What You Need to Know to Qualify for Medicaid Nursing Home Coverage

No one wants to spend their twilight years in a long-term care facility, but for many North Carolina residents, that situation becomes a necessary reality. The benefits of having access to constant medical care at any time of day can’t be overlooked. Unfortunately, nursing home stays can very quickly drain your funds and leave nothing left over for your family.

Due to the prohibitively high cost, programs like Medicaid are an option many seniors consider to cover nursing home expenses. Qualifying for Medicaid coverage can be an absolute minefield, however, as the program has a complicated application system that includes unexpected restrictions. 

If you’re considering Medicaid for a nursing home stay, you need to consult an medicaid planning attorney who is well-versed in crafting elder law plans to avoid many common pitfalls during the process.

Qualifying for Medicaid 

Both a state and federal program, Medicaid provides access to healthcare services for those with low incomes. It’s particularly helpful for elderly North Carolina residents in covering Medicaid-certified beds at long-term care facilities.  

With extremely strict rules on assets, it is all-too-easy to be denied Medicaid coverage or booted off the program after you’ve already settled into a nursing home. These are the basic thresholds you need to hit to qualify for Medicaid assistance: 

• No more than $2,000 in countable assets
• Monthly income must be less than the cost charged by the nursing home

Those are extremely hard caps with little-to-no wiggle room, as nearly 100% of your monthly income must go towards the nursing home stay. Under current Medicaid rules, only $30 is allowed per month to cover personal costs. If your spouse remains at home rather than living in the nursing home alongside you, however, they have no limit on monthly income amounts. 

It’s the asset cap that frequently trips people up, however, as having even a penny over $2,000 in countable assets disqualifies you from coverage. That limit can be confusing for people who haven’t used Medicaid before, as countable assets don’t just include your actual cash on hand. You also need to count the value of: 

• Stocks
• Bonds
• Savings accounts
• Life insurance policies
• Additional vehicles or homes if you own more than one of either

How an Elder Law Attorney Helps With Medicaid Eligibility

It’s your money. You worked for it, so you should get to keep as much of it as possible, even if you need to utilize Medicaid to help cover a nursing home. There’s no need to lose sleep over planning to pay for an extended nursing home stay within these strict rules because a lawyer can help. 

An adept elder law attorney can utilize creative methods to convert your countable assets over the $2,000 cap into what’s known as “non-countable” form transparently and completely legally. Many people preparing for a nursing home stay attempt to skirt asset rules on their own by gifting money, vehicles, or second homes to family members. This practice causes major problems in qualifying for Medicaid due to the program’s five-year look-back period. Any assets you gifted during this time will reduce your coverage, even if you gave the assets to your spouse. 

If you already went this route before consulting an attorney, that is a hurdle that can be overcome. Legacy Lawyers utilizes outside-the-box solutions with patented trust types that other elder law attorneys can’t offer. It is possible to reverse those transfers and avoid the look-back penalties with our patented trust.

Whether you are already in the nursing home or are getting ready to make the move, an elder law attorney assists in filling out your Medicaid application in the right way so you keep as much of your assets as possible now, and ensure those assets stay with your family after you pass away.

Contact a Wilmington Elder Law Attorney Today for Peace of Mind

You don’t need to lose all your assets to the nursing home or the government during a nursing home stay, because we’ve got a large and varied legal toolbox to help. Not all tools work for all situations, but we can find one that’s right for you. Setup a free consultation with Legacy Lawyers today to make sure you are cared for, the nursing home gets paid, and your family retains your assets.