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Last column I explained how the health of a senior is assessed to determine if Medicaid will assist with the costs of long-term care. However, even if the Medicaid applicant’s health requires long term care, the applicant must also establish a financial need.

The misinformation about how one financially qualifies for Medicaid assistance is remarkable. Too often applicants disqualify themselves from assistance, and create other problems, because they do not understand the requirements. With the assistance of a knowledgeable professional, many seniors with long terms care needs can receive assistance that they may have felt was not available to them.

To qualify for Medicaid assistance, many seniors believe the following:

  • They can have only $2000 in assets to qualify for Medicaid assistance.
  • They must have less than $2000 in monthly income to qualify for Medicaid assistance.
  • If they have more than $2000 in assets or monthly income, the best way to preserve their estate is to give the excess to family.

Each of these state statements is false. And yet, because they do not understand the rules, seniors make life altering decisions – including divorce – because they think it is necessary to receive Medicaid assistance. In reality, those decisions have unforeseen ramifications . . .  and did not need to be taken in the first place. In some cases, those decisions actually disqualify an otherwise qualified person from receiving Medicaid assistance.

Over the next few columns, I will describe in some detail how one qualifies financially to receive Medicaid assistance for long term care. It may help to keep in mind what I believe are three policies the government is attempting to balance in addressing this issue. First, a person with sufficient resources should not expect Medicaid to pay for his/her long-term care. Second, because home-based care is typically preferable to institutional care, those intending to return home are not expected to give up certain significant assets (such as their home) to qualify for care. Third, Medicaid is specifically designed to avoid impoverishing the applicant’s healthy spouse while the applicant receives care.

Starting next week, I will begin explaining the rules to qualify financially for Medicaid assistance and how these policies apply.