Medicaid Presentation Alzheimers Association

MEDICAID: HOW TO MANAGE THE COST OF STAYING IN A NURSING HOME

P. Haans MulderCunningham Dalman, P.C.321 Settlers RoadHolland, MI 49423(616) [email protected]

Alzheimer's Association-West Michigan

Background• Grew up in Holland• Attorney and Partner at Cunningham

Dalman, P.C.• Masters in Tax, CFP®, and specialize in

estates/elder law and business planning

Serving the Holland area since 1900

Background• Cunningham Dalman, P.C. is located in

Holland and has been serving the greater Holland/Zeeland since 1900

• We have 14 attorneys specializing in all areas of the law

Serving the Holland area since 1900

Overview• Discuss the Medicaid process• Talk about the Medicaid eligibility rules• Cover recent new developments and

changes in the Medicaid rules

Serving the Holland area since 1900

What is Medicaid?• State and federal program that pays

for medical treatment (including nursing home care)

• Oftentimes confused with Medicare

Serving the Holland area since 1900

When does Medicaid apply?• Must be in a nursing home or be in

certain counties that have the MI Choice Waiver program

• Waiver program provides care in a person’s home and may cover residential facilities

Serving the Holland area since 1900

Who does Medicaid apply to?

• Applies to people who are 65 years or older, blind, or disabled

• Must satisfy the medical requirements (have level of care assessment done)

• Must meet income and asset tests

Serving the Holland area since 1900

Who does Medicaid apply to?

• You cannot have enough income to pay the monthly cost of staying in a nursing home ($6-7,000 in this area)

• Cannot earn more than $2,022/month for the MI Choice Waiver program

Serving the Holland area since 1900

Who does Medicaid apply to?

• Asset test requires that a single person cannot have more than $2,000 in countable assets

• Can keep your home (it’s not in your trust) and a vehicle

Serving the Holland area since 1900

Who does Medicaid apply to?

• Asset test allows a married couple to keep their home (again, if it’s not in a trust), a vehicle, and one-half of their other assets

Serving the Holland area since 1900

Where do you apply?• Apply for Medicaid at the Department

of Human Services (DHS)• DHS offices are located in each county• Apply to the county office that the

nursing home is located

Serving the Holland area since 1900

Example• Clients were husband and wife• Drafted an estate plan for them• A couple years later, the wife’s health

declined significantly and had to go to a nursing home

Serving the Holland area since 1900

Example• She didn’t stay in a hospital for three

days so Medicare didn’t cover any of the stay at the nursing home

• They had a house, vehicle, and investments

Serving the Holland area since 1900

Example• Could keep the house (because it was

properly owned) and their vehicle• Without any Medicaid planning, they

would have had to spend down one-half of their investments

Serving the Holland area since 1900

Example• Drafted a trust that allowed them to

protect all of their investments (as opposed to just half)

• This provided peace of mind to the husband

Serving the Holland area since 1900

New Developments-House• If the house is in your trust, it becomes

a countable asset• If it’s in your individual name, it will go

through probate• Probate could subject your house to

the Medicaid lien

Serving the Holland area since 1900

New Developments-House• Don’t have enough cash to pay the

costs of maintaining the house• House can be rented to pay these

costs• Evaluate whether it’s economically

feasible

Serving the Holland area since 1900

New Developments-Long Delays

• Process normally took 45-60 days• State of Michigan budget cuts have led

to long delays• This becomes very problematic if the

Medicaid application is denied  

Serving the Holland area since 1900

New Developments-Technology• New computer system has caused

problems• Make sure to understand what the

Medicaid notices really mean

Serving the Holland area since 1900

Questions……

Serving the Holland area since 1900

Thank YouP. Haans MulderCunningham Dalman, P.C.321 Settlers RoadHolland, MI 49423(616) [email protected]

Serving the Holland area since 1900