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Medicaid provides reimbursement for eligible clients in a nursing home and also covers home and community based care in some instances. Think of a Medicaid application as insurance.

Medicaid benefits are available in home and community based settings. The rules are complex, but an experienced attorney can assist you in determining if these benefits can help you pay for healthcare costs at home or in senior living.
  • As insurance, Medicaid covers medical bills but not the cost for housing in a private senior living facility. Generally, individuals living in independent living or assisted living settings are not eligible to receive Medicaid. Medicaid will cover the entire cost of a nursing home for eligible individuals.
  • If you give away your assets, you are disqualified for Medicaid for five years. NOT TRUE! Five years is the time period that Medicaid agencies review financial records. This is called the “look-back period”. Any gifts made within that period will be penalized based on a formula, but knowing this rule presents many planning opportunities where an individual can give away some of their assets while retaining others to pay for the cost of care during the imposed period of ineligibility.
  • If you are in a nursing home, it is too late to protect your assets. NOT TRUE! It is never too late to protect your assets from the nursing home. Through a combination of spousal budgeting, exempt asset spend-down planning, and “half-a-loaf” strategies, significant wealth can be protected, even if you are already in a nursing home.
  • Annual exclusion gifts are not exempt from Medicaid. While you may make an annual exclusion gift ($15,000 per year, per individual for 2018 and thereafter) and these gifts are not subject to gift tax, they still count as transfers, resulting in periods of ineligibility for Medicaid. Medicaid rules are complex and often contradict rules in other areas of law.
  • It is not illegal to give away assets to qualify for Medicaid. No law prohibits you from transferring your property in order to qualify for Medicaid. However, because of the penalties that are imposed on uncompensated transfers, planning strategies need to be employed in order to legally structure your assets and shelter them from long-term care costs. Nursing home Medicaid is complex. Medicaid is a federally mandated, state legislated and locally administered system of medical welfare. Each state does it differently. Each county does it a little differently. Situations are always different. Your best strategy is to confer with an experienced attorney so that you may understand how these rules apply to your individual situation.
Applying for Medicaid is a complex and often daunting process. If an individual does not provide all of the necessary information, benefits will be denied, and the process may have to start again.

Medicaid employs a “snapshot” approach to determine eligibility. An individuals financial snapshot occurs on the first day of each month. A Medicaid application made in a particular month may seek benefits retroactive to proceeding months.

We have a team of attorneys and paralegals who file applications for Medicaid benefits every month. We have the requisite experience, forms and relationships necessary to effectively file and advocate for our clients.

When selecting a firm to help you with your Medicaid application, you should seek someone with significant experience. The right attorney can make all the difference.

Qualifying for Medicaid
When an individual is admitted to Chronic Care in a nursing home, the costs can exceed $14,000 per month, easily consuming a lifetime of savings.

Our firm can help you and your loved ones protect assets from being spent at the nursing home. We employ a variety of techniques, including irrevocable trusts, exempt asset transfers, exempt asset spend-down planning, spousal budgeting, spousal refusal and gift and note (so called “half-a-loaf”) planning. Each of these strategies require a thorough understanding of the clients situation and how existing law relates to it.

No one strategy is right for everyone and each case requires analysis and planning.

Irene and I would like to take this opportunity to thank you and your staff for providing outstanding professional services to our company.

- Jane S. & Irene C.


Richard A. Kroll, Esq. has an active practice in the area of Estate Planning, Trusts, and Probate. He is a member of the...

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Private practice in Rochester, New York with the Kroll Law Firm since 2007, a group practice in Brighton, New York with emphasis on...

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Marcus's practice involves estate planning for all families, including LGBT couples, second marriages, and families who have members with...

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Richard A. Kroll
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