Non Countable Assets Research Paper

Certain assets of the beneficiary are exempted from determining eligibility under for SSI and Medi-Cal purposes (generally the same items). (42 U.S.C.A. § 1382b and 42 U.S.C.A. § 1396p(h) and Cal. Code Regs. tit. 22, § 50418.) Exempted assets are listed in the statute and generally include those assets listed under “Permissible Distributions” in the section below, Allowed Distributions. Those resource limits are $2,000 for an individual or $3,000 for a couple. (20 C.F.R. § 416.1205, Cal. Code Regs. tit. 22, § 50419 and Cal. Code Regs. tit. 22, § 50420.) Also, for eligibility purposes, the income and resources of a minor child are deemed to include the income and resources of the parents. (20 C.F.R. § 416.1202(b).)

Contact your county department of health or DSS to apply for Medicaid. You must fall into a certain financial classification in order to qualify for Medicaid. It may be in your best interest if your assets or income is greater than the allowable limits to work with an elder law attorney or eldercare financial planner in order to restructure your assets. If you are medically and financially eligible, you must go through the Managed Medicaid Long Term Care Program or Community First Choice to access the CDPAP program.

The asset eligibility limit in Hawaii is $2,000. This means that a Medicaid applicant can only have $2,000 worth of eligible assets in order for Medicaid to cover their full long-term care costs. Despite not qualifying as a requirement, there is a limit to the amount of a grantor’s equity interest is in their primary residence. According to the Medicaid website, as of 2013, an applicant cannot have an equity interest of more than $840,000 fair market value in their primary residence. (Hawaii Medicaid Nursing Home Information & Rules For 2017, n.d.)

Some of the items that are covered in the Spousal Impoverishment Protection Program is automobiles that the couple owns, Businesses, houses, farming assets. And the reason why it is important for the community spouse to be protected while the other spouse is in a nursing home. Is because nursing home cost a lot of money for the individual to sustain care in the nursing home and the nursing home will take all of the assets from both individuals to pay for the care of the spouse that is in the nursing home while the other spouse is left with no income to take care of themselves and keep their individuality and their pride. And the reason why it is important for the spouse to be protected by this program is so the spouse that is living in the

First of all, keeping track of a monthly spend down of an elderly, disabled patient is ridiculous. In Mrs. Jackson’s case, she needed Medicaid to cover her transportation needs. Its close to impossible to schedule appointments and procedures if you are not sure how you are going to get there. Other patients use Medicaid for numerous reasons. A better option for Medicaid would be to take an average of a few months expenses and use that to determine eligibility for longer than a month at a time. It is common for patients to spend the same amount on medication each month. They also try to visit doctors on a regular basis. Knowing they are covered by Medicaid for longer than a month, would be a huge relief. The patients could keep their appointments without worrying about transportation costs. Also, medicine could be taken as directed instead of trying to make it last longer in fear of losing coverage the next month. Another area which needs addressing is in the area of medically necessary items. Who determines if adult diapers is necessary or a convenience? For an elderly person who does not want to walk to the wash room after going to the bathroom, I can see how diapers would be convenient. But what about the person with no legs and not adequate enough help to lift them out of bed? I would definitely say adult diapers is medically necessary for this person.

In order to qualify for Medicaid individuals must meet certain regulations. Eligibility depends on each state, age and whether the individual is a U.S. Citizen, blind, pregnant, single parent, or suffers from any disabilities; all of this plays a huge role in the Medicaid eligibility criteria. Although, some immigrants may be able to benefit from this program, if the immigrant is a woman whose labor and delivery of child is taken care of inside the U.S. that is enough to make them eligible for Medicaid (Medicaid, 2012). Even though the states are allowed to provide their own regulation guidelines along with other decisions for this health program, there are certain mandatory federal requirements that must be met by each state in order to receive funding. Some of those requirements include; inpatient hospital service, prenatal care, vaccines for children, rural health clinic services, transportation services and many others that according to the federal government are extremely essential for the management of this program ("What is medicare/medicaid?," 2012).

Spousal Impoverishment protection law applies for the nursing home admission for the spouse. The purpose of the law is to allow the community spouse to keep some of the couple’s income and assets while still qualifying the nursing home spouse for Medicaid. The Law was amended in 1988. The program also allows the spouse at home or also known as the community spouse to maintain their income and independence financially. It also protects items like the couple’s home, vehicle, funeral cost, and household goods. The program is simple and helps to keep the other spouse at home and not on the streets and not have to rely on other people help for

Many nursing homes assume in error that if a patient has stopped making progress towards recovery then Medicare coverage should end. In fact, if the patient needs continued skilled care simply to maintain his or her status then the care should be provided and is covered by Medicare.In fact, patients often receive an array of treatments that don 't need to be carried out by a skilled nurse but that may, in combination, require skilled supervision.Even in cases where the SNF initially treats the patient as a Medicare recipient, after two or more weeks, often, the SNF will determine that the patient no longer needs a skilled level of care and will

There are approximately 9 million dual eligibles based on CMS data. People who are dual eligibles suffer from multiple chronic and complex medical issues compared to those who are Medicare only. They are more likely to have severe mental disorders, be disabled, and live in an institution and have poor health status. Dual eligibles are also noted to be of low socio-economic status, with more than half earning less than $10,000 annually. The 2016 MedPAC reports showed that 59% of dual eligibles are 65years or older and the rest are less than 65 and disabled. The report also showed that 20% of the Medicare and 14% of Medicaid beneficiaries are dual eligibles. This group utilized 35% ($114.1 billions) of all Medicare and 33% ($180.2 billions) of all Medicaid expenditure for the 2011 calendar

A patient must fall into one of the defined categories. Poverty is a requirement but it alone does not qualify.

This includes individuals considered to be medically frail, American Indian/Alaska Natives, pregnant women, and dual eligible beneficiaries. Alternative Medicaid assistance is provided to those who fall under these categories (Medicaid Expansion in Arkansas, 2015).

The amount of money the state is leaving on the table over the next decade due to the lack of expansion is $5.3 billion. Medicaid is available for pregnant women with incomes 139% of FPL, children with incomes up to 200% of FPL, and parents with incomes up to 51% of

Taking care of the individuals that are getting older takes many different needs. Most of these needs cannot be given from the help of a family. This causes the need of having to put your love one into a home and causing for the worry of how they will be treated. It is important for the family and also the soon to be client to feel at home in their new environment. This has been an issue with the care being provided for each individual, which has lead to the need of making sure individuals have their own health care plan.

Usually Medicare does not pay for long-term care; it will only pay for medically necessary skilled nursing facilities or home health care. With Medicare certain criteria has to be met for certain conditions for Medicare to pick up the cost. Medicare also does not pay for any kind of long-term care that helps assist with activities of daily living. This kind of care includes dressing, bathing, and using the bathroom. Medicare Advantage plans can offer limited skilled nursing facility and home care coverage if the patient’s long-term care is medically necessary. Medicaid offers coverage for both medical and non-medical associated long-term care, but the person will only qualify if they have less than $2000 in assets and income that is inadequate to pay for the cost of their care. If a veteran is at least 70% service connected disabled the Veterans Administration will pay the costs of long-term care for life. Long-term care that is not provided by the government is usually paid out-of –pocket by family members. Most people choose the option of home health care because long-term care is too costly.

We all know that nursing home is extremely expensive and not everyone can afford it. I personally think that there is not enough Medicaid to help people who need it the most. Many people want to go a nursing home, but they do not have Medicaid to pay for it. Medicaid becomes important for some families when their parents cannot no longer take care of themselves in their own home. Some people do find a way to get Medicaid to cover them but it is not going to do a lot. Nursing home facilities are doing business and they also need to pay their employees I guess that is why Medicaid is really expensive. I do not know anyone who uses Medicaid spend down, but when my parents get older I will observe them to see if they will use Medicaid spend