Posted by: Thomas D. Begley, Jr.
In 1988, Congress passed the Medicare Catastrophic Coverage Act (MCCA). Pub. L. No. 100-360 codified at 42 U.S.C. § 1396p(c) as amended by 42 U.S.C. § 1396r-5. Provisions of this Act were designed to avoid impoverishing the community spouse. For example, since October 1, 1989, the income of the community spouse is no longer deemed available to the institutionalized spouse at any time for the cost of care. In addition, the community spouse is entitled to a Minimum Monthly Maintenance Needs Allowance (MMMNA), which may come in whole or in part from the income [...]
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Filed under Library, Medicaid Planning, Medicaid Planning.
Tags: Medicaid Planning
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Posted by: Susan Green
An important issue in New Jersey probate litigation for the past two decades has been whether or not guardians can undertake Medicaid planning on behalf of their wards. Since 1995, many Courts in New Jersey have begun to permit guardians to transfer assets in order to expedite his or her ward’s eligibility for Medicaid benefits. For several years, no statute or regulation existed to authorize this planning, nor was there any written opinion from the Appellate Division or state Supreme Court to provide direction to the Superior Courts. Fortunately, New Jersey courts have rendered decisions over the past few years, [...]
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Filed under Medicaid Planning, Medicaid Planning.
Tags: Medicaid Planning
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Posted by: Begley Law Group
The previous blog discussed the importance of ensuring that plaintiffs in personal injury lawsuits obtain the best possible medical coverage. This blog continues the discussion and focuses on other medical insurance that may be available. This includes: • Medicare. A person receiving SSDI for two years will receive Medicare. It is important to obtain a Medicare supplement, if at all possible. There is an open enrollment period for Medicare supplements for six months after the Medicare recipient obtains Medicare Part B. Another option is to enroll in a Medicare Advantage Plan. There is an open enrollment period for Medicare Advantage [...]
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Filed under Medicaid Applications, Medicaid Planning, Medicaid Planning.
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Posted by: Begley Law Group
Not all cases require a Medicare Set-Aside Arrangement. It is important for personal injury attorneys to understand when a set aside is required and when it is not. While the MSA protects the client and the personal injury attorney, it does reduce the pool of money available from the settlement to be used by the client for other purposes. Therefore, the goal is always to avoid establishing an MSA, if prudently possible. Here are some important considerations: • No Future Care Related to Injury. The theory is that it is not fair for a plaintiff in a personal injury action [...]
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Filed under Medicaid Planning.
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Posted by: Thomas D. Begley, Jr.
Introduction Continuing Care Retirement Communities (CCRCs) are an excellent alternative for long term care for the middle and upper middle income population. These facilities offer residents an active lifestyle with many friends and plenty of activities. In fact, most people enter CCRCs close to their home and know a certain number of residents upon admission. A good CCRC can provide an excellent lifestyle for senior citizens. The person to whom the CCRC appeals is an adult who wants recreation and activities, wants to know that his health care costs are covered at a fairly foreseeable fixed fee, and wants daily [...]
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Filed under Medicaid Planning, Medicaid Planning.
Tags: Medicaid Planning
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Posted by: Thomas D. Begley, Jr.
Long-term care is a problem affecting all economic strata. Financing long-term care is uniquely a middle class problem. It is not just a problem for the elderly; it is an inter-generational issue. One-third of all Americans receiving long-term care are under 65. The elderly receiving long-term care are the parents of children of middle age or the grandparents of Generation Xers. The system or delivery of long-term care in the United States is fragmented. We need to develop an integrated system of medical and personal services required by individuals who have lost some capacity for caring for themselves due to [...]
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Filed under Library, Medicaid Planning, Medicaid Planning.
Tags: Medicaid Planning
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Posted by: Thomas D. Begley, Jr.
A state is entitled to recover for Medicaid payments correctly paid on behalf of the individual by use or real or personal property liens and recovery from decedents’ estates. 42 U.S.C. § 1396p(b)(1)(B); HCFA Transmittal 63; N.J.S.A. 30:4D-7.2 et seq.; N.J.A.C. 10:49-1 et seq. The state is required to seek reimbursement from an individual’s estate for the cost of nursing facility services. 42 U.S.C. § 1396p(b)(1)(B). However, no recovery may be made until after the death of the recipient’s surviving spouse, and only when there are no surviving children who are under age 21 or blind or permanently disabled. A. [...]
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Filed under Medicaid Applications, Medicaid Planning, Medicaid Planning.
Tags: Medicaid Applications, Medicaid Planning
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Posted by: Thomas D. Begley, Jr.
Prepared for The Medicaid Long Term CareFunding Advisory Council by Thomas D. Begley, Jr. 1. BACKGROUND The Independence, Dignity and Choice in Long-Term Care Act1 has a stated goal of rebalancing state long-term care programs and budgets so that more older adults and persons with disabilities live in their homes and communities.2 The Act acknowledges that it is easier for adults and persons with disabilities to qualify for Medicaid long-term care coverage if they are admitted to a nursing home than if they seek to obtain services through one of the Medicaid home and community-based long-term care options.3 Many of [...]
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Filed under Medicaid Planning, Medicaid Planning.
Tags: Long Term Care, Medicaid Planning
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Posted by: Thomas D. Begley, Jr.
If an SSI recipient or spouse of an SSI recipient disposes of resources for less than fair market value during a 36-month lookback period,1 the individual is ineligible for benefits for a period of time. The period is calculated by dividing the uncompensated value of the transfer by the amount of the maximum monthly benefit payable, including any state supplement.2 The penalty is rounded to the nearest whole number with a cap of 36 months.3 The penalty begins the first month in or after which resources were transferred which does not occur during any other period of ineligibility.4 The exemptions [...]
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Filed under Library, Medicaid Planning, Medicaid Planning.
Tags: Medicaid Planning, SSI
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Posted by: Begley Law Group
There are a great many public benefit numbers and tax numbers that are adjusted on an annual basis. This chapter is designed to make these numbers readily available to Elder Law practitioners. The following are current numbers for 2010. I. 2010 FIGURES A. Medicaid $2,022 Income Cap [1] $109,560 Maximum Community Spouse Resource Allowance (CSRA) [2] $21,912 Minimum CSRA [3] $2,739 Maximum Minimum Monthly Maintenance Needs Allowance (MMMNA) [4] $1,821.25 MMMNA (July 1, 2009 until June 30, 2010) [5] $546.38 Excess Shelter Allowance (July 1, 2009 until June 30, 2010) [6] $2,000 Maximum Resource Limit (individual) [7] B. Social Security [...]
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Filed under Medicaid Applications, Medicaid Planning, Medicaid Planning, Personal Injury Consulting.
Tags: Medicaid Applications, Medicaid Planning, Personal Injury Consulting, SSI
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