MEDICAID: HOW TO MANAGE THE COST OF STAYING IN A NURSING HOME
P. Haans MulderCunningham Dalman, P.C.321 Settlers RoadHolland, MI 49423(616) [email protected]
Alzheimer's Association-West Michigan
Background• Grew up in Holland• Attorney and Partner at Cunningham
Dalman, P.C.• Masters in Tax, CFP®, and specialize in
estates/elder law and business planning
Serving the Holland area since 1900
Background• Cunningham Dalman, P.C. is located in
Holland and has been serving the greater Holland/Zeeland since 1900
• We have 14 attorneys specializing in all areas of the law
Serving the Holland area since 1900
Overview• Discuss the Medicaid process• Talk about the Medicaid eligibility rules• Cover recent new developments and
changes in the Medicaid rules
Serving the Holland area since 1900
What is Medicaid?• State and federal program that pays
for medical treatment (including nursing home care)
• Oftentimes confused with Medicare
Serving the Holland area since 1900
When does Medicaid apply?• Must be in a nursing home or be in
certain counties that have the MI Choice Waiver program
• Waiver program provides care in a person’s home and may cover residential facilities
Serving the Holland area since 1900
Who does Medicaid apply to?
• Applies to people who are 65 years or older, blind, or disabled
• Must satisfy the medical requirements (have level of care assessment done)
• Must meet income and asset tests
Serving the Holland area since 1900
Who does Medicaid apply to?
• You cannot have enough income to pay the monthly cost of staying in a nursing home ($6-7,000 in this area)
• Cannot earn more than $2,022/month for the MI Choice Waiver program
Serving the Holland area since 1900
Who does Medicaid apply to?
• Asset test requires that a single person cannot have more than $2,000 in countable assets
• Can keep your home (it’s not in your trust) and a vehicle
Serving the Holland area since 1900
Who does Medicaid apply to?
• Asset test allows a married couple to keep their home (again, if it’s not in a trust), a vehicle, and one-half of their other assets
Serving the Holland area since 1900
Where do you apply?• Apply for Medicaid at the Department
of Human Services (DHS)• DHS offices are located in each county• Apply to the county office that the
nursing home is located
Serving the Holland area since 1900
Example• Clients were husband and wife• Drafted an estate plan for them• A couple years later, the wife’s health
declined significantly and had to go to a nursing home
Serving the Holland area since 1900
Example• She didn’t stay in a hospital for three
days so Medicare didn’t cover any of the stay at the nursing home
• They had a house, vehicle, and investments
Serving the Holland area since 1900
Example• Could keep the house (because it was
properly owned) and their vehicle• Without any Medicaid planning, they
would have had to spend down one-half of their investments
Serving the Holland area since 1900
Example• Drafted a trust that allowed them to
protect all of their investments (as opposed to just half)
• This provided peace of mind to the husband
Serving the Holland area since 1900
New Developments-House• If the house is in your trust, it becomes
a countable asset• If it’s in your individual name, it will go
through probate• Probate could subject your house to
the Medicaid lien
Serving the Holland area since 1900
New Developments-House• Don’t have enough cash to pay the
costs of maintaining the house• House can be rented to pay these
costs• Evaluate whether it’s economically
feasible
Serving the Holland area since 1900
New Developments-Long Delays
• Process normally took 45-60 days• State of Michigan budget cuts have led
to long delays• This becomes very problematic if the
Medicaid application is denied
Serving the Holland area since 1900
New Developments-Technology• New computer system has caused
problems• Make sure to understand what the
Medicaid notices really mean
Serving the Holland area since 1900
Questions……
Serving the Holland area since 1900
Thank YouP. Haans MulderCunningham Dalman, P.C.321 Settlers RoadHolland, MI 49423(616) [email protected]
Serving the Holland area since 1900
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