New York Medicaid eligibility rules impose strict limitations on who can qualify for Medicaid coverage. Unfortunately, for those who do not qualify, the financial consequences can be severe. If you require costly medical care or if you need nursing home care, you could end up spending a lot of your personal wealth if you don’t qualify for Medicaid. This can be an especially big problem for seniors who have often worked hard to acquire savings and who end up needing nursing home care and having to spend their assets if their savings prevents Medicaid eligibility.
If you know the New York Medicaid eligibility requirements, you may have options to try to make sure you can qualify for coverage when you need it. Mark S. Eghrari and Associates PLLC can help.
Our Suffolk County Medicaid planning lawyers assist clients of all ages in understanding why they may need to qualify for Medicaid and what they must do to prove their eligibility. Our legal team can also help you to create an advanced plan so you can get covered when you need it.
Why is New York Medicaid Eligibility Important to You?
New York Medicaid eligibility is of vital importance because Medicaid is likely the only insurance provider who will pay for nursing home care costs. Medicare pays for skilled medical care services only in a nursing home setting. While this means you could get Medicare to pay if you need rehab services or require bandages changed after surgery, Medicare won’t pay for routine custodial care. Most private insurers won’t pay for routine care either.
This is a big issue because the average cost of a nursing home is astronomically expensive. New York State Department of Health has a summary of different nursing home costs statewide. Costs can range from $111,024 per year to $151,596 per year in and around the Long Island area. Suffolk and Nassau County have the most expensive average nursing home rates in the state, at an average cost of $415 per day.
Paying these costs can mean you spend your entire life savings very quickly when you need custodial care in a nursing home. You don’t want to waste all of your money just because you happen to be unlucky enough to need nursing home care- you want your assets to go to children, relatives, or charities that you care about.
In order to avoid having to spend all of your money, you need to be able to be eligible for Medicaid coverage.
How Can You Ensure New York Medicaid Eligibility?
Because Medicaid is means-tested, you must have limited resources to qualify for coverage when you need it. For seniors with a nest egg and assets, it is difficult to ensure you are able to get benefits. If you don’t take action in advance of the time when you need nursing home care, you could end up having to spend down your assets.
Fortunately, there are ways to structure the ownership of your assets strategically so you do not end up having to spend down your money and potentially even liquidate property just to pay nursing home bills. You can work with a New York Medicaid eligibility lawyer to create a comprehensive Medicaid plan. This usually involves the creation of an irrevocable trust which you transfer assets into. Not only will those assets not count as a resource for Medicaid eligibility but the assets also will not be subject to Medicaid estate recovery, which is a process that occurs after your death in which the state tries to recoup some of the money spent on providing medical care to you.
Medicaid planning must occur at least five years prior to the time of your application for Medicaid benefits, because otherwise transfers of assets to the trust could trigger a period of disqualification from Medicaid coverage. However, even if you must go into a nursing home sooner than five years from the time when you seek legal help, you may be able to protect some of your assets if you speak with an attorney and discuss your options for securing Medicaid eligibility.
Getting Help from a New York Medicaid Eligibility Lawyer
Mark S. Eghrari and Associates PLLC will provide you with comprehensive help in protecting your assets while ensuring you meet New York Medicaid eligibility requirements. To find out more about the ways in which we can assist you, give us a call at (631) 265-0599 or contact us online to schedule a consultation.
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