the Medicaid ruling. Many times, property that is counted as an asset can be debated.
Understanding The Medicaid “Spend Down”
You may, like many Americans, have “excess income” that prevents you from immediately qualifying for Medicaid. However, your increasing medical bills may deplete that excess income to a level that makes you eligible for Medicaid. This must be done following specific rules or you may put your eligibility at risk.
The Three Medicaid Basics
Medicaid laws are an evolving area of law. Be sure to work with an attorney who understands the process, and has extensive experience with current Medicaid laws and requirements.
- Apply through your state Medicaid program. If you are uncertain as to how to do this, an attorney can help you through the process.
- Coverage may start three months before you are officially approved. Applications can take longer than expected. An attorney can ensure that your application is correct and can monitor the progress.
- Know that your assets are limited to $2,000. If you have more than this, an attorney who works in with Medicaid can assess your financial situation and offer assistance in legally spending down so that you are eligible.
Who Qualifies For Medicaid?
While Medicaid can be a tremendous help for many people, not everyone qualifies. To be eligible, you must be one of the following:
- A child under 21
- An adult over 65
- Disabled or blind
- A family in which one parent is absent, deceased, disabled or out of work
Which Bills Count Toward A Spend Down?
Mainly, the medical bills of you and your spouse count toward spend down. However, there are other qualifying bills, including:
- Your children’s medical bills
- The medical bills of a child living with you
- Bills of a child who does not live with you, but whose medical bills you contribute to
- Past unpaid medical bills of family members who live with you
- Expenses you paid that were not covered by Medicare or private insurance
- Public medical program expenses
Divorce And Medicaid
The end of a relationship can complicate the Medicaid process. There are certain things to consider if your are going through a divorce. If one partner is in better health and financial standing, it may be beneficial for that partner to retain more assets. This can ensure the spouse with greater needs can qualify for Medicaid.
Acceptable Ways To Spend Down
As a low-income senior, there are legitimate ways to “spend down” your assets to qualify for Medicaid. You can gift some assets, within limits, and use your money to cover your increasing medical costs, including therapy and high-quality medical equipment. Certain spousal poverty protection laws let the spouse keep 50 percent of the assets if the other spouse requires long-term nursing home care. Speak with an attorney who handles elder law and Medicaid issues to guide you through the spend-down process.
Herrenkohl Law Office is focused on getting you the best result possible. With offices in Beckley and Barboursville, West Virginia, we are near you. Call us today at 304-948-5703 or email us to schedule a consultation with a lawyer.