Cucinelli Geiger, PC

Individuals who are faced with the need to enter a long-term care facility such as a nursing home or assisted living facility or who are being provided with similar care at home face the very difficult issue of how to pay for that care.  Nursing home care can cost $8,000 to $12,000 per month.

While some have provided for this need with long-term care insurance and a fortunate few are able to afford their care without other assistance, most people find that long-term care expenses pose the danger of significantly and quickly depleting their life savings. For those who must seek assistance with their long-term care, there are a few forms of governmental assistance available including Medicaid, the Auxiliary Grant in Virginia, and veteran’s benefits.

Medicaid is a program administered by each state that provides medical care for the aged, blind, and disabled. Medicaid can help with nursing home expenses for those who have limited resources and income. For many, it is the only practical alternative to pay for their care in a nursing home. Congress has recognized this and has added provisions to the Social Security law to make nursing home Medicaid available to many middle class families. Contrary to popular belief, the typical Medicaid client is neither indigent nor very wealthy, but is generally a person of middle class means – a home, a car, a modest amount of financial assets.

To qualify for Medicaid, an individual must be medically needy and financially needy.  A person is medically needy if they are age 65 or over, blind or disabled as defined by Social Security.  A person is financially needy if in Virginia they have $2,000 or less in resources and monthly income of $2,094 or less.  However, there are some assets that are exempt from counting as a resource, such as the family home.

Spousal Medicaid rules differ from Individual Medicaid rules. But all Long-term Care Medicaid involves a 5-year “look back” period which requires disclosure of all financial transactions during the five years before an application is submitted. Prior to initiating a Medicaid application, we meet with the client for a thorough intake to assess eligibility. If needed, we recommend strategies for spending down excess assets and maximizing (or minimizing) income to reach allowable Medicaid levels.

Our firm handles the process so that the client can focus on caring for their ailing or disabled loved one. Prior to submission of an application, we review, collate, and prepare the application materials. We take the time to address potential “red flags” based upon the information the client provides before we present the Medicaid Application to the Medicaid Unit. We work closely with clients, assisting with obtaining documents and managing the application process. We clarify issues and follow up with the case worker. And we represent the applicant throughout the process until Medicaid benefits are approved.

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