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Texas Medicaid Eligibility 2012

Rich Shea — Tue, 03 Jan 2012 18:02:24 +0000

Certain numbers used to determine eligibility for Texas Medicaid benefits are subject to change every January 1st. For 2012 there was a change in the income limits while there was no change in the resource limits. Unfortunately the minimum and maximum Community Spousal Protected Resource Amounts remained the same. The current figures are listed below.

Income Limit for an Individual:$2,094/month

Income Limit for a Couple: $4,188/month

Resource Limit for an Individual: $2,000

Resource Limit for a Couple: $3,000

Home equity is limited to $500,000

Minimum Community Spousal Protected Amount: $21,912

Maximum Community Spousal Protected Resource Amount: $109,560

How Does this Impact Your Family?

If your loved one’s income or assets exceed the values listed above do not give up. A Houston Medicaid Attorney can help you establish Medicaid eligibility through proven techniques while protecting everything your family is entitled to protect. Act now to secure Medicaid eligibility and eliminate the uncertainty and restless nights wondering who will pay the nursing home costs of more than $100 every day. Remember, only you can protect your rights and property. Call The Shea Law Firm at (832) 592-7913 to get started today.

TexasTitle19.com is your connection to an experienced Houston Medicaid Attorney who can help you find the right nursing home, get the best care, and pay for it all without going broke. We are currently focused on Harris and Montgomery Counties, including the areas of Houston, Conroe, The Woodlands, Spring, Tomball, Humble, and Katy. We also provide consulting services throughout all of Texas.

The Right Time to Create a Miller Trust

Rich Shea — Tue, 18 Jan 2011 12:42:56 +0000

Everyone who comes to TexasTitle19.com to solve their Texas Nursing Home Medicaid eligibility issues is well aware that if a Texas Medicaid applicant receives more than $2,022 (for year 2011) in a month that person is not eligible in any way, shape, or form for Texas Nursing Home Medicaid unless they create a Miller Trust. So if you know you need a Texas Miller Trust in order to be eligible for Medicaid, then when is the time to begin the process and get everything setup?

For the people that I work with I recommend having the Texas Miller Trust signed and the bank account opened at least a month before you need Medicaid benefits to begin. Why? The reason is simple, if the income for any given month is not properly coordinated with the Texas Miller Trust then you can lose an entire month of Medicaid eligibility which could leave your family with a bill of a few thousand dollars in nursing home costs. When you have the Miller Trust prepared the month before you need Medicaid benefits to begin then I can guide you through the steps you need to take with the Miller Trust so your loved one is no longer over the income eligibility limit and Medicaid benefits can begin.

If you wait until after the Medicaid application is submitted, it may already be too late to use the Miller Trust to establish income eligibility for the month of application. Once the income for the month has been received and spent without a Miller Trust it cannot be undone.

Don’t make a costly mistake. Speak with a Texas Medicaid Attorney at (832) 592-7913 if your loved one needs Medicaid benefits to pay for nursing home care.

Medicaid Eligibility 2011

Rich Shea — Sat, 08 Jan 2011 23:53:31 +0000

Certain numbers used to determine eligibility for Texas Medicaid benefits are subject to change every January 1st. For 2011 there were no changes in the income or resource limits. Unfortunately the minimum and maximum Community Spousal Protected Resource Amounts remained the same. The current figures are listed below.

Income Limit for an Individual:$2,022/month

Income Limit for a Couple: $4,044/month

Resource Limit for an Individual: $2,000

Resource Limit for a Couple: $3,000

Home equity is limited to $500,000

Minimum Community Spousal Protected Amount: $21,912

Maximum Community Spousal Protected Resource Amount: $109,560

How Does this Impact Your Family?

Medicaid Mythbusters Part 2

Rich Shea — Tue, 14 Dec 2010 23:18:21 +0000

This is another installment in my mythbusters series to help get some accurate information out there concerning some popular myths that surround eligibility for Texas nursing home medicaid benefits.

Myth
You can make gifts within five years of applying for benefits and just not tell anyone; or the State of Texas will not find out.

Fact
A Medicaid application averages about 45-90 days before the HHSC makes a decision. What do you think they are doing during that time? They are investigating and looking for clues to any assets that may not have been identified on the application. And even if you slip by on the initial application, if the asset is discovered later on you will lose your benefits then and incur liability for the benefits the state already paid. Hoping that you do not get caught is not a strategy.

Myth
You can make gifts of real estate, or cash, or stock, without creating a penalty as long as they are “small”.

Fact
Gifts or any transfer where the Medicaid applicant or their spouse receives less in value than they transferred to another person are a minefield for the inexperienced. There is no blanket exemption that a person can gift without penalty like there is for federal gift tax purposes. Any gift or questionable transfer can be the basis of a penalty that disqualifies your loved one from Medicaid. Unfortunately too many people without proper advice end up spending several thousands of dollars on nursing home costs because they incurred a penalty over a few hundred dollars. Not a good trade in my opinion.

Myth
If you have a joint account with a family member or someone else and you simply remove your name from the account that is not a transfer resulting in a penalty.

Fact
Removing an account owner’s name from an account and cutting off their access to the funds in the account is a gift transfer which will result in a penalty and period of ineligibility. This is the same as writing a check for the full amount of the account to the other account owner.

Don’t make the mistake that ends up costing your family tens of thousands of dollars. The Texas Medicaid rules are very harsh and do not distinguish between “innocent” mistakes and intentional acts to deceive. Protect yourself and your property with an experienced Texas Medicaid Attorney today.

Medical Necessity and Nursing Home Medicaid

Rich Shea — Thu, 09 Dec 2010 11:41:39 +0000

In order to qualify for nursing home Medicaid benefits the applicant must have a “medical necessity” to be in a nursing home. If you do not have a valid medical necessity then you will not be eligible for Medicaid. What is a “medical necessity?”

A Medical necessity exists when a person meets all of the following criteria:

(1) The individual must demonstrate a medical condition that:

(A) is of sufficient seriousness that the individual’s needs exceed the routine care which may be given by an untrained person; and

(B) requires licensed nurses’ supervision, assessment, planning, and intervention that are available only in an institution.

(2) The individual must require medical or nursing services that:

(A) are ordered by a physician;

(B) are dependent upon the individual’s documented medical conditions;

(D) are provided either directly by or under the supervision of a licensed nurse in an institutional setting; and

(E) are required on a regular basis.

This decision is generally made by the staff at the nursing home the Medicaid applicant resides at. It is a medical decision, but it can be appealed by your Medicaid Attorney if you believe the staff made a wrong decision. Get help today if your loved one needs nursing home Medicaid benefits.

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Medicaid Mythbusters

Rich Shea — Thu, 25 Nov 2010 13:23:34 +0000

The Medicaid nursing home benefits program causes a lot of confusion. Part of why I publish this website is to get accurate information out there into your hands so you don’t make a decision based on rumors, stories, and other inaccurate sources of information. There are a lot of popular misconceptions about eligibility for Texas Medicaid. Let’s take a look at some of them.

Myth

You can make small or large gifts to family members within five years of applying for benefits and still qualify for Medicaid benefits without penalties.

Fact

There is no annual limit you can give to family members that will not create a penalty for Medicaid eligibility. Any gift can create a penalty. The confusion that sparked this myth is the annual gift tax exclusion which only applies to gift taxes and has no impact on Medicaid.

Myth

Your parent will lose everything before he or she can receive Medicaid benefits.

Fact

Potential Medicaid applicants do have some flexibility in making the most of their assets before qualifying for nursing home benefits. Married applicants can usually protect a sizable amount of assets for their spouse, and unmarried applicants can usually get more with their remaining assets than simply paying the nursing home bill until everything is gone.

Do not spend all of your money on nursing home bills. Find out how you can protect yourself and your family with a Texas Medicaid attorney.

Medicaid Mythbusters Part 2

Funeral Contract Mistakes

Rich Shea — Sun, 21 Nov 2010 13:05:13 +0000

Before spending all of their assets many families that work with an experienced Medicaid Attorney purchase a funeral contract for the Texas Medicaid recipient. The reason is simple, once the family member is on Medicaid they will never be allowed to have more than $2,000 in assets. Funerals generally cost a lot more than $2,000 so it makes sense to use some of the remaining funds to provide for this future need while the funds are available now.

Funeral contracts are like any other contract and can be a bit complicated. In any given funeral contract you may have 3 different roles to identify: purchaser, owner, and beneficiary. Unfortunately, many of the funeral contracts I see that people have purchased without legal advice are not setup in the proper way. These families often end up with a family member who has power of attorney for the Medicaid applicant being identified in the contract as the owner or purchaser. That is not the best way to setup a funeral contract if you want to go “by the book” and minimize potential problems during the 45+ day Medicaid application review period.

Speak with a Texas Medicaid Attorney and get help if you want to avoid mistakes like these before and during an application for Medicaid nursing home benefits.

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When Does Income Become a Resource?

Rich Shea — Mon, 12 Apr 2010 11:46:22 +0000

What happens to income after you receive it? As we have covered in other articles Texas Medicaid has very specific rules for the treatment of income and the treatment of assets. Therefore, it is critical your Houston Medicaid Attorney understands when property is labeled as income and when it is labeled as a resource.

The General Rule of Income for Texas Medicaid

Income is anything a person receives in cash or in kind that can be used to meet the person’s needs for food and shelter. It is the receipt of any property or service a person can apply, either directly or by sale or conversion, to meet basic needs for food and shelter. Income is normally counted on a monthly basis.

Is Income Always Treated as Income?

No. The legal definition of income for Texas Medicaid eligibility only applies for a limited time. For example, if you receive pension checks that you do not spend but rather deposit into a separate bank account where nothing else goes; is that account treated as income because that is all that was deposited into it? Unfortunately no, property loses its label as income through the passage of time, not through how it is used.

For Texas Medicaid the receipt of a payment – in the form of cash, property, or service – is income in the month of receipt and a resource as of 12:01 a.m. on the first day of the month after receipt. If you receive a payment on April 26th the payment may be treated as income only until 12:01 a.m. on May 1st.

Sort Out Income and Resources

Speak with a Woodlands Medicaid Attorney today if you need help sorting out what property is treated as income and what property is treated as a resource for Texas Medicaid eligibility. The wrong identification of property can cost your family thousands of dollars in unpaid nursing home bills while the mistakes are remedied.

Texas Medicaid Eligibility for 2010

Rich Shea — Wed, 06 Jan 2010 13:00:26 +0000

Certain numbers used to determine eligibility for Texas Medicaid benefits are subject to change every January 1st. This year there were not many changes. Unfortunately the minimum and maximum Community Spousal Protected Resource Amounts remained the same. The current figures are listed below.

Income Limit for an Individual: $2,022/month

Income Limit for a Couple: $4,044/month

Resource Limit for an Individual: $2,000

Resource Limit for a Couple: $3,000

Home equity is limited to $500,000

Minimum Community Spousal Protected Amount: $21,912

Maximum Community Spousal Protected Resource Amount: $109,560

How Does this Impact Your Family?

If your loved one’s income or assets exceed the values listed above do not give up. A Houston Medicaid Attorney can help you establish Medicaid eligibility through proven techniques while protecting everything your family is entitled to protect. Remember, only you can protect your rights and property. The nursing home and the DADS are not responsible for helping you with asset protection. Call (832) 592-7913 to get started today.

It Counts: Individual Retirement Accounts

Rich Shea — Wed, 02 Dec 2009 12:24:47 +0000

Retirement accounts can cause a lot of confusion when planning for Texas Medicaid eligibility. This is in large part due to the many different kinds of retirement accounts out there. Today we are going to look at one very common kind of retirement account, the individual retirement account, or IRA. This includes the traditional IRA and the Roth IRA. Many families saved funds in these accounts during their lifetime, but what happens to them when the owner of the account or their spouse needs Medicaid nursing home benefits?

§358.435(d) — The resource value of a time deposit is the net amount due after penalties are imposed for early withdrawal. If the funds cannot be withdrawn before maturity, the time deposit is not a resource until it matures. Time deposits include but are not limited to certificates of deposit, savings certificates, and individual retirement accounts (IRAs).

The Texas Health and Human Services Commission takes the approach that the availability of funds is the controlling factor in determining whether a time deposit such as an IRA is a resource. They examine the terms of the account to determine when the funds can be withdrawn and which penalties to impose. An early withdrawal penalty does not change the HHSC’s view that the account is still a counted resource. The penalties for withdrawal will be subtracted from the total value to determine its resource value.

Put simply, the balance of the retirement account counts as a resource for the purpose of determining eligibility. You may have to face penalties and other negative consequences, but the bottom line is if you can get the funds out of the account under any circumstances, then it counts.

Evidence Needed

If the Texas Medicaid applicant or their spouse own an individual retirement account the more information you can provide to your case worker the faster your case can be decided. Some of the documents you should begin gathering with your Houston Medicaid Attorney are account statements and letters from the financial institution establishing any early withdrawal penalties.

TexasTitle19.com is your connection to an experienced Houston Medicaid Attorney who can help you find the right nursing home, get the best care, and pay for it all without going broke. TexasTitle19.com is currently focused on Harris and Montgomery Counties, including the areas of Houston, Conroe, The Woodlands, Spring, Tomball, Humble, and Katy. If you need legal assistance for eligibility or a Miller Trust, learn more about the author at http://SheaLawOnline.com/.