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Understanding the Difference Between Medicare and Medicaid Coverage for Long-Term Care in Michigan

Why is it important to know the difference between Medicare and Medicaid?

This article discusses the difference between Medicare vs Medicaid medical insurance in long-term custodial care, also known as nursing home care, in Michigan. It is important to understand these distinctions as they can significantly impact an individual's ability to access the health coverage needed for necessary medical treatments. Medicare health insurance only covers up to 100 days in a skilled nursing facility.  Most people will need the assistance that Medicaid coverage provides.

This article is not intended to provide legal advice.  It is for general informational purposes only.

Summary

    • Long-term care prices in Michigan are increasing more than the national trend, which means that someone just using Medicare might not be able to afford the treatments they need while in the facility. 

    • Medicare part A only covers up to 100 days in a skilled nursing facility, and any services provided...

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Program of All-Inclusive Care for the Elderly (PACE)

With PACE, teams of health care professionals focus on the unique needs and circumstances of participants, and their families, to make sure participants receive the coordinated care they need.

 

The Program of All-Inclusive Care for the Elderly (PACE) is a program that helps seniors meet their health care needs at home & in their community as an alternative to a nursing home or other care facility.

SERVICES

With PACE, an individualized plan of care is developed and maintained by a team of health care and service professionals to meet specific needs. These services include all Medicare and Medicaid-covered services and may include, but are not limited to:

  • Primary and Specialist Care (including Women's Health)
  • Medications
  • Medical Transportation
  • Therapy (Occupational, Physical, Speech)
  • Recreational Day Center Activities
  • Home Care
  • Hospital & Emergency Services
  • Dental
  • Vision
  • Hearing
  • Foot Care
  • Nursing Home
  • End of Life Supportive Care

In Michigan, the areas serviced by PACE...

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Revocable Living Trusts (Part 2) With Nicole Wipp

Revocable Living Trusts (Part 2) with Nicole Wipp

This is Part 2 of a two-part series on Revocable Living Trusts. To listen to Part 1, Click Here.

Options

When it comes to revocable living trusts, people often don’t know the options that they may be able to include to protect loved ones.  When given these options, however, many people definitely want them!  Know the different types of options you can have to help those you love and help ensure your money goes to who you want, when you want, in the way you want.

Thank you for listening!

 

Be a SMART PLANNER!

Contact Us Today at (248) 278-1511. We Can Help.

The information in this podcast is not intended to be, nor should it be, construed as legal advice. It is for informational purposes only. For advice, specific to your situation, consult with a qualified attorney.

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What Are the Rules for Medicaid Qualification (Part 5)? - 60 Months

What Are the Rules for Medicaid Qualification (Part 5)?

As in part four of our series, your Medicaid planning advisor can best help you determine how the rules apply to your specific circumstances in your specific locality. Before you get into the specifics, however, it’s a good idea to familiarize yourself with the general federal guidelines for Medicaid qualification that apply everywhere.

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Do I Have to Wait 60 Months?

The Asset Transfer "Box”

Many people believe that if you give your assets away, you must wait 60 months to qualify for Medicaid. This is not the case. The 60 month requirement only applies to the financial disclosure you must provide, not eligibility.

Think of it this way: When you go to apply for Medicaid, imagine you’re bringing a box with you. In that box is every financial transaction you’ve made for the previous 60 months. That is all you need to provide – if you made a transaction 61 months ago, it’s not...

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What Are the Rules for Medicaid Qualification (Part 4)? - Allowable Income

As part 3 of our series, your Medicaid planning advisor can best help you determine how the rules apply to your specific circumstances in your specific locality. Before you get into the specifics, however, it’s a good idea to familiarize yourself with the general federal guidelines for Medicaid qualification that apply everywhere.

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Allowable Income

How much income are you allowed under Medicaid law?

There are different answers for the “community spouse” and the individual who resides in a nursing home.

  • Nursing home residents can only keep $60 a month as a personal needs allowance – the rest of their income must go to help cover the cost of their care.
  • If the resident is married, the community spouse can keep between $2.288/.75 - $3,435.00 a month (in 2022), including income from the nursing home spouse.
  • Many states permit the community spouse to retain all of their individual income without limit. In other states, the community...
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What Are the Rules for Medicaid Qualification (Part 3)? - Property Liens

As in part two of our series, your Medicaid planning advisor can best help you determine how the rules apply to your specific circumstances in your specific locality. Before you get into the specifics, however, it’s a good idea to familiarize yourself with the general federal guidelines for Medicaid qualification that apply everywhere.

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PROPERTY LIENS

In addition, the state can place a lien on an unmarried Medicaid recipient’s home, unless certain dependent relatives live on the premises or the state permits a “Homestead Exemption”.

Sale of the property, while the person receiving Medicaid is still living, could result in the loss of Medicaid coverage (due to excessive assets) and an obligation to use the sale proceeds to satisfy the lien that Medicaid places against the home.

There are exceptions to this rule. Satisfaction of the lien is not required if the applicant returns home prior to their death or one or more of the following...

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What Are the Rules for Medicaid Qualification (Part 2)? - Estate Recovery

What Are the Rules for Medicaid Qualification (Part 2)?

As in Part One of our series, your Medicaid planning advisor can best help you determine how the rules apply to your specific circumstances in your specific locality. Before you get into the specifics, however, it’s a good idea to familiarize yourself with the general federal guidelines for Medicaid qualification that apply everywhere.

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ESTATE RECOVERY

What happens to a Medicaid recipient’s estate when he or she passes away? Like so much else, that depends on whether they have properly planned to protect it.

When a Medicaid recipient dies, the state may attempt to recover the benefits paid to that individual from his or her estate – that is a requirement under federal Medicaid law. However, the state cannot proceed with this recovery process if any of the following applies:

  • if the recipient’s spouse is still living
  • if the recipient has a child under age 21
  • if the recipient has a...
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Discharged From Rehab: Is Your Loved One Really Ready?

One of the things that we hear (a lot) from clients is how panicked they are when a loved one that has been in rehab is being suddenly discharged - but the family doesn't think they're really ready to go home - or, even worse, the family is told that their loved one is being discharged but needs 24/7 care or supervision.

Very few families are ready for this. The logistics of getting care for a person in a home environment may seem easy (just hire someone!), but most families, when faced with the cost, realize that this is not a long-term solution. That's when the questions start:nursing home medicaid

  • Should you quit your job, to care for your loved one?
  • Should you hire someone anyway, even if you (or they) can't afford it long-term?
  • What benefits might be available to pay for care?
  • How long will it take for benefits to kick in?
  • What happens if benefits aren't enough - or if there are no benefits available?

Timing: Seeking Answers Before Your Loved One Is Discharged From Rehab Is Crucial

It is...

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Medicaid Planning - Things to Remember

Get The Help (and Protection) That You Deserve. 

Though there are many complexities to Medicaid planning, it’s important to understand Medicaid is there to help families like yours. Medicaid planning is the best way to ensure you receive the benefits to assure you protect as much of your hard-earned assets as the law allows, and to receive the care you need.

It is also important to understand that Medicaid planning may be a necessary component in ensuring that the spouse “left behind” is not left in poverty. The first step in Medicaid planning is education. The more you know about how Medicaid works, the better you will be able to look out for the interests of your family.

For more detailed information, it’s best to consult with a qualified legal advisor. So think of this as an introduction.

Things to Remember... 

It’s NEVER Too Late

Medicaid planning can begin anytime, even if your loved one is already living in a skilled care facility....

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Medicaid Planning - The Facts

MEDICAID PLANNING

The Facts...

Assets in a Revocable Living Trust are not protected and must be used to pay for the costs of long term care.

If you are married, your home is exempt and cannot be taken when applying for Medicaid.  If you are single or widowed, your home is exempt up to $552,000 (2015). If you transfer your home to your children, not only will it result in immediate ineligibility for Medicaid, but it could also:

  • Trigger a gift tax,
  • Result in the loss of your homestead tax exemption, and,
  • Result in your child’s spouse (the in-laws) inheriting your home. 

Giving your assets away means losing control. It’s not safe even if you “trust” who you give it to. If that person divorces, goes bankrupt or is sued, all of the money you transferred is at risk. There are asset protection trusts that permit you to keep 100% control of your assets without the risk of losing them if long-term care is needed.

You do not have to wait 60 months to...

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