Tags Posts tagged with "Nancy Burner"

Nancy Burner

By Nancy Burner, ESQ.

Nancy Burner, Esq.

For many, the question of how to best care for our aging loved ones becomes a reality sooner than we think. Most people, when given the option, would prefer to age in place, remain in their homes for as long as possible receiving the care services they need in a familiar setting surrounded by family. For many, the Community-Based Long-Term Care Program, commonly referred to as Community Medicaid, makes that an affordable and therefore viable option.

Oftentimes we meet with families who are under the impression that they will not qualify for these services through the Medicaid program due to their income and assets. In most cases, that is not the case. Although an applicant for Community Medicaid must meet the necessary income and assets levels, it is important to note that there is no “look back” for Community Medicaid. What this means is that for most people, with minimal planning, both the income and asset requirements can be met with a minimal waiting period, allowing families to mitigate the cost of caring for their loved ones at home.

An individual who is applying for Medicaid Home Care may have no more than $14,850 in nonretirement liquid assets. Retirement assets will not be counted as a resource so long as the applicant is receiving monthly distributions from the account. An irrevocable prepaid burial fund is also an exempt resource. The primary residence is an exempt asset during the lifetime of the Medicaid recipient; however, if the applicant owns a home, it is advisable to consider additional estate planning to ensure that the home will be protected once the Medicaid recipient passes away.

With respect to income, a single applicant for Medicaid is permitted to keep $825 per month in income plus a $20 disregard. However, if the applicant has income that exceeds that $845 threshold, a pooled income trust can be established to preserve the applicant’s excess income and direct it to a fund where it can be used to pay his or her household bills.

These pooled trusts are created by not-for-profit agencies and are a terrific way for persons to take advantage of the many services available through Medicaid Home Care while still preserving their income for use in meeting their monthly expenses.

Functionally, the way that these trusts work is that the applicant sends a check to the fund monthly for that amount that exceeds the allowable limit. Together with the check, the applicant submits household bills equal to the amount sent to the trust fund. The trust deducts a small monthly fee for servicing these payments and then, on behalf of the applicant, pays those household bills.

As you can see, this process allows the applicant to continue relying on his monthly income to pay his bills and, at the same time, reduce his countable income amount to the amount that is permitted under the Medicaid rules. An individual who is looking for coverage for the cost of a home health aide must be able to show that they require assistance with their activities of daily living. Some examples of activities of daily living include dressing, bathing, toileting, ambulating and feeding. In fact, where the need is established, the Medicaid program can provide care for up to 24 hours per day, seven days per week.

The Community-Based Medicaid Program is an invaluable program for many seniors who wish to age in place but are unable to do so without some level of assistance.

Nancy Burner, Esq. practices elder law and estate planning from her East Setauket office.

By Nancy Burner, Esq.

In December 2014 the federal government passed a law known as the Achieving a Better Life Experience Act, also known as the ABLE Act. This law allows family members of a disabled person to create an account that is exempt from federal income tax to be used for certain “qualified expenses” related to the person’s disability. This act is created under the same provisions of the tax code as 529 plans for college savings although they have different rules governing the plans.

Unlike the college savings plans, the beneficiary of the New York ABLE Act accounts must have been deemed disabled prior to 26 years old. If a beneficiary is entitled to Supplemental Security Income (SSI) or Social Security Disability Income (SSDI), they are automatically eligible. However, if they are not entitled to these sources of income, there are other methods of proving disability that will establish eligibility. The account can be created by any person, and the owner can be the beneficiary or their parent, legal guardian or representative of that beneficiary.

However, it is important to note that there is a maximum contribution of $14,000 annually, the federal gift tax exemption amount. Each beneficiary can only have one ABLE account created for their benefit. This could create an unintended tax liability if there is no coordination among the persons that wish to contribute to the account. ABLE accounts are meant to supplement the government benefits that a disabled person is receiving. In New York, ABLE account funds are not counted as a resource at all for Medicaid eligibility for the disable beneficiary of the account. For an individual who is receiving SSI, the account is not considered a resource as long as it is below $100,000.

The benefit of having an account like this is that the disabled individual can access the account on their own without requesting a distribution from a trustee as they would have to do with a supplemental needs trust. The accounts can be used to pay for “qualified expenses,” including but not limited to education, transportation, training, legal fees, etc. The expense must be one that is related to the person’s disability and provides them with a resource that will improve their health, independence or quality of life. If the funds are misappropriated to an expense that does not fall into this category, there is a 10 percent penalty and the full amount of the nonqualified expense will be deemed an available asset for Medicaid or SSI eligibility purposes.

Upon the death of the account beneficiary, there is a payback to the Medicaid program for services rendered. This payback includes services to the beneficiary starting on the date the account was created. If a beneficiary received services for 20 years before the account was created, there is no payback to Medicaid for the prior 20 years of services.

The ABLE Act provides a new and creative vehicle for disabled persons to have access to additional assets while maintaining their government benefits. However, these accounts are, in most cases, a supplement to traditional planning for persons with disabilities. If a beneficiary has multiple persons that wish to leave assets to them that may exceed $14,000 per year in contributions or $100,000 in total, a supplemental needs trust will be more beneficial than the ABLE account. Money that is contributed to a disabled person from a third party can go into a trust that does not require payback to the Medicaid program. If funds are given outright to the disabled person who subsequently places it into a trust, this is considered a first-party supplemental needs trust and it also requires a payback to Medicaid.

New York State signed the ABLE Act into law in December 2015. However, these accounts are not yet available to New York State residents. While the state says they may be available at the end of 2016, there is no set date for the program launch.

Nancy Burner, Esq. practices elder law and estate planning from her East Setauket office.

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By Nancy Burner, Esq.

While discussing an estate plan with a client, she stopped me and said “What is probate.” Sometimes we forget to explain the simplest concepts. Probate is the process by which a last will and testament is given effect. Under New York State Law, a will is admitted to probate after the executor files a Petition for Probate with the decedent’s will attached and gives proper notice to the individuals that would have inherited from the decedent had the decedent died without a will. The proceeding for the probate of a will takes place in the Surrogate’s Court in the county where the decedent resided at the time of his or her death. The probate proceeding gives the interested parties (distributees) the right and opportunity to object to the probate of the will.

Typically, we advise that a client that creates a will consider if there are any circumstances that will make the probate proceeding an expensive one. For instance, is any distributee being disinherited? If so, that disgruntled distributee may come to Surrogates Court and object to the will. The litigation objecting to a will can be long and drawn out — and expensive as well. Are there missing heirs that must be found before the will can be probated? If so, it could be very expensive and time-consuming to find all the individuals that are required to be given notice and an opportunity to object. Is there real property owned by the decedent in different states? If so, then the will would have to be probated in each state. If any of these circumstances exist, you may want to avoid probate altogether.

We also suggest avoiding probate if you are the surviving spouse and your spouse is or has received Medicaid benefits. Medicaid has a lien against the spouse’s estate for any Medicaid benefits paid for the other spouse within 10 years of the death of the surviving spouse.

Another reason to avoid probate is if you have a disabled beneficiary as the Surrogate’s Court may appoint a guardian ad litem to protect that person’s interest. That could be another delay and cost to the estate.

The next question to consider is how do you avoid probate? One way to avoid probate is to name beneficiaries on all your accounts. But I rarely, if ever, suggest that a client resort to this solution without first considering the consequences. First, it may not be possible to name beneficiaries on all your accounts. What if your beneficiaries are minor’s or disabled? If that is the case, the minor or disabled beneficiary would have to have a guardian appointed to collect the bequest. This is also timely.

For minor’s, the guardian would have to put the money in a bank account, earn little or no interest and turn the money over to the beneficiary when he or she turned 18. If the account was a retirement account, the result is even harsher. The IRA or other retirement account would have to be liquidated, all income taxes paid and then put into a custodial account at a bank, earn little interest and then be paid to the beneficiary at age 18.

Most clients, when given the choice, would rather protect their heirs from divorcing spouses, Medicaid liens, creditors and taxes than avoid probate. We can protect beneficiaries by having their assets paid to trusts. This can be done in a will (and probate) or by avoiding probate altogether by using a revocable trust.

The important point here is that it is a mistake to make the avoidance of probate the overriding consideration when embarking upon an estate plan. Not everyone needs a revocable trust, but some people will be well served by using a trust, if the circumstances make probate impractical.

One size does not fit all. A successful estate plan takes all factors into consideration. In a world where people are computer savvy and everything is available on the internet, it is easy to believe that you can just do it yourself. The fact is attorneys are called counselors at law for a reason. The documents are only part of the problem and solution. The fact is, there is no substitute for competent legal advice.

Nancy Burner, Esq. practices elder law and estate planning from her East Setauket office.

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By Nancy Burner, ESQ.

Many people who own real property, whether it is a family home or a vacation home, have a common estate planning goal: protect the house and transfer it to the next generation.

One way to transfer real property to your beneficiaries during your life is to execute a deed with a life estate. For the owner, this means that you will retain the right to live in the home until your death, but upon your demise, the property will be fully owned by your beneficiaries. Because you retained a lifetime interest in the property, you would still be able to claim any exemptions with respect to the property.

There are several benefits to executing a deed with a life estate. First, it is easy and relatively inexpensive. Because the property is a transfer, it will start the look-back period for Medicaid. For nursing home care, the transfer must be more than five years prior to your application for coverage. There is no look-back period for home care, so the property would be considered “unavailable” in the month after the transfer. Moreover, when you pass away, the beneficiaries will get a “step-up” in basis that will eliminate or lessen capital gains tax due if they did sell the property. 

However, the negative aspects to this kind of transfer typically outweigh its benefits. The first is loss of control. Once you have transferred the deed to your beneficiaries, they own it. If you wanted to sell the property or change who received it, you would have to get the permission of those to whom you initially transferred the property. If one of your beneficiaries dies before you, their estate will own a piece of your house. If their estate pays to their spouse, you could have in-laws owning your property when you would have preferred that share to go to the decedent’s children.

Lastly, if the property is sold during your lifetime, you may incur a capital gains tax. When a person sells their primary residence, they receive a $250,000.00 exemption, which means that a tax would only be imposed if the gain on the property was more than $250,000.00. However, when your ownership interest is a life estate, you do not get the full $250,000.00 and therefore may inadvertently incur a tax. For Medicaid purposes, if the house is sold, your interest in the property will be valued and what was once an exempt asset will convert to cash. If this cash amount plus what you already have exceeds the Medicaid asset limit, currently $14,850.00, you would be ineligible for Medicaid.

Another way to transfer real property at death is to create a last will and testament with specific provisions with respect to that property. For instance: “My Executor shall distribute my real property located at 1 Smith Street, Smithsville, New York, to my children, in equal shares.” This means that upon your death, your executor would probate your will in Surrogate’s Court and once they receive approval from the court, they could effectuate the transfer to your children as desired.

The benefit to this kind of planning is that you retain complete control over the property until your death. The downside is that it provides no asset protection and your beneficiaries would have to wait until the probate process is completed before they received the real property.

Moreover, any disinherited heirs would have the opportunity to object to your will. If you have children and are treating them equally, then this would not be a concern, but for those who are treating children unequally or for those who do not have children and are leaving property to a nonfamily member, a traditional will may not be the best option.

The last way to devise real property is through a trust. While there are many different types of trust, for the purposes of this article we can divide them into two categories: revocable vs. irrevocable trusts. A revocable trust allows the creator to maintain complete control over the property in the trust, whereas an irrevocable trust typically limits your access to the property and forces you to designate someone other than yourself (or your spouse) as the trustee. All trusts avoid the probate process. Similar to a will, the property would continue for your benefit during your life and would not transfer to the beneficiaries until after your death.

In addition to avoidance of probate, irrevocable Medicaid trusts protect the property in case you need Medicaid to cover the cost of long-term care in the future as transfers to irrevocable Medicaid trusts begin the five-year look-back period even though you maintain control over the asset. This control is in the form of the ability to change your trustee and your beneficiaries any time. The house can be sold at any time and a successor property purchased without incurring any negative tax consequences.

The biggest negative to the trust is the cost to set it up. Typically, attorneys charge more to prepare a trust than a simple will or deed transfer.

Nancy Burner, Esq. practices
elder law and estate planning from her East Setauket office.

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By Nancy Burner, Esq.

The Question:

My mom has been a recipient of Community Medicaid. As her condition is deteriorating, it is apparent that she will require long-term care in a nursing facility. I have heard that her Community Medicaid will pay for the nursing facility. Is that correct?

The Answer:

No, Community Medicaid will not pay for long-term care in a nursing home. Community Medicaid is the program that covers care at home; such has a personal care aide. Chronic Medicaid is the program that covers nursing home care. The requirements and application process for Community Medicaid and Chronic Medicaid are very different. An individual is unable to receive both Community and Chronic Medicaid simultaneously, so it is important to know the differences and make sure you have the correct Medicaid in effect.    

For 2016, an individual applying for Community Medicaid can have no more than $14,850, not including their home, in resources and no more than $845 per month in income. Qualified funds such as IRAs or 401(K)s are exempt, but the applicant is required to take periodic distributions that are counted as income each month.

While these limitations may seem daunting, the good news about Community Medicaid is that there is no look-back period and the individual can opt to use a pooled trust to preserve any excess income above the $845. That means someone looking to get care at home can transfer assets and set up a pooled trust in one month and be eligible for Community Medicaid in the following month.

This is much different than Chronic Medicaid. For 2016, an individual applying for Chronic Medicaid can have no more than $14,850 in resources, including a home, and no more than $50 per month in income. There is no pooled trust option to protect the excess income.

Like Community Medicaid, qualified funds such as IRAs or 401(K)s are exempt, but the applicant is required to take periodic distributions that are counted as income each month.

Chronic Medicaid has a five-year look-back. The look-back refers to the period of time that the Department of Social Services will review your assets and any transfers that you have made. To the extent that the applicant has made transfers or has too many assets in their name to qualify, they will be ineligible for Medicaid.

However, there are some exempt transfers that the applicant can make that will not render them ineligible. If transfers were done in order to qualify the individual for Community Medicaid, those same transfers may pose an issue for a Chronic Medicaid application. 

Due to the differences in Community and Chronic Medicaid requirements and regulations, it is imperative to consult with an expert.

Nancy Burner, Esq. practices elder law and estate planning from her East Setauket office.

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By Nancy Burner, Esq.

The typical Medicaid trust is a grantor trust for income and estate tax purposes. The grantor trust rules came about after high earners tried to lower their income tax consequence by scattering their income to various trusts over which they maintained control. By spreading their income out, the earners were subject to the lower tax brackets since each trust was considered a separate entity, rather than all the income being taxed to one individual.

Eventually, the IRS caught on to this technique and the grantor trust rules were born. The grantor rules state that if the grantor, that is, the creator of the trust, maintains certain “strings” of control over the trust, such as the right to principal or the right to change the beneficiaries, then all the income from said trusts must be reported on the grantor’s individual tax return.

In addition, the IRS imposed compressed tax rates for trusts. For instance, in 2016 once the income of a trust exceeds $12,500.00, the trust is taxed at the highest tax bracket of 39.6 percent. An individual would have to earn $415,050 to reach that rate. Similarly, a trust can be a grantor trust for estate tax purposes. This would mean that despite the fact that the grantor transferred assets to an irrevocable trust during their life, if they retain certain rights under the terms of the trust, the assets are still includible in their estate for estate tax purposes.

While this combination of new rules from the IRS does not help to lower income or estate tax, it provided for the perfect vehicle for Medicaid planning. Nursing Home Medicaid imposes a penalty for any transfers made within the 5 years prior to the date of the application. If assets are transferred to a trust, the trust must be irrevocable and must provide that the grantor has no right to principal in order for Medicaid to consider the asset unavailable for eligibility purposes. Individuals interested in Medicaid planning were anxious to protect assets but did not want to give up complete control of their assets, nor did they want to incur any negative tax treatment. The grantor trust rules solved those concerns.

While Medicaid does prevent the trust from returning principal to the grantor, the grantor can still receive any income earned in the trust, can retain the right to reside in any real property in the trust and can change the trustee or beneficiaries at any time.

Moreover, because the grantor retains the right to reside in any real property in the trust, the grantor is still entitled to any real property tax exemptions and still receive their $250,000 capital gains exemption if the property is sold.

As mentioned above, if properly drafted, a grantor trust will provide that any income generated within the trust will be reported on the creator’s individual tax return, thus eliminating the possibility of a compressed tax rate.

Additionally, since the assets are still includible in the grantor’s estate when they pass away, there will be a 100 percent step-up in cost basis equal to the fair market value as of the date of their death. This means that if a grantor purchased her home for $30,000.00 in 1980, the property will be re-assessed upon her death to the fair market value. Therefore, when the beneficiaries sell the property there will be no capital gains tax incurred.

Not all trusts are created equal. If you are considering a Medicaid trust, consult with an elder law attorney in your area to learn more.

Nancy Burner, Esq. practices elder law and estate planning from her East Setauket office.

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By Nancy Burner, Esq.

Each January, the governor of the State of New York puts out a proposed budget from which the legislative and executive branches will base their negotiations to determine a final budget.  The budget is set to be passed by March 31; the date that marks the end of the fiscal year for the state. Just as in years before, our state legislature is in the process of reviewing the proposed budget.

There are several proposals in the budget that, if passed, will have an impact on the Medicaid program as we know it in New York State. Specifically, two in particular will affect married couples in need of care. 

For the 27th year there is a proposal that “spousal refusal” be abolished in the home care Medicaid setting. Spousal refusal is the mechanism by which the spouse of a Medicaid applicant can maintain a Community Spouse Resource Allowance (CSRA) of assets above the Medicaid level as long as the spouse receiving Medicaid maintains assets below the permissible amount of $14,850.00. 

The removal of this provision from our program would not only apply to spouses but to other “legally responsible relatives” including the parents of children in need of the Medicaid program to help pay for the cost of care. The fear of losing the spousal refusal option is that this will force individuals to put a child or spouse in a nursing home in order to maintain enough assets to support themselves or force divorce or separation. 

Compounding the issue of the loss of spousal refusal in the home care setting is the proposal to reduce the CSRA to $23,844.00. Currently, the law in New York states that a spouse can have up to $74,820.00 while the federal maximum is $119,220.00.  Many fear that reducing the CSRA would make it difficult for couples to have a large enough emergency fund, putting them one leaky roof or flooded basement away from impoverishment. 

Oftentimes, the spouse requiring Medicaid may live a long life beyond that of their sick spouse. The loss of these two important parts of our Medicaid program will force the healthy spouse to spend all of their money on the sick spouse and be left without assets to take care of his or her own needs.

Nancy Burner, Esq. practices elder law and estate planning from her East Setauket office.

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By Nancy Burner, Esq.

Question: I would like to protect my home by transferring it to my children but am concerned about losing my tax exemption. Is there a way that I can protect my home while still maintaining my exemptions?

Answer: Yes there is. For many of our clients, without the property tax exemptions that they receive, staying in their homes would be a hardship. When faced with the decision of either protecting that home or potentially losing the exemptions, the decision is not an easy one. 

The good news is that you can get the asset protection you desire while still maintaining your tax exemptions.  One way to achieve this is with an irrevocable trust, oftentimes referred to as a Medicaid protection trust. These trusts enable our clients to maintain a certain level of control and beneficial ownership over their home while garnering the same potential asset protection that they would achieve through an outright transfer.   

The way this works is that you as the owner of the property would create a trust; you are the grantor, sometimes referred to as the settlor. You would name a third party (anyone other than your spouse) to act as trustee, and the trust would also provide for distribution at the time of your death to your named beneficiaries. Oftentimes, the trustee and the beneficiaries are one and the same.

Once you transfer the home (or any other nonretirement assets) into the trust, the “clock” begins to run for the purpose of asset protection in the context of Medicaid planning. As you may know, in New York State, we currently have a five-year look back when applying for Chronic Care Medicaid, which means that once assets have been transferred into a properly drafted irrevocable trust and five years has passed, they are no longer countable resources when applying for Medicaid. 

The trust is considered a grantor trust for tax purposes, meaning that the grantor is still considered the owner for tax purposes. Because the grantor retains certain rights with respect to lifetime use of the properties in the trust, the grantor is permitted to maintain any tax benefits associated with ownership of the property, including the Enhanced STAR benefit, veteran’s benefit and any capital gains exemptions they would otherwise be eligible to receive.   

Contrast that with a decision to transfer the property outright to your children for the purpose of protecting the asset, which would result in a total loss of all preferential tax treatment. 

Transferring your home or any nonretirement assets into an irrevocable trust offers flexibility in planning, maintenance in any current tax exemptions and complete asset protection. To determine if an irrevocable trust is appropriate, you should consult an elder law expert in your area.

Nancy Burner, Esq. has practiced elder law and estate planning for over 25 years.

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By Nancy Burner, Esq.

The New York State estate tax exclusion amount will be increasing again as of April 1, 2016, to $4,187,500. This is an increase from the $3,125,000 exclusion amount that has been in effect since April 1, 2015. As of Jan. 1, 2016, the federal estate tax exclusion is $5,450,000.

The New York State estate tax exclusion will increase again on April 1, 2017, to $5,250,000. This exclusion amount will remain in effect until Dec. 31, 2018. On Jan. 1, 2019, the basic exclusion amount will be indexed for inflation annually and will be equal to the federal exclusion amount. The New York State and federal exclusion amount is estimated to be $5,900,000 in 2019.

An item still of particular concern to many is the “cliff” language contained in the law. If the estate is valued between 100 and 105 percent of the exclusion amount, the amount over the exclusion will be taxed. As of April 1, 2016, the 105 percent amount is $4,396,875. However, once an estate exceeds the exclusion amount by more than 5 percent, not just the amount in excess of the exclusion amount is taxed, but, rather, the entire estate is subject to estate tax.

Practically, this means that taxable estates greater than 105 percent of the exclusion amount receive no benefit from the exclusion amounts shown above and will pay the same tax that would have been paid under the prior estate tax law.

New York repealed its gift tax in 2000.  This meant that as a New York resident, if you made lifetime gifts to friends or family members, the gift was not taxed or included in your New York gross estate for purposes of calculating your estate tax. With the estate tax law as enacted in 2014, there is a limited three-year look-back period for gifts made between April 1, 2014, and Jan. 1, 2019. This means that if a New York resident dies within three years of making a taxable gift, the value of the gift will be included in the decedent’s estate for purposes of computing the New York estate tax. 

The following gifts are excluded from the three-year look-back: (1) gifts made when the decedent was not a New York resident; (2) gifts made by a New York resident before April 1, 2014; (3) gifts made by a New York resident on or after Jan. 1, 2019; and (4) gifts that are otherwise includible in the decedent’s estate under another provision of the federal estate tax law (that is, such gifts aren’t taxed twice).

For federal gift tax purposes, in 2016, you can still make annual gifts of $14,000 per person without having to report these gifts on a gift tax return. These $14,000 gifts are also not included for New York State estate tax purposes.

The New York State estate tax law does not contain a portability provision like in the federal estate tax law. Portability is a provision in the federal estate tax law that allows the unused estate tax exemption of a married taxpayer to carry over to his or her surviving spouse. Without portability, the manner in which a married couple holds title to their assets may continue to have a significant effect on the amount of New York State estate tax ultimately payable upon the survivors’ death.

This New York estate tax law is working to close, and eventually eliminate, the gap between the New York and federal estate tax exclusion amounts. For the next three years, however, as the exclusion amount increases and the three-year look-back for taxable gifts applies, tax planning will still be complex. That being said, it is important for anyone considering whether to make changes to their estate plans or gifting strategies to see an estate planning attorney specializing in these matters.

Nancy Burner, Esq. has practiced elder law and estate planning for 25 years.

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By Nancy Burner, Esq.

The Question: I am considering applying for Community Medicaid for my mom in order to cover the cost of home health aides. I heard that Community Medicaid might pay for certain supplies my mom could use in her home. Is that true?

The Answer: Yes. The Community-Based (Homecare) Medicaid program can assist families in paying for the cost of home health aides as well as other programs, supplies and equipment.  Once approved for Community Medicaid, the individual may be enrolled in a Managed Long Term Care Company (MLTC).  The MLTC will be in charge of coordinating the recipient’s health care needs including, but not limited to, a home health care aide.

The MLTC will determine the amount of hours per day and days per week that the individual is entitled to have a home health care aide. The determination is based upon the needs of the individual. The home health care aide can assist with all activities of daily living, including but not limited to bathing, grooming, toileting, ambulating, meal preparation, laundry and light housekeeping. 

The MLTC will also cover adult day care health programs that offer a place for seniors to go during the day and then return home at night. There are two different options: Medical Model and Social Model. Medical Model will provide meals, rehabilitation, monitoring of health conditions and assist with personal hygiene. Social Model will provide meals, stimulation and senior activities. Some programs will offer transportation to and from the facility.  The entire cost of the program, including transportation, will be covered by Community Medicaid. 

Another service covered by the MLTC is transportation to and from nonemergency medical appointments.  The individual can schedule pick-up at his or her home to any doctor’s office with prior notice. The MLTC will also have a network of providers that will accept Medicaid to cover audiology, dentistry, podiatry, optometry and physical/occupational/speech therapy.

The individual may also be entitled to medical supplies such as diapers, pull-ups, Chux, a wheelchair, walker, hospital bed and portable ramp, depending on the individual’s need. These supplies can be ordered with a prescription from the primary physician. These supplies will be delivered to the home of the Medicaid recipient at no cost.

Finally, certain MLTC providers also offer additional coverage that could be used to pay for premiums, deductibles and other co-pays for medical and prescription drugs. This additional coverage could eliminate the need for supplemental health insurance. It is important to speak with the specific MLTC to find out about what they specifically offer to enrollees.   

The Community-Based Medicaid Program is an invaluable program for many seniors who wish to age at home but are unable to do so without some level of care and certain supplies the cost of which would be otherwise too expensive to sustain on their own. In order to get specific eligibility requirements, please see a local elder law expert in your area.

Nancy Burner, Esq. has practiced elder law and estate planning for over 25 years.