Contrary to what many people believe about Medicaid Asset Protection, the process DOES NOT involve hiding assets from Medicaid or the nursing home. Rather, Medicaid Asset Protection involves simply converting assets that Medicaid wants the applicant to spend into assets Medicaid will allow the applicant to keep without penalty.
The State of Florida has specific guidelines, including asset caps and income caps, for qualifying to receive Nursing Home Medicaid Benefits; Medicaid Eligibility Standards. These guidelines define which assets are "Countable" assets and which assets are "Non-countable" or "Exempt" and are thereby not used to calculate qualification for Nursing Home Medicaid benefits. Therefore, the secret sauce to "Medicaid Asset Protection Planning" involves restructuring assets that are "Countable" into assets that are "Non-Countable" or "Exempt".
To illustrate this concept, consider a piece of real estate that is "For Sale" at fair market value. Medicaid considers this to be an asset "Non-Countable" for calculating eligibility for Nursing Home Care payment. However, if the property sells, the funds received from the sale transaction are now considered a "Countable" asset for determining Medicaid eligibility.
It's important to understand that the "Medicaid Asset Protection Planning" process, in most cases, does not include simply giving the assets away to a child, relative, etc. In fact, gifting will generally (limited exceptions) create a Medicaid benefits ineligibility period. Rather, assets must either be converted to a "Non-Countable" or "Exempt" asset of relatively equal value.
The following is the Florida Administrative Code definitions of "Exempt/Excluded" resources:
(a) Resources of a comatose applicant (or recipient) are excluded when there is no known legal guardian or other individual who can access and expend the resource(s).
(b) The value of a life estate interest in real property is excluded.
(c) The cash surrender value of life insurance policies is excluded as resources if the combined face value of the policies is $2,500 or less.
(d) The individual, and their spouse, may designate up to $2,500 each of their resources for burial funds for any month, including the three months prior to the month of application. The designated funds may be excluded regardless of whether the exclusion is needed to allow eligibility. The $2,500 is not reduced by the value of excluded life insurance policies or irrevocable burial contracts. The funds may be commingled in the retroactive period.
(e) One automobile is excluded, regardless of value.
(f) Property that is essential to the individual’s self-support shall be excluded from resources if it is producing income available to the individual which is consistent with its fair market value. This includes real and personal property used in a trade or business; non-business income-producing property; and property used to produce goods or services essential to an individual’s daily activities. Liquid resources other than those used as part of a trade or business are not property essential to self-support. For the purpose of this section, mortgages are considered non-liquid resources, if they were entered into on or before September 30, 2004.
(g) An individual who is a beneficiary under a qualified state Long-Term Care Insurance Partnership Policy is given a resource disregard equal to the amount of the insurance benefit payments made to or on behalf of the individual for long term care services when determining if the individual’s countable resources are within the program limits to qualify for Medicaid Institutional Care Program (ICP), HCBS, the Program of All Inclusive Care for the Elderly (PACE), or hospice benefits.
It is important to understand that many of the Florida Medicaid Eligibility guidelines entail caveats that should be thoroughly discussed with a qualified Medicaid Attorney.
Medicaid Asset Protection Planning falls into two categories: "Pre-planning" and "Crisis Planning".
Medicaid Pre-planning involves "setting the table", so to speak, in the event that a long-term stay in a nursing home is necessary in the future. The assets, beneficiary statuses, titling, powers of attorney documentation, health care surrogates, probate avoidance, etc. have all been evaluated, documents prepared (perhaps executed) and an action plan has been formulated. If a long-term nursing home stay becomes necessary, the plan is set into motion, the application prepared and filed. In many cases, the applicant can then begin receiving Medicaid benefits from the very moment that Medicare coverage ends or Medicare co-pays are needed.
Medicaid Crisis Planning involves a loved one in immediate need of long-term nursing home care. Time is of the essence in this type of situation. Each day that passes without eligibility will result in approximately $270.00 ($8,000+ monthly) being added to the nursing home bill. While attorneys may be able to assist with "Medicaid Pre-planning", teamed with Platinum Benefit Services, Inc., they are well suited for the timely execution of "Crisis Medicaid Planning" and application filing because Platinum specializes in quick, accurate, and efficient plan implementation and application processing (far in excess of the capabilities of most attorneys).
The approach of a "Medicaid ICP" team is that Crisis planning is not simply doing whatever will get the applicant qualified. The approach will be to prepare an "Asset Protection Plan" that will take into account a wide range of scenarios for the applicant, as well as, the spouse. Then, in an expedited fashion, efficiently implement the plan and process the application until "APPROVED" is achieved.
Many unforeseen traps can be created by improper "Crisis Planning" and/or application processing. Traps such as excessive tax liability, unnecessary probate issues, ineligibility due to the community spouse predeceasing the applicant, missed deadlines, delayed approval due to the inability to properly convey Medicaid Policy to DCF staff, among many others.
With more than 6,000 cases successfully processed by Platinum Benefit Services, Inc., and, with our TEAM of other professionals operating within their respective roles, you can be assured that we will execute YOUR complete, concise, Medicaid plan and quickly navigate the application through the "Department of Children and Families" bureaucracy to obtain "APPROVAL" status.
Platinum Benefit Services, Inc. puts it in writing:
"100% Money Back Guarantee
if we fail to gain Eligibility for the month applied for."
With more than 6,000 approvals achieved resulting in more than an estimated $700 Million protected,
You Can Be Confident in Platinum Benefit Services, Inc Obtaining the All Important "APPROVED" Status!
Key elements of a proper "Strategy Implementation and Application Process".
- Written verification of applicant and community spouse assets
- Written verification of applicant and community spouse income
- Obtain appropriate bank statement and other assets to document and verify gifting
- Verification that all necessary documents described in the "Asset Protection Plan" are executed and available
- Packaging of all information for DCF
- Proper Completion of the Medicaid application
- Proper submission of the Medicaid application
- Proper submission of all supporting documentation
- Following of the application through the process
- Meeting all deadlines for additional requested information
- Holding the department to its own deadlines
- Challenging incorrect department findings
- Requesting, attending, and representing the applicant or applicant spouse at a Fair Hearing if necessary
- Obtaining approval status
- Filing for annual re-certification if requested by the applicant
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