Michelle Dempsey answers questions about qualifications for applying for Medicaid benefits to help pay for longterm care in Connecticut.
Among other things, it’s a group of federal/state funded programs that can help pay for nursing home and long term home care costs for the elderly and disabled. This is also the umbrella term for a host of other programs, each of which has their own eligibility criteria, target population and benefit levels. And the terms Title XIX, Title 19 and Medicaid can be used interchangeably, as they all refer to the same group of programs.
As conservator, you can be held liable if you delay or do not complete a Title XIX application for the conserved individual, especially when the conservatee is in a nursing home. Most conservators are unfamiliar with the program and have no idea what to do and when to do it. Michelle Dempsey can help you complete the application correctly and in a timely manner.
The simplest answer is that for most Medicaid programs a recipient can have:
- $1,600 in assets
- Irrevocable pre-paid funeral contract of $10,000
- Burial plot or burial space contract, which can ONLY include the following: burial plot, headstone, casket or cremation urn, outer burial container, opening/closing of the site.
- Life insurance policies are often the most difficult assets to determine when they count as part of the $1,600 in assets and when they don’t, especially whole life insurance policies. The actual wording of the rules is difficult and often misinterpreted, so beware.
- Term Policies – Exempt
- Group & Retiree Policies with NO cash value – Exempt
- Whole Life Policies*
If the face values of all policies are added together and the resulting amount is $1,500 or less – Exempt
- If the face values of all policies are added together and the resulting amount is $1,501 or more – NOT EXEMPT! The CASH value of all policies will count as part of the Title XIX recipient’s asset limit.
* Subject to certain restrictions
Yes. But Title XIX applications for married couples have become more complicated. The minimum amount of assets can be increased from $27,480 up to a maximum of $137,400 when a spousal assessment is done. Don’t assume that if your assets fall in that range that you are automatically financially eligible. The amount a married couple can keep varies from family to family and an accurate spousal assessment is a critical aspect in determining when a married couple is financially eligible for Title XIX assistance.
The healthy spouse may have:
- the primary residence*
- one vehicle
- Minimum of $27,480 in cash and other assets up to a maximum of $137,400*
- Whole life insurance policies where the couple’s total face value is $1,500 or less are exempt, otherwise, the cash values of all the policies will count toward the asset limit*
- Like the Title XIX recipient, the healthy spouse is also entitled to an irrevocable pre-paid funeral contract of $10,000 and burial plot, all term, group, and retiree life insurance policies (provided they have no cash value).
* Subject to certain restrictions6
The initial consultation fee is $150. Pricing ranges from $2,750 to $6,500, depending on the circumstances. Factors that go into determining the fee include: whether you are single or married, whether it is a homecare application or nursing home long term care, how complex the case might be, and how many accounts are in the lookback period. Homecare applications look at all transactions of $1,000 or more compared to $5,000 or more for nursing home applications. Since homecare applications are more time consuming to review and prepare, it is reflected in Michelle’s pricing.