Your Trusted Partner For Medicaid Approval
Expert guidance with dedication, diligence, and empathy.
Navigating Medicaid can be complex
and challenging. Let Us Handle It For You.
We will guide you through the Medicaid process, beginning with a complimentary introductory consultation and continuing until Medicaid approval.
Assess
Income and Asset Assessment
We begin with a complimentary consultation to educate you on the Medicaid process and guidelines, followed by a review of your income and assets to determine eligibility.
Apply
Medicaid Application Support
We assist in gathering the required information for the Medicaid application, review the financial details and complete the application on your behalf.
Advocate
Advocate for approval
Medicaid applications can be denied for various reasons. We provide advocacy in cases of improper denial.
About Us
Protecting Your Assets, Securing Your Future
Eldercare Resource Solutions was founded on the basis of advocating for the elderly. We have years of experience working in the front lines of skilled nursing and assisted living facilities.
We understand the worry and fear that families experience when faced with the daunting task of paying for long-term care.
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Your Pathway to Medicaid Approval
At Eldercare Resource Solutions, our goal is to clarify the Medicaid application process and offer expert, personalized guidance at every step. We allow you to prioritize your well-being while securing the benefits you’re entitled to.
Our Services
Expert Planning, Trusted Solutions.
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Eldercare Financial Guidance
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Medicaid Education (rules are complex)
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Asset Protection
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A Note from Our Founder
FAQs
Frequently Asked Questions
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Why should I hire Eldercare Resource Solutions? Can’t I just do this on my own?
You can fill out the Medicaid application yourself, although there are many factors to consider. In addition to the headache of gathering, organizing and disclosing five years of financial information, the documentation and presentation of the information is critical. A large transaction that is mistakenly presumed to be a divestment may result in an incorrect penalty or a denial. A loss in Medicaid coverage for a nursing home that costs over $10,000 a month can be catastrophic. We will also determine if you are eligible for Medicaid. Many are under the misconception that they aren’t eligible for Medicaid until all of their money has been spent. If you are over the asset limit, we will review spenddown alternatives with you. A professional with a deep understanding of the Medicaid rules can help avoid missteps that can lead to avoidable periods of ineligibility and financial devastation.
What is the Medicaid Lookback period?
The lookback period for every state is five years with the exception of California, that has a lookback period of 30 months. In order to qualify for Medicaid, a person’s assets cannot be greater than a certain limit. Medicaid will review your past transactions within the lookback period to make sure you didn’t give away your assets to reach this limit. There are many rules that determine whether a transaction is considered a divestment in the eyes of Medicaid. Some examples of divestments are giving money or property as gift, selling an asset for less than the market value, and purchasing an asset for more than the market value.
If Medicaid determines that a divestment has taken place, they will impose a penalty. Medicaid penalties are not monetary penalties but are delays in eligibility. If Medicaid imposes a penalty, the applicant will be required to pay privately until the penalty period expires.
What is a Medicaid penalty and how is it calculated?
A Medicaid penalty is imposed if it is determined that an applicant achieved Medicaid eligibility by gifting assets during the lookback period. The Medicaid penalty is actually a delay in eligibility and is not a monetary penalty. The Medicaid penalty is calculated by dividing the total amount of the gift by a penalty divisor, which varies by state.
As an example, suppose a Medicaid applicant gifted a car worth $10,000 to her granddaughter. If the penalty divisor in her state is $5,000, then the payments of Medicaid benefits will be delayed by two months.
Why do I need Medicaid? Won’t Medicare pay for my nursing home stay?
Medicare and Medicaid are two entirely different programs. Medicare is a health insurance program that covers nursing home care for a set period of time after a person has had a qualifying hospital stay. Medicare will pay the full amount for the first 20 days, and requires a co-payment for the next 80 days. Medicare coverage will only continue if the person’s condition improves to the level he or she was at before the illness occurred. Lastly, Medicare is not a means-tested program. People qualify for Medicare at any income level.
Medicaid, on the other hand, is a long-term care payment source for those that meet certain eligibility requirements. Medicaid pays for nursing homes, assisted living facilities (not all states) and home care. In order to qualify for Medicaid, a person’s assets and income must be below certain eligibility criteria. Lastly, Medicaid will seek reimbursement of the benefits paid after the Medicaid recipient passes away. This is known as estate recovery.
Will Medicaid allow gifts as long as I stay withing the IRS guidelines?
This is a common area of confusion. The IRS gift exemption, which addressed income tax thresholds for gifts, is completely separate from the Medicaid guidelines. In other words, even though a gift complies with the IRS guidelines, it will be considered a penalty-causing divestment by Medicaid.
