Will Medicaid Pay for Your Home Care?

The state budget of New York was passed in mid-2020, and there have been specific changes that every resident in the state should be aware of. As of October 1, 2020, the Medicaid program now has a 2 ½ year lookback period.

The lookback period affects older beneficiaries of the program as it does affect eligibility.Those who have qualified will receive Medicaid payments for long-term care at home. These payments are under Community Medicaid. The lookback period was designed to save the state money as it is still under a state of fiscal emergency. An estate planning law firm can explain to you how these changes affect your eligibility for Medicaid.

To clarify, the Medicare program is for people 65 years old and above and people on disability, as covered by the Social Security System. Medicaid is different. The Medicaid program is delivered jointly by the federal program and the state, so Medicaid benefits and eligibility requirements vary across states.

Despite the budget cuts, Medicaid in NYS remains a reasonably robust and comprehensive benefits package. Medicaid still covers long-term care, prescription drug coverage, dental care, outpatient service, in-patient services, and health providers, too.

Medicaid recipients in the 62 counties of NYS will receive benefits under the Medicaid program unless an exclusion or exemption is encountered. Should an individual meet an exception or exclusion, he/she must look for a healthcare provider that accepts Medicaid, as he/she will require medical services via fee-for-services.

Households and individuals must meet eligibility criteria for the Medicaid program, including financial measures, immigration/citizenship criteria, and residency.New Yorkers who are low-income may still qualify under the MAGI eligibility rule. Non-MAGI beneficiaries may still receive benefits like waiver service, community-based long-term care, and institution-based services.

NYS has one of the most generous Medicaid programs in the country, which eventually led to conditions where they had to make budget cuts to the program. Essentially, the Medicaid program costs the NYS too much, so they had to add the lookback period.Consult with an estate planning law firm if you think you may be affected by these changes.

Estate planning is critical if you don’t want to run changes, such as the lookback period. You can set up trusts and allocate your assets, which then protects you and your loved ones. Legal methods such as redirecting income to a pooled trust, spending down assets will allow you to apply for specific benefits such as long-term home care.

With changes like the lookback period now in effect, you need to begin estate planning as soon as possible. Estate planning should ideally be done long before your parents (or you) require long-term home care. When you engage in thoughtful estate planning, you get long-term peace of mind. You also gift your family with preserved, and well-allocated assets with your intentions stated very clearly for everyone.

Estate planning prevents or at least minimizes family disputes when a family member or a parent suddenly needs long-term care and assistance.

Engaging in family disputes in the pandemic will add more stress to an already tense situation. These additional burdens on your family are entirely avoidable–you have to act early. An estate planning law firm can help remove these difficulties in the future.

In legal practice, there is elder law planning which focuses on the long-term care needs of the elderly. The process may seem overly complex, but essentially, an estate planning law firm will assist you in making arrangements for possible long-term care.

Care at home often requires specialized professionals such as therapists, aides,or a combination of different professionals depending on the actual needs.

Suppose you have ever encountered anyone who required long-term home care. In that case, you may have already seen how these professionals come to the beneficiary’s home to provide various types of assistance, from doing laundry, eating, showering, getting dressed, going shopping, etc.

Elder law planning also allows clients to think about whether one or both parents may require nursing facility care.Nearly everyone prefers to stay in their homes when critical or long-term illness sets in. Long-term home care isn’t always tenable or possible because of the level of specialized care required for managing specific conditions.

When a person needs three or more specialists, long-term care becomes unmanageable, and nursing facility care becomes necessary. At this point, facility care becomes more cost-effective in the long term. If you worry that your assets and other resources will be drained by possible future long-term care, you can speak to an estate planning law firm to explore your options. The best time to do it is now.

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