Fact vs. fiction: Myths shroud maze of Medicare, Medicaid benefits

|tab|

|ret||ret||tab|

As our population ages, more adult children find they must help their parents wind through the maze of health care decisions, including how to pay for health care and eventually long-term care. People frequently ask, "Will the nursing home take everything?" "Can the state come in and take my home?"|ret||ret||tab|

There is great confusion about Medicare and Medicaid, what each program covers and how to qualify. |ret||ret||tab|

Following are some common myths that can get you into trouble. |ret||ret||tab|

Myth: Medicare will cover my nursing home bill.|ret||ret||tab|

Truth: Medicare is primarily a health care benefit to cover expense for doctors and hospitals. Medicare only covers a small amount of nursing-home care. In general, there are 20 days of full coverage if you go into the nursing home after at least three days in the hospital and are getting skilled care. |ret||ret||tab|

Then, if you still need skilled care, you can get up to 80 days of partial coverage from Medicare. |ret||ret||tab|

After that, you will either pay out-of-pocket, or get Medicaid, unless you have private long-term care insurance.|ret||ret||tab|

Myth: I have to spend or give away everything I have to get Medicaid.|ret||ret||tab|

Truth: Basically, a person may own some property and still be eligible for Medicaid. The trick is knowing what is "countable" and "noncountable" under Medicaid rules. |ret||ret||tab|

Certain types of prepaid burial contracts are noncountable. The residence is usually noncountable as well. There are many other types of "noncountable property." The bottom line is, you do not need to be completely without assets to be Medicaid eligible. |ret||ret||tab|

Some assets may be given away under Medicaid rules in special circumstances. To make these determinations, consult a lawyer familiar with Medicaid law.|ret||ret||tab|

Myth: I have to wait three years after giving anything away to get Medicaid.|ret||ret||tab|

Truth: The disqualification is not always three years long and sometimes there is no disqualification at all. True, there is a three-year look back for some asset transfers. The Medicaid agency will look back at all transfers of property, including sales for less than market value. |ret||ret||tab|

For some transfers, the look back actually goes back five years. However, the rules penalizing transfers only apply to certain transfers.|ret||ret||tab|

Myth: I can keep all our marital property and my inherited property when my spouse gets Medicaid.|ret||ret||tab|

Truth: When a married person applies, assets in either or both spouses' names are considered by Medicaid. |ret||ret||tab|

However, some assets will not be "countable" and you may keep some as an asset allowance if your spouse enters a nursing home.|ret||ret||tab|

Myth: If I put my property into my spouse's name, I will be eligible for Medicaid.|ret||ret||tab|

Truth: Assets are counted, regardless of which spouse's name they are in. However, the healthy spouse will be given several months to re-title assets from the name of the spouse in the nursing home, into the name of the healthy spouse. |ret||ret||tab|

The Medicaid agency can explain these rules. |ret||ret||tab|

Myth: I can only give away $11,000 a year under Medicaid rules.|ret||ret||tab|

Truth: This is a rule under federal estate and gift tax law, not Medicaid law. In 2003, this tax law only applies to people who have over about $1 million in assets. |ret||ret||tab|

People who would pay federal estate tax should not worry about getting Medicaid.|ret||ret||tab|

Myth: My income may have to be used to pay my spouse's nursing home bill.|ret||ret||tab|

Truth: This is not true in Missouri.|ret||ret||tab|

Myth: All of my spouse's income must be used to pay the bill if my spouse is on Medicaid in a nursing home.|ret||ret||tab|

Truth: You may keep a portion of your spouse's income if your income is below certain limits. In addition, you may be entitled to a greater allowance if the cost of maintaining your home exceeds a certain amount. |ret||ret||tab|

Myth: I can hide my assets and get eligible for Medicaid.|ret||ret||tab|

Truth: Intentional misrepresentation in a Medicaid application is a crime and can be costly. |ret||ret||tab|

The IRS shares any information concerning income or assets you have with the state Department of Social Services. You or whoever applied may have to pay Medicaid back to avoid prosecution.|ret||ret||tab|

Myth: Medicaid rules that applied to my neighbor when he went in a nursing home will apply to me.|ret||ret||tab|

Truth: Medicaid rules change; so do not count on the law that applied to your neighbor still applying to you. In addition, there may have been facts about your neighbor's situation that you just do not know. |ret||ret||tab|

Entire books are written on Medicaid and its rules, so obviously this article cannot go into great detail. If you or your parent are facing these issues, consult with an elder law attorney about your own situation.|ret||ret||tab|

[[In-content Ad]]