PB Elder Law is the only firm in WNY whose practice is dedicated to elder law. Mel talks with Jean E. Harris, a partner at the firm. She says she thinks people are afraid of the cost of long-term care. They are concerned that Medicaid or any government programs are too restrictive and so sometimes, because of that they don’t actually seek professional help by way or legal support or maybe care management services that they can avail themselves of. One of the things they try to do at PB Elderlaw, is to get as much education out there as possible so that people aren’t making decisions in the dark.
What does Medicaid pay for? Harris says when you are talking about Medicaid what you are talking about generally is health care services related either to aging or some manor of disability paid for either at home by way of therapies or adaptive equipment which allows an individual to stay in their home and not have to go into a skilled nursing facility. Sometimes they are talking about things which have advanced to the point of requiring skilled or assisted nursing care and we are asking Medicaid to come in and help pay that bill so that a family is not privately paying a bill to the tune of $12,000 - $15,000 a month.
Are there any income or resource restrictions? Yes, says Harris. She says Medicaid is what is known as a means-tested program which essential means you have to have no more than a certain level of income and no more than a certain level of resources in order to qualify. Income is considered to be anything that you are getting really on a monthly basis so like your social security, pension, or potentially an annuity payment in the form of income. Resources are sort of static assets; things you have in the bank, like a checking account or savings account. She goes on to say whether an asset is considered income or resources can really dramatically impact your eligibility for Medicaid and what actually has to be done with those resources. Harris says it’s really important to have things really evaluated by somebody who understand the exceptions for Medicaid, the exemptions for Medicaid and how to categorize your assets.
One of the most commonly asked questions at PB Elderlaw is can people gift money to qualify? She says the answer is both a yes and a no. So yes, assets can be gifted but it must be done in a very specific and careful way. If there are transfers of assets within five years prior to the application for Medicaid going into the Department of Social Services (DSS), can and will impose a penalty which is a period of time during which the applicant is not eligible for Medicaid, even if they would have otherwise been eligible. Harris says we want to make a gift and want to get assets safely into the hands of family members but they want to do so in a way that is either going to work with the Department of Social Services or going to be a way that takes advantage of one of the statutory exemptions so it is not doing something against what the Department of Social Services would allow. Harris says at PB Elderlaw one of their main areas of focus is Medicaid planning and asset protection for individuals so that they can help to preserve assets in the event a person requires skilled nursing or long-term care.