Medicaid is a federal health insurance program that helps low-income people get the medical care they need. It is run jointly by the state and federal governments. To qualify, an applicant must meet specific criteria for age, income, assets, and healthcare needs.
Medicaid can also deny or disqualify people from the program if they fail to follow proper guidelines. A Texas Medicaid applications and enrollment lawyer can help you make sure you’re taking the right steps to get the coverage you need.
At Marc Whitehead & Associates, our Texas Medicaid eligibility and asset protection lawyers have helped Texans with complicated legal issues since 1992.
Who Is Medicaid for?
Medicaid is for low–income individuals and families, as well as people with disabilities and special health care needs. It is an important resource for people who otherwise would not be able to afford quality healthcare, especially children and older Texans.
To be eligible for Medicaid in Texas, you must meet the basic requirements. A Medicaid applications and enrollment attorney in Texas can tell you if you meet the application criteria for age, income, assets, and care needs.
Medicaid is sometimes confused with Medicare, another federal healthcare program available to people over the age of 65. Although they are very different programs, some people may be eligible for both.
Do You Need an Attorney to Apply for Medicaid?
You can apply for Medicaid at any time on your own; however, by doing so, you risk making a mistake that could cause your application to be denied. A Texas Medicaid applications and enrollment attorney can help you with the process.
When you are denied from the Medicaid program, you delay getting the care you need for yourself or your family. An attorney can ensure you follow the correct steps and don’t miss any important information so your enrollment goes smoothly.
A lawyer can help you:
- Understand the Medicaid program
- Devise a plan for your estate
- Check your eligibility before applying
- Prepare the necessary documents
- Submit paperwork
- Appeal or contest a denial
- Stay up to date on changes to the program
Medicaid for Skilled-Nursing Residents
Nursing home residents are another group that benefits from Medicaid. However, if they have significant income and assets, their path often differs from that of other applicants. Many skilled-nursing residents are ineligible for Medicaid when they first move into a nursing home.
They are required to spend down their assets until they are eligible. This means exhausting savings and other resources. Some assets, such as your family home, may be exempt from consideration for Medicaid eligibility. Consult with an attorney to find out.
Medicaid can cover the difference between what a nursing home resident can pay on their own and the total cost of care. However, debt accumulates each month during the resident’s skilled nursing stay, and when the resident dies, the state will seek to recover those costs.
The Texas Medicaid Estate Recovery Program
If you have benefited from Medicaid during your skilled-nursing stay, the state of Texas will put a claim against your estate when you die to recover your costs of care. This can mean losing major assets such as a family home, even if it is willed to someone.
Some assets, such as retirement accounts and life insurance, may be exempt from the estate recovery process. There also are ways to protect your assets if you work with an attorney and plan ahead.
Estate recovery is a major concern for Medicaid recipients in nursing homes and their families, especially when it could mean losing a property that has been in the family for decades. A Medicaid application and enrollment lawyer in Texas can help you understand your options.
The Medicaid 5-Year Lookback Rule
When you apply for Medicaid as a nursing home resident, they will ask about your assets. This includes things like your savings, your home, valuable possessions, and automobiles. There are some exceptions to what you must include. Generally, they want to know what your estate is worth.
However, they also want to know about any assets you sold or gave away over the last five years. This is known as the lookback period, and making a mistake here can mean you are ineligible for Medicaid.
For example, you may not give away money during the lookback period, except as specified by Medicaid rules. You may not sell your home for less than fair market value. It is important to talk to a lawyer so you fully understand what you can and can’t do with your assets.
How to Protect Your Assets From Medicaid
It is smart to begin the estate planning process as soon as possible. An attorney can help you understand your options for protecting your assets, so when it comes time to apply for Medicaid, you won’t risk your eligibility.
Medicaid typically does not require applicants to sell their homes to be eligible. However, the home could be part of the estate recovery program. To protect it, you may consider a trust or a life-estate deed, or selling to a loved one for fair market value.
Protecting your assets from the Texas Medicaid estate recovery program requires careful planning and getting an early start. While they are your assets to do with what you wish, making a mistake means losing out on your eligibility.
Connect With a Texas Medicaid Applications and Enrollment Lawyer
If you intend to apply for Medicaid, it is smart to take the time to understand the program and what it takes to qualify. The sooner you can do this, the better, as Medicaid requires a 5-year lookback period for asset transfers.
To remain eligible, you must manage your finances and assets correctly and meet additional criteria for income, residency, and care needs. If this sounds confusing, that’s because it is. A Texas Medicaid applications and enrollment attorney can help you make sense of it all.
Our team at Marc Whitehead & Associates have over 120 years of experience helping Texas citizens understand complicated insurance, disability, and health care issues. Contact us today.