A Medicaid specialist, also known as a Medicaid consultant, assists people in qualifying for Medicaid without depleting their assets and resources. Medicaid, a government insurance program funded jointly the US federal government and individual state governments, is intended to cover the costs of healthcare for the poor, but it also serves as the insurer of last resort for long-term care. Americans may seek the help of a Medicaid specialist in this area to help them navigate the sometimes complex rules, as well as the asset and income limitations imposed on applicants for government insurance.
In the United States, Medicaid covers the cost of medical services for those who cannot afford them and do not have health insurance. In general, the average American who cannot afford medical services or health insurance qualifies for Medicaid without difficulty, and no professional consultant is required to assist with the application process. Long-term care, on the other hand, is not medical care; only about 5% of the care provided to such patients is medical, with the rest consisting of custodial tasks such as bathing, dressing, and eating. In general, older people require the most long-term care, but because it is not medical care, Medicare, the American medical insurance for the elderly, only covers a small portion of such costs.
Long-term care costs are generally met the wealthy, either from their own resources or through long-term care insurance. The poor usually qualify for Medicaid, so they’re already covered if they need long-term care. The middle class, on the other hand, often cannot afford long-term care insurance due to the high premiums, and their savings and other resources may not be sufficient to cover an extended period of care, especially if a nursing home is required. A Medicaid specialist can assist these individuals in qualifying for Medicaid without “spending down” all of their assets.
Some assets are considered “countable” and others are considered “non-countable” when determining Medicaid eligibility, according to state-by-state rules. In 2010, for example, a person with assets of no more than $2,000 USD and a monthly income of $50 USD or less could be considered poor. When considering a couple, the spouse who does not require long-term care — the “community spouse” — can keep all of his or her income and half of the couple’s assets up to $110,000 USD, including a house, car, and some other personal belongings such as clothing and jewelry. Anything over these annual inflation-adjusted limits must be used to pay for medical or long-term care through a “spend down” process. The Medicaid specialist will examine the couple’s assets and income and devise a strategy for spending the least amount of money possible during the process, preserving as much of the estate as possible.
Many people in the United States believe that as they get older, they will simply pass their assets on to other family members. The problem with this strategy is that Medicaid has a legal right to a five-year “look back” period, allowing it to reverse any such transactions made in the five years prior to the Medicaid application, or to hold the couple financially responsible for the value of any such transactions. A good Medicaid specialist, on the other hand, will know how to legally reclassify assets and even income to reduce the impact of a spend-down while also preserving the estate.