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The Top Eight Mistakes People Make With Medicaid Qualification

The eight biggest mistakes people make in attempting to qualify for Medicaid for long-term skilled nursing care are:

  1. Thinking it’s too late. It is almost never too late to take planning steps, even after a senior has moved to a nursing home.
  2. Giving away assets too early. First, it’s your money, your house, or both. Make sure to take care of yourself first. Don’t put your security at risk by putting it in the hands of your children. Sudden transfers done without careful planning can cause significant tax and Medicaid issues as well.
  3. Ignoring important “safe harbors” created by Congress. Certain transfers are permitted by the law without jeopardizing Medicaid eligibility. These include: transfers to:  one’s spouse; disabled children; caretaker children; a “pay-back” trust if under 65; a pooled disability trust at any age.
  4. Failing to take advantage of protections for the spouse of a nursing home resident. These protections include petitioning for an increased community spouse resource allowance, in some instances petitioning for an increased income allowance, and/or establishing an estate plan which includes provisions to protect both spouses in the event a spouse predeceases the nursing home resident, or in the event the other spouse also needs long-term care.
  5. Applying for Medicaid too early. This can result in a delay in getting benefits, and in some instances a longer ineligibility period.
  6. Applying for Medicaid too late. This can mean the loss of many months of eligibility, and of the assets which were spent to pay out-of-pocket for those months of care (in York County, nursing home care costs between $10,000 and $12,000 a month).
  7. Confusion about Medicaid Estate Recovery. Estate recovery is the process by which the State recovers certain Medicaid benefits paid on behalf of a Medicaid enrollee after he or she passes away. In Pennsylvania, Medicaid can only recover from the decedent’s probate estate (not from anything passing by beneficiary designation, such as IRAs, life insurance, jointly owned property, and such). This even can include property which is exempt as long as the surviving spouse is alive.
  8. Not getting expert help. This is a complicated field that most people only have to navigate once in their lives. Tens of thousands of dollars are at stake (remember, nursing home care costs between $10,000 and $12,000 a month). But don’t worry – we’ve got your back. A qualified elder law attorney can help you through this maze of rules and regulations and maximize the protection of your assets, in some cases to the point of preserving nearly all of them for you and your family. It’s penny wise and dollar foolish not to consult with people who specialize in guiding clients through the process – qualified elder law attorneys well-versed in the Medicaid rules.

If you have questions about Medicaid planning consider joining us for one of our upcoming workshops.  Just click here to RSVP.

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May is Older Americans Month

May is Older Americans Month, which was established in 1963, when only 17 million Americans had reached their 65th birthday. Today 46 million people are 65 or older, and that is projected to exceed 98 million, or 24% of the population, by 2060. As our population ages, the need to assure the quality of life for older folks is obviously increasing.

The Administration for Community Living, which leads the observance of Older Americans Month, has themed 2019 as Connect, Create, Contribute – Connect with friends, family, and support services; Create by engaging in activities that promote learning, health, and personal enrichment; Contribute time, talent, and life experience to benefit others.

These are all worthy endeavors. However, older Americans and their families should also take time to make sure that they have a current estate plan in place, including, at a minimum, a Last Will and Testament, a financial Durable Power of Attorney, a Health Care Power of Attorney, and a Living Will. The older population, and indeed their families, should also be planning for unanticipated events, such as illness or even the potential future need for care outside the home.

Thus, as you celebrate Older Americans Month and consider the many contributions older Americans have made and continue to make to our nation, consider visiting an elder law attorney to get an estate plan in place which will provide peace of mind; if you already have estate planning documents, this month would be a good time to review them with an elder law attorney to determine if they continue to meet your needs, or if you need to expand your estate planning as you age.

We as older Americans need to keep our own ship on course; then, we will be able with a clear, untroubled mind to Connect, Create, Contribute.

So, to those who make up our senior population, happy Older Americans Month, and thank you for your contributions, past, present, and future!

Upcoming workshop dates: https://bellomoassociates.com/workshops/

Jeffrey Bellomo, Esq.

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Medicare, Medicaid, and Long-Term Care Planning

Many people are confused about the difference between Medicare and Medicaid as it relates to paying for long-term care. Although both provide for medical care, they are very different.

Medicare is an entitlement program for everyone at age 65 (or for certain disabled people, regardless of age). Medicaid, on the other hand, is a public assistance program designed to help people with limited assets pay for medical care. Medicaid applicants must meet certain strict income and asset guidelines.

Medicare is run entirely by the federal government, while Medicaid is a joint federal-state program. Each state has its own Medicaid system; thus, the eligibility rules (and sometimes even the name) vary from state to state. However, each state must adhere to federal guidelines.  Medicare does not cover long-term nursing home care.

Part A covers only up to 100 days in a skilled nursing facility, and only if the patient has been admitted to a hospital for at least 3 days. Worse, from days 21-100, the individual must make a daily copayment (the amount changes every year – in 2019 it is $170.50 a day), and it is quite difficult to qualify for those extra days.

Medicaid pays for all of one’s nursing home care if the person’s assets and income are below that state’s guidelines. However, do not be discouraged; if they exceed the state limits, steps can be taken to still be eligible, but care must be taken. There are many traps for the unwary.

For example, giving away one’s assets can be disastrous. If an applicant or spouse gives away assets within 60 months before applying, the applicant will suffer a significant penalty period, during which time the applicant is ineligible for Medicaid benefits; the larger the total of all gifts, the longer the penalty. However, through proper planning with a qualified elder law attorney who is versed in the rules of Medicaid eligibility, those who need skilled nursing care can become Medicaid eligible relatively quickly without having to spend down all of their assets.

The sooner you start planning, the better your chances of getting the care you need most while protecting much, if not all, of your assets. Join us for one of our upcoming workshops to discover what you need to know to get the process started.  You’ll find dates, times and locations here! 

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nursing homes medicaid planning york pa

A Financial Success Story for a Nursing Home Resident


A family was recently referred to us by a local nursing home because the wife had a stroke and she is going to need care for the foreseeable future. The nursing home social worker was talking with the husband, who was scared because he had a modest amount of money that he has accumulated during his lifetime, but was nervous that it would not take long at $11,400 a month for him to not be able to provide for himself in the future.  

For help with that problem, the Pennsylvania Medicaid spousal rules are certainly a great start and provide that as the community spouse, the husband would be allowed to keep the house, his car, his retirement account, and one-half of the remaining assets, up to a maximum in 2019 of $126,420.00 and no less than $25,284.00 (those amounts change each year).  The social worker explained this to the husband and he still had some trepidation, being only in his late 50s, wanting to know if that would be enough for him to live another 50 years of his life. He loved the nursing home that he was able to get his wife into and was excited about the care that she will receive.

After several sleepless nights for him, the social worker told him to give us a call and I met with him recently.  The husband is an absolute joy to work with and was very appreciative of the care that his wife was receiving. He was ecstatic when I was able to tell him that we would be able to not only protect the aforementioned items, but also the additional $350,000 on top of the $124,000 that was guaranteed under the law.

We were able to put the plan in place and did get approval on the Medicaid application.  It is very rare in our profession that family members hug or show outward affection toward their lawyers.  I will never forget the moment when we received the application and I was able to tell my client that we were able to protect the items that he knew about, but in addition to that, the other monies that he had feared of losing.  

With tears in his eyes, he hugged me and said, Jeff I will never be able to repay you. I appreciate everything that the nursing home has done for me and for my wife, but it is also comforting to know that now I don’t have to worry about how I’m going to live for the remainder of my life and the care that I receive.

We are pleased to report that this outcome is a very common for our clients; we have been able to secure this result for hundreds of clients in and around York, Pennsylvania.  If you or a family member have a loved one in a nursing home and need assistance, please call us (717-845-5390) or click here and give us a little information and we’ll call you, and it will be our pleasure to make this success story yours.

Jeffrey Bellomo

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What Estate Plans do Parents Need?

This is a question that I’m often asked by young clients with young children.  The basics of the plan are very similar to what a lot of individuals would expect.  I always encourage people to have a financial power of attorney, a medical power of attorney, a living will, and Last Will and Testament.  

Incapacity is something that often occurs, and older age is not always a factor. Even young individuals should have a financial power and medical power of attorney in place if they are over 18.  I have gone at length in other blogs and in my workshops to explain the importance of financial powers of attorney, and I certainly cannot stress them enough. However, this article is specifically going to discuss whether a family with young children needs more than just a base Will.  

Our office offers both base and enhanced Will plans for families.  Our base wills are approximately 23 to 25 pages and typically will cover everything that a family would need from an understated age trust to a trust in case anyone has a loved one with special needs who upon inheriting assets would be disqualified from receiving benefits, which is called a special needs trust.  We put both of those on standby, or “what if”, trusts in every document to ensure that families will be protected in the unlikely event that they were to die with beneficiaries under a specified age (at a minimum 18) and/or with any beneficiaries who are incapacitated or disabled.

These plans are able to cover most situations, but our enhanced Will plan provides something that our base plan cannot, which is the ability to protect inherited retirement accounts and other assets for children.  Although our base plan provides an understated age trust in it, which allows a family to be able to set the age at which a child is able to receive a lump sum distribution, it cannot put a retirement account into that trust without triggering tax consequences.  

In order for a retirement account to be inherited by a child and still be able to stretch out the tax benefits, it has to be put into a qualified trust called a see-through trust. Our enhanced plans are equipped with qualified see-through trusts which allow you to protect your retirement accounts without triggering any negative tax consequences.  This is essential when dealing with young children because, if we use a base plan, then we must name the beneficiary outright in the retirement account.

Once we name a beneficiary outright, the beneficiary is able, at the age of 18, to force liquidation of the entire account, pay all the tax consequences, and do what they wish with the remainder of the retirement account.  This is often not what parents want; rather, they want the money to be able to stretch out over the child’s life expectancy from a tax perspective, but also keep it asset protected so that an 18-year-old cannot force distribution. Such trusts also protect the retirement account from the child’s creditors.

We at Bellomo and Associates have had great success at protecting young families with our enhanced plans so that we can stretch out tax benefits over the children’s life expectancy and also keep the money protected from any unforeseen creditors.  Please come to one of our workshops or contact our office to learn more about these benefits.

Jeffrey Bellomo, Esq.

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