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The 7 Tests of Medicaid Qualification. 2 Understanding What Medicaid Does/Doesn’t Do Medicaid pays for: Long term care in a nursing home Skilled nursing.

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Presentation on theme: "The 7 Tests of Medicaid Qualification. 2 Understanding What Medicaid Does/Doesn’t Do Medicaid pays for: Long term care in a nursing home Skilled nursing."— Presentation transcript:

1 The 7 Tests of Medicaid Qualification

2 2 Understanding What Medicaid Does/Doesn’t Do Medicaid pays for: Long term care in a nursing home Skilled nursing care at home, in some cases You are wondering: Will your loved one will get good care if on Medicaid? Will your loved one get into a good nursing home if Medicaid is in the picture? Will I have to go broke paying for nursing home care before I can get Medicaid?

3 3 The 7 Tests and The “Deal” You have to pass these 7 tests: 1. Sickness 2. Age 3. Citizenship 4. Residence 5. Income 6. Assets 7. Compliance The Medicaid “Deal” If you: Pass the 7 tests AND chip in your monthly income Then Medicaid will pay for Nursing Home care

4 4 What Does Medicaid Pay For? Does Pay for: Room and Board in a semi-private room All Medicines Health Insurance premiums (Medicare/Medigap) Physical/Occupational Therapy All medically necessary odds/ends Does not Pay for: TV and typical extras would normally pay for Private nurse

5 5 Tests One through Four Test One: Sickness Test Two: Age Test Three: Citizenship Test Four: Residence

6 6 Satisfying the Income Test Test Five: Income Maximum Allowable Monthly Income ($) If your Income is above: YOU FAIL If your Income is below: YOU PASS Qualified Income Trust* * The “Deal”: Income still goes to Nursing Home

7 7 Satisfying the Assets Test Test Six: Assets Be broke: Countable Assets must be less than $2000 Clothing Furniture Jewelry Art ? Available?Un-Available? House/Car (now)House/Car (later) Checking ($3000)Furniture ($2000) Checking ($1000*) Over 200,000 conditions to consider * Strategy: Convert a Countable Asset into a non-Countable Asset If Married*: (almost $100,000*) COUNTABLE ASSETS NON COUNTABLE ASSETS Investments

8 8 Satisfying the Compliance Test Test Seven: Compliance You can legally shelter assets as long as you play by the rules TIMING IS CRITICAL ASSET $100,000 Your Assets $2000 You Qualify! Within the Lookback? Penalty Due? Gifting

9 9 Qualifying for Medicaid GOOD NEWS: You don’t need to worry about all these rules and tests NESA We understand We’ll shelter every penny the law allows We provide Peace of Mind NESA cares for YOU


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