Can My Parent Still Qualify For Medicaid If They Live With Me
- May 19, 2015
If your parent is living with you, he or she can still qualify for Medicaid.
It is very common for a parent who is ill, or one that requires some care, to move in with an adult child in order to receive the care and attention they need. Typically in these situations, the child will pay many of the parents expenses, which can deplete the childs financial resources. What is equally as important to realize, is that taking on the role of caretaker can also be taxing on the childs time, energy, and emotions.
It is also not uncommon for one child to pay all or a majority of the expenses while his or her siblings pay a lesser amount. It may be that the caretaker child does not think it is worth asking for money for groceries, gas money for doctors visits, and medical co-pays, from his or her siblings, but these small amounts can add up to significant expenses when taken in the aggregate.
For this reason, it may make sense to help your parent apply for
This would help alleviate some of the stress financial expenses. It may also help avoid the resentment that can occur between siblings.
It is important to speak with a qualified professional who can guide you through the pitfalls of the Medicaid application and help you with your parents Medicaid planning.
Eric J. Einhart-Guest Blogger
Reduced Coverage / Medicare Cost Sharing Or Premium Payment
Qualified Medicare BeneficiariesCovered group: individuals covered by MedicareIncome limits: Income cannot exceed 100% of the federal poverty level. For more information, view the Guidelines for Medicare Cost-Sharing Programs brochure.Age: Medicare beneficiaries of any ageQualifications: Individuals must be eligible for Medicare Part A hospital insurance.
Specified Low-Income Medicare BeneficiariesCovered group: individuals covered by MedicareIncome limits: Income cannot exceed 135% of the federal poverty level. For more information, view the Guidelines for Medicare Cost-Sharing Programs brochure.Age: Medicare beneficiaries of any ageQualifications: Individuals must have Medicare Part A
Qualified IndividualsCovered group: individuals covered by MedicareIncome limits: Income cannot exceed 135% of the federal poverty level. For more information, view the Guidelines for Medicare Cost-Sharing Programs brochure.Age: Medicare beneficiaries of any ageQualifications: Individuals must have Medicare Part A
Medicaid Coverage Improves Families Access To Care Health And Financial Security
A large and growing body of research shows Medicaid expansion has improved access to medical care and health for parents and other adults with low incomes. In Arkansas and Kentucky, parents and other adults with low incomes saw significant gains in access to care and improvements in self-reported health compared to those in Texas, which hasnt expanded Medicaid. And mental health outcomes improved among parents who gained Medicaid coverage through pre-ACA increases in state eligibility limits.
Improved parental access to care and health is important to their children because childrens health and development depends in part on their parents health and well-being. Childrens relationships with their parents can influence their brain structure and function, such as by mitigating the negative effects of trauma, poverty, or other adverse childhood experiences. For example, maternal depression can negatively affect childrens cognitive and social-emotional development as well as their educational and employment outcomes.
Research also confirms that coverage gains for parents, and the associated gains for children, improve childrens access to care. For example, a 2017 study found that children are 29 percentage points more likely to have an annual well-child visit if their parents are enrolled in Medicaid.
Read Also: Does Medicaid Cover Family Therapy
Lawfully Residing Targeted Low
States have the option to provide CHIP and Medicaid coverage to children and pregnant women who are lawfully residing in the United States and are otherwise eligible for coverage, including those within their first five years of having certain legal status. If states do not adopt this option, federal law requires a 5-year waiting period before many legal immigrants are permitted to enroll in Medicaid and CHIP. Learn more about providing health coverage to lawfully residing children and pregnant women at 2107 of the Social Security Act, and in SHO# 10-006 . A list of states providing Medicaid and CHIP coverage to lawfully residing children and/or pregnant women.
Using A Supplemental Needs Trust
If the daughter sets up a third-party Supplemental Needs Trust for her mom, then the daughter can put money into the trust, and the trust can pay for any goods or services not covered by Medicaid, such as clothing and technology, and it will have no effect on the Moms Medicaid eligibility. Whether the Trust can be used for the cost of a private room depends on the state, as described above.
A third-party Supplemental Needs Trust is a legal trust created for the benefit of a disabled person, typically over 65 years old. SNTs are intended to enhance quality of life while maintaining eligibility for government benefits, which are funded by assets of a person other than the beneficiary, such as a family member. SNTs are traditionally not included as countable assets for Medicaid eligibility purposes . Thus, SNTs are an excellent option for those looking to help an elderly family member.
SNTs have a variety of limitations. Funds are distributed by a trustee and are paid directly to the third parties who provide the goods or services. Funds can only be used for supplemental items for beneficiaries such as clothing, transportation, technology, and travel. SNT funds cannot be used to buy food, toward shelter costs, or for medical care which Medicaid would otherwise cover. Finally, the remainder beneficiary must be Medicaid.
Recommended Reading: Medicaid Services Department Frankfort Ky
What Is Considered A Household For Medicaid
Because Medicaid eligibility depends on household size and income, you may want to understand what counts as a household. Medicaid usually defines households based on tax relationships.
Parents can claim adult children as dependents under some circumstances. If your parent claims you as a dependent on their taxes, your household is the same as theirs. That means your household includes:
- The parent’s spouse
- Any other person your parent claims as a dependent
If no one claims you as a dependent, your household usually consists of yourself, your spouse and anyone you claim as a dependent. Sometimes an adult child is living with a sick or disabled parent, and in these situations, the child may claim the parent as a dependent. However, any income received by your parent still counts toward your household income.
Your parents will always be considered part of your household if you are under 19 and live with them, regardless of tax filing status. Be aware that there are limited exceptions to these rules, and some states have slightly different ways of defining households.
Can My Father Repay A Loan Without Affecting His Medicaid Application
This really depends on the actual documentation and the practice in your state. If by documentation you mean a promissory note, repayment should work. But if its simply documentation that the money came from your sister, it probably wont. To be certain you would really have to consult with a local elder law attorney. The other option would be to reimburse your sister, making sure that she understands that if it doesnt work shell have to return the money to your father.
For more about Medicaid’s asset transfer rules, .
Local Elder Law Attorneys in Your City
You May Like: Kansas Nursing Homes That Accept Medicaid
Monitoring Substitution Of Coverage In Chip
States are required to include in their state plan a description of procedures used to ensure that CHIP coverage does not substitute for coverage under group health plans. States use various procedures to prevent substitution of coverage, such as monitoring survey data or private insurance databases, or applying a waiting period for individuals who are no longer enrolled in private coverage. This requirement can be found at section 2102 of the Social Security Act. Additional information on states specific CHIP waiting period policies.
How Can My Parents Protect Their Savings When They Apply For Medicaid
The rules differ so much from state to state that it can be difficult to advise you. In general, assuming your parents are 65 or older, if both are seeking Medicaid coverage, they must spend down their savings to $3,000 . If only one is seeking coverage, the other may be able to keep all of the savings.
Your parents can spend down by paying for whatever they need, including paying you fair market rent. They can also prepay for their funerals admittedly a bit morbid. However, in most cases they cannot give their money away. Doing so could cause them to be ineligible for Medicaid for up to five years. But even this isnt certain. While such a transfer penalty always applies to Medicaid in a nursing home, some states dont apply it to Medicaid coverage while living in the community.
Local Elder Law Attorneys in Your City
Recommended Reading: How To Renew Medicaid Nc
Using An Annuity For Medicaid Planning
An annuity is a regular stream of payments back to you, in exchange for a lump sum of money. It can be either a private arrangement or commercial . Medicaid only allows commercial annuities.
For example, if you are a male, age 70, you could transfer $50,000 to an insurance company in exchange for a monthly annuity payment of $400, guaranteed for your life, no matter how long you lived. But what if you died unexpectedly after two years? The annuity payments would stop. Most people do not like that, and therefore will typically purchase the annuity with a “guarantee period” of at least a certain number of years.
According to the Medicaid rules, a male age 70 has a life expectancy of 12.8 years. So you cannot purchase an annuity with a guarantee period that exceeds 12.8 years without causing a period of disqualification from Medicaid. So let’s stick with 12.8 years to be safe. Because you are guaranteed payments for the longer of your life expectancy or 12.8 years, the monthly payments will be lower. In this example, they drop from $400 to $354 per month.
So if the Medicaid “bill” is for two years of Medicaid coverage, it could easily be in the amount of $96,000 . Since that exceeds the value of the annuity, the state will receive all of the remaining payments and your family will get nothing.
- How much money is there to invest in the annuity?
- What is the age of the nursing home resident?
- What is the expected life expectancy of the resident?
Who Is Eligible For Medicaid
You may qualify for free or low-cost care through Medicaid based on income and family size.
In all states, Medicaid provides health coverage for some low-income people, families and children, pregnant women, the elderly, and people with disabilities. In some states the program covers all low-income adults below a certain income level.
- First, find out if your state is expanding Medicaid and learn what that means for you.
- If your state is expanding Medicaid, use this chart to see what you may qualify for based on your income and family size.
Even if you were told you didn’t qualify for Medicaid in the past, you may qualify under the new rules. You can see if you qualify for Medicaid 2 ways:
- Visit your state’s Medicaid website. Use the drop-down menu at the top of this page to pick your state. You can apply right now and find out if you qualify. If you qualify, coverage can begin immediately.
- Fill out an application in the Health Insurance Marketplace. When you finish the application, we’ll tell you which programs you and your family qualify for. If it looks like anyone is eligible for Medicaid and/or CHIP, we’ll let the state agency know so you can enroll.
Recommended Reading: How To Stop Medicaid Benefits
Effective Date Of Coverage
Once an individual is determined eligible for Medicaid, coverage is effective either on the date of application or the first day of the month of application. Benefits also may be covered retroactively for up to three months prior to the month of application, if the individual would have been eligible during that period had he or she applied. Coverage generally stops at the end of the month in which a person no longer meets the requirements for eligibility.
Can I Be Claimed As A Dependent If I Have Medicaid
Having or not having Medicaid has no effect on whether your boyfriend can claim you as a dependent or not. He can claim you as a dependent if in addition to being a citizen of the US or a resident of the US, Canada or Mexico: he provides more than 1/2 of their support, you earn less than $3,900 in gross income subject to tax . you don’t file a joint return with another you live with your boyfriend all 365 days of the year
Don’t Miss: Medicaid Healthy Connections Phone Number
Do I Qualify For Medicaid
Medicaid provides free or low-cost health coverage to some low-income people, families and children, pregnant women, the elderly, and people with disabilities. Many states have expanded their Medicaid programs to cover all people below certain income levels. Medicaid qualifications depend partly on whether your state has expanded its program.
Purchasing Items & Paying Bills On Someones Behalf
If the daughter pays Moms bills herself, for example, pays the assisted living community directly for the difference between a shared and a private room, then the money will be considered an in-kind payment. In-kind payments impact Supplemental Security Income and could lower public assistance payments made to the mother by up to one-third.
Depending on the state in which the mother resides, the daughters assistance could also make her mother ineligible for Medicaid. However, in some other states, known as Family Supplementation states, the daughter is allowed to help her mother and her assistance has no impact on her mothers Medicaid eligibility.
Family supplementation was created to enable families to help in these situations without jeopardizing the elderly family members Medicaid eligibility. What can be paid for is restricted by state. So while family supplementation is an effective way to give Mom or Dad money to help pay their bills, it could cause some problems. Furthermore, not all states allow for family supplementation. It is best to check with a Medicaid expert in your state before purchasing items or paying bills for a loved one who is receiving Medicaid-funded care.
How Medicaid Works With Other Coverage
You may still qualify for Medicaid even if you have other health insurance coverage, and coordination of benefits rules decide who pays your bill first. In this case, your private insurance, whether through Medicare or employer-sponsored, will be the primary payer and pays your health care provider first. Medicaid comes in as second insurance to settle what your private insurance doesnt pay, up to its limit.
If you have both Medicaid and private health insurance, you should show both your private health insurance card and Medicaid card to your medical provider every time you receive services.
A health-service provider who accepts both your Medicaid and private insurance card wont bill you for copayments or deductibles.
Any money received from an insurance company or as compensation for a medical care lawsuit must be used to pay the health provider. If Medicaid already has covered the cost of care, you must make a refund to Medicaid. If your private insurance is through an employer-sponsored plan, you may be an eligible candidate for the Health Insurance Premium Payment program. HIPP is a voluntary program that may pay your insurance premium as long as you or a family member qualifies for Medicaid coverage.
If your service provider wont take your Medicaid and private insurance card, your insurance company may help you locate a doctor in its provider network.
How To Apply For Medicaid In Florida
Knowing where and how to apply for Medicaid in Florida is important for residents who need medical benefits assistance. Petitioners must complete the FL Medicaid application form properly as well as submit the required documents. The Medicaid application and associated paperwork helps officials determine who is eligible for Medicaid coverage. Prospective applicants wondering where to apply for Medicaid in FL may be surprised about the methods and locations available for signing up for government assistance. To find out more about applying to Medicaid in Florida, continue reading the outlined information below.
Where do you sign up for Medicaid in Florida?
To find out where to apply for Medicaid, you first must look at all the options available in Florida. Applicants can apply for Medicaid online, by mail, in person or via fax. For those who have questions about Medicaid eligibility requirements, applying for Medicaid in person may be the best option, as there are representatives to assist with the process. Please be aware that enrollment in Medicaid is not lifelong. Recipients will have to reapply for Medicaid every 12 months or another predetermined time period.
Information Required on the Medicaid Application Form in Florida
The Florida Medicaid application form requires you to give a lot of details about yourself and your family. Regardless of how and where you apply to Medicaid, you will need to provide the following information:
You May Like: What Kind Of Insurance Is Medicaid
Opt For Professional Guidance
Now, folks, this sounds simple, but let me warn you. Do not try this on your own without competent legal advice! There are a number of details that I omitted for simplification, and the rules of each state vary on exactly how this approach can be implemented. Nonetheless, it can be a powerful technique to save your family many thousands of dollars in the right circumstances.