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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.

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.

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.

The Spousal Assessment of Assets

Rich Shea — Tue, 16 Mar 2010 13:19:15 +0000

How will you be able to survive if your spouse needs expensive nursing home care? I hear this question a lot from families facing an unexpected nursing home placement. Unfortunately some families that contact me have already spent more of their own funds than they need to before qualifying for Texas Medicaid nursing home benefits. For the families that contact me early enough to protect assets for the healthy spouse or parent the process all begins with something called the “Spousal Assessment.”

The Spousal Assessment for Texas Medicaid is rather straightforward. It is a snapshot of a married couple’s combined countable resources. This snapshot is the starting point for determining the amount of assets the spouse at home will be able to keep while the spouse in the nursing home pursues Medicaid eligibility. The Spousal Protected Resource Amount is later determined from this initial assessment which many people do not even understand is taking place behind the scenes.

When Can You Initiate a Spousal Assessment

The request and assessment may be made any time from the beginning of the continuous period in an institutional setting to the date of application for Medicaid. Ordinarily this is handled by the Woodlands Medicaid Attorney handling the application for the family.

If you do not have a Woodlands Medicaid Attorney representing you then the couple must provide information on their resources and verification as required by HHSC. If the couple does not provide the verification within the time frame requested by HHSC, HHSC does not complete the assessment and takes no further action = no Medicaid benefits.

When is the Assessment Date

The couple’s combined countable resources are assessed as of 12:01 a.m. on the first day of the month in which the first continuous period in an institutional setting began. When determining the first day of the month in an institutional setting for the Spousal Protected Resource Amount, HHSC may count days the person spent in a hospital if the person admits directly from the hospital to an institutional setting. After the continuous period begins, hospital stays and therapeutic home visits are not considered as breaks in the 30-consecutive-day period.

Are You Giving Away Assets You Can Keep?

The Spousal Assessment procedure is a reminder of how important it is to understand the legal rights you have when faced with a nursing home situation. As I mentioned at the beginning, some families do not contact me until it is too late and they have already spent more than they need to. In situations like that, the family voluntarily gave up assets the healthy spouse was entitled to and it can make surviving that much more difficult for the healthy spouse when they are left with less assets than the law allowed them to keep. Don’t make the same mistake. Speak with a Texas Medicaid Attorney today to protect your rights and property.

The Spousal Protected Resource Amount

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/.

How Long Will You Have To Pay The Nursing Home Bill?

Rich Shea — Sun, 22 Nov 2009 12:44:53 +0000

Sometimes a loved one enters a nursing home as the result of the gradual progression of an illness such as Alzheimer’s. Sometimes a loved one needs nursing home care unexpectedly and everyone is caught by surprise and quickly finds themselves in a overwhelming situation. In either case, one of the vital questions you need to ask and prepare for is how long will your family have to pay the nursing home bill before your loved begins receiving Texas Medicaid benefits?

We’ve discussed specific eligibility issues such as assets and income in other articles. Today we are only looking at the timelines involved when a person meets the eligibility criteria for Texas Medicaid.

You may find yourself in the following situation:

Your loved one enters a nursing home on a random day of the month, let’s say October 10th.
Medicare covers the first 20 days but it becomes clear an extended nursing home stay is needed.
You consult with a Texas Medicaid Attorney on November 1st who prepares and files your Medicaid application on November 15th.
The application is approved December 10th.
When do Medicaid benefits begin?

Your loved one can be covered as of October 1st if all of the other criteria were satisfied as of October 1st, namely asset and resource eligibility.

If your loved one did not meet all of the eligibility criteria as of October 1st (which is common in cases where the nursing home admission is unexpected) your family may have to pay the nursing home bill until Medicaid eligibility is created which could be November 1st or December 1st in the above example. Exactly which date it is depends on how quickly you create Medicaid eligibility with the advice of a Texas Medicaid Attorney.

The important thing to remember about asset and income eligibility for Texas Medicaid is that it is only examined at the first moment of the month. By rule, if your loved one has too many assets or too much income as of that first moment of the month they are ineligible for Texas Medicaid nursing home benefits for the entire month and you will have to deal with an uncovered nursing home bill.

Create Medicaid Eligibility As Soon As Possible

In the above example the family began to work with a Texas Medicaid Attorney on November 1st. By that time it was already too late for the attorney to fix any eligibility issues to establish a benefits date of November 1st. The next earliest potential benefits date is December 1st, leaving the family to pick up the bill until then. If the family in the above example began to work with an attorney while there was still enough time in October, they may have been able to obtain a benefits date of November 1st.

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