Medicaid and Elder Law:

"Medicaid is health insurance that helps many people who can't afford medical care pay for some or all of their medical bills.

Good health is important to everyone. If you can't afford to pay for medical care right now, Medicaid can make it possible for you to get the care that you need so that you can get healthy and stay healthy.

Medicaid is available only to people with limited income. You must meet certain requirements in order to be eligible for Medicaid. Medicaid does not pay money to you; instead, it sends payments directly to your health care providers. Depending on your state's rules, you may also be asked to pay a small part of the cost (co payment) for some medical."[http://www.cms.hhs.gov/MedicaidEligibility]

Are you or your loved one eligible?

The Law Offices of Mary K. Kelly, Esq. can help you apply for Medicaid benefits if you are aged (65 years old or older), blind, or disabled and have limited income and resources. Further, if you are terminally ill and want to get hospice services, we can help. Also if you are aged, blind, or disabled; live in a nursing home; and have limited income and resources we can help you get benefits. Finally, if you are aged, blind, or disabled and need nursing home care, but can stay at home with special community care services, call us. We can help you apply if you are eligible for Medicare and have limited income and resources.

Note in Nassau and Suffolk County, the expense of nursing home care, which ranges from $10,000 to $14,500 a month or more, can rapidly deplete the lifetime savings of elderly couples. In 1988, Congress enacted provisions to prevent what has come to be called "spousal impoverishment," which can leave the spouse who is still living at home in the community with little or no income or resources. These provisions help ensure that this situation will not occur and that community spouses are able to live out their lives with independence and dignity.

The spousal impoverishment provisions apply when one member of a couple enters a nursing facility or other medical institution and is expected to remain there for at least 30 days. When the couple applies for Medicaid, an assessment of their resources is made. The couple's resources, regardless of ownership, are combined. The couple's home, household goods, automobile and burial funds are not included in the couple's combined resources. The result is the couple's combined countable resources. This amount is then used to determine the Spousal Share, which is one-half of the couple's combined resources.

To determine whether the spouse residing in a medical facility meets the state's resource standard for Medicaid, the following procedure is used: From the couple's combined countable resources, a Protected Resource Amount (PRA) is subtracted. The PRA is the greatest of:

• The Spousal Share, up to a maximum of $109,560 in 2009;
• The state spousal resource standard, which a state can set at any amount between $21,912 and $109,560 in 2009;
• An amount transferred to the community spouse for her/his support as directed by a court order; or
• An amount designated by a state hearing officer to raise the community spouse's protected resources up to the minimum monthly maintenance needs standard.

At our Law Offices we can help you determine if you and your loved one can qualify for Medicaid. Call us at 631-691-2823.