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Author: Graham
Date: 03-29-05 09:17
I am trying to figure out how if at all the interaction between LTCI policies, Medicare and Medicaid work. If you have a LTCI policy is it always primary over both Medicare and Medicaid. I know Medicare does not cover much with respect to long term care but in some circumstances it does. With Medicaid (if eligible), would it cover the difference between my policy and the actual costs of a nursing home or home health care or do you have to wait until the LTCI policy runs out. Anyone know of a web site or something that can help me understand the interactions between these?
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Author: Josh Fink
Date: 03-29-05 22:00
In Nebraska its only about 5k in assets. 90k for medicaid cant be right in any state. I will take it was a typo. Otherwies i think i agree with Jack on this one.
Josh
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Author: Arthur Rudnick, LTCP
Date: 03-29-05 22:47
Josh;
I think you're getting the 2 numbers confused ($5k & $90k)
The $90,000 figure (actually $92,000) is the amount that is exempt for the community spouse, if the other spouse is in the nursing home. The $5,000 figure (in Nebraska, it's most likely about $2,000) is the amount that the spouse in the nursing home must spend down to, before applying for Medicaid.
Example:
A couple has $200,000 in assets (not counting their home) and one spouse has to go into a nursing home. By law, the assets are split down the middle, so each one has a $100,000. The spouse in the nursing home would have to pay for care, until he/she was left with only $2,000. At that point, the community spouse would have to spend about $8,000, or until he/she were left with $92,000. Only at that time, could they apply for Medicaid.
Also, keep in mind that although the house is considered exempt, there's something called "Estate Recovery". When that house is sold, or goes through probate, the Dept. of Social Services (Medicaid) will be the first leinholder on the estate, trying to recoop the money that the state paid for care. Not many realize it, but Medicaid is not a gift or an entitlement, it's a loan.
Arthur
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Author: jake
Date: 03-29-05 23:23
Now days people are living longer and because of this people are out living thier assets faster. This is causing most to end up on Medicaid. Nursing homes are becoming flooded with Medicaid(welfare) patients. Also with the new DRG laws the hospitals don't keep people as long as they used to. It's in and out to a rehabilatation center otherwise known as a nursing home. The average person who needs a bed has less and less of a chance. Thats why home health care is becoming more and more popular in the U.S.
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Author: Bill Berry
Date: 03-30-05 07:57
If one spouse goes to the home, and gets medicaid, and the well spouse stays home with the 92,000 home, then dies, can medicaid come after the home even though the well spouse that kept the home never used medicaid?
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Author: Bill Berry
Date: 03-30-05 09:05
Can they come after the house after the well spouse has survived the sick spouse that dies in the NH on medicaid, then the well spouse dies, having never been on medicaid. Is the house clear or encumbered by medicaid?
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Author: Arthur Rudnick, LTCP
Date: 03-30-05 12:08
Bill,
That's $92,000 PLUS the primary residence. Legally, after the well spouse dies or sells the home, and the state has paid for Medicaid, the state has the right (actually, the Federal government encourages Estate Recovery)to go after any assets that are discovered, or that are part of probate.
Some states are extremly agressive in doing this, other states are not. But, the potential for Estate Recovery exists and is very real.
Arthur
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