The 9 most common myths of Medicaid & Medicaid Planning which your clients believe

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1 The 9 most common myths of Medicaid & Medicaid Planning which your clients believe Mark B. Heffner, Esq. Certified Elder Law Attorney Heffner & Associates 615 Jefferson Boulevard Warwick, Rhode Island

2 DISCLAIMER Presentation based on CURRENT RHODE ISLAND Regulations and Policy, which are subject to change at any time. Medicaid eligibility is STATE-SPECIFIC. Even variations within State depending on regional office General presentation for educational purposes only. No substitute for individual consultation with COMPETENT Medicaid lawyer in particular State.

3 MEDICARE AND BLUE CROSS WILL COVER IT MYTH #1 Medicare & Medigap supplements such as Blue Cross Plan 65 and Blue Chip only small fraction of nursing homes residents at any given time. Many residents never receive Medicare coverage. For those who do, most people are NOT covered for the full 100 days and many have substantial co-pays during the period they receive skilled benefits.

4 IT S TOO LATE WE SHOULD HAVE DONE THIS 5 YEARS AGO MYTH #2 It is not too late to pursue effective asset protection planning, even after someone enters a nursing home. Text Plan may include purchase of exempt assets ( spenddown ), transfers which do not create ineligibility, calculated transfers.

5 IT S TOO LATE WE SHOULD HAVE DONE THIS 5 YEARS AGO MYTH #2 Examples for single people: Plan may include purchase of exempt assets ( spenddown ), transfers which do not create ineligibility, calculated transfers (e.g. reverse half a loaf )

6 IT S TOO LATE WE SHOULD HAVE DONE THIS 5 YEARS AGO MYTH #2 Significant opportunities for married couples e.g., purchase of Medicaidqualifying annuities, revisions to community spouse estate plan.

7 I CAN GIVE AWAY $10K PER YEAR TO ANYONE AND IT S OK MYTH #3 Annual exclusion gifts--now $14/year-- are NOT exempted transfers for Medicaid eligibility Rather, generally will create a period of ineligibility.

8 THE STATE WILL MAKE ME SELL MY HOUSE TO QUALIFY FOR MEDICAID MYTH #4 You can own a principal residence (with equity of less than $525K) and still qualify for Medicaid, provided you declare an intention to return home. No recovery until after death, and then only against recipient s probate estate. However, though permitted to retain principal residence, no income may be retained (other than portion of rental income) to pay house expenses.

9 MY KID S NAME IS ON ALL OF MY ACCOUNTS, SO 1/2 IS SAFE MYTH #5 Except in the case where the money truly belongs to the child or other coowner, 100% of the bank account will be exposed for spend-down. There are some exceptions for brokerage accounts, stock and real estate provided the penalty period has passed for adding the name.

10 THE STATE WON T MAKE ME SELL MY BEACH HOUSE/REDEEM MY CD/ANNUITY TO QUALIFY MYTH #6 Except for a limited number of exempt resources (e.g., principal residence (equity less than $525K), irrevocable burial contract), all other assets are deemed available for spenddown regardless of whether there is a penalty to redeem the asset or the asset cannot be immediately liquidated. AT BEST, may be given time to liquidate non-cash or cash-equivalent resources.

11 AS A SPOUSE, I GET TO KEEP ANYTHING IN MY NAME ALONE MYTH #7 The spousal allowance is calculated by totaling all of the available marital assets (regardless of which spouse s name is on the asset) and dividing by two. The Community Spouse is allowed to keep one-half of the total joint resources up to a maximum of $115,920.

12 MY ANNUITY IS PROTECTED FROM NURSING HOME COSTS MYTH #8 An annuity must be specifically designed in order to be Medicaid qualifying. Elements: irrevocable cannot be surrendered, transferred, collaterally assigned, or returned for a return of the premium paid, name State as beneficiary.

13 MY ANNUITY IS PROTECTED FROM NURSING HOME COSTS MYTH #8 Very unlikely that annuity purchased prior to individual s nursing home placement will pass muster.

14 IF I QUITCLAIM MY HOUSE TO MY KIDS, IT S PROTECTED MYTH #9 Unless SPECIFCALLY exempted, the transfer of ANY asset is subject to a 5 year look-back period. In addition, outright transfer of interest in home produces negative tax consequences, exposure of home to claims of kids creditors, loss of control by parent in most important asset.

15 *Copyright 2013, Mark B. Heffner, Esq. Heffner &Associates 615 Jefferson Blvd Warwick, RI

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