Like many seniors, you may have managed to go through your entire life to date without ever even considering the need for Medicaid benefits because you were fortunate enough to be covered by employer-sponsored health insurance. If you now find yourself faced with the need to qualify for Medicaid to help cover long-term care costs, you may be a bit intimidated at the seemingly daunting prospect. To get you started, an experienced Hartford Medicaid attorney explains how to apply for Medicaid in Connecticut if you are a senior.
Why Might You Need to Qualify for Medicaid as a Senior?
Why might you suddenly need to qualify for Medicaid? Like most people, you may have relied on employer-sponsored medical insurance throughout your working years. When you entered your retirement years, you naturally assumed that Medicare would pick up your medical expenses from that point onward. While Medicare does cover most healthcare expenses for seniors, Medicare does not cover one of the most expensive bills of all — long-term care. Moreover, your odds of needing long-term care (LTC) increase with each passing year. For this reason alone, it is always wise to plan ahead for the need to cover LTC expenses. Even if you purchased a private healthcare policy when your employer-sponsored health insurance terminated, it probably excludes LTC expenses. With both Medicare and private insurance failing to help with LTC, Medicaid is often the only avenue left to obtain help covering your LTC expenses.
How Do I Apply for Medicaid?
Filling out an application for Medicaid benefits in Connecticut is not necessarily difficult; however, if you failed to plan ahead if may be difficult to get your application approved. You can start the application process on the State of Connecticut Department of Social Services website. Before you apply, however, you should have at least a basic understanding of the eligibility requirements so that you understand why planning ahead is often the key to approval.
Medicaid is a “needs based” program, which means you must demonstrate a financial need for benefits because it is intended to help low-income families, pregnant women, children, the disabled and the aged with healthcare costs. Consequently, an applicant cannot have income or assets that exceed the program limit. The income limit is tied to the Federal Poverty Level for your area and household size and changes each year. In Connecticut, there are also two different income limits based on the region of the state in which you live. More information on income limits can be found on the Husky Health Connecticut website.
In addition, an individual cannot have “countable resources” that are worth more than $1,600 while a married couple cannot have resources valued at more than $2,400. Although some assets are exempt, the countable resources limit can be problematic for those who failed to plan ahead. If your assets do exceed the program limit, your application will be denied and you will be expected to “spend-down” your assets. In reality, what this means is that you are expected to sell those assets and use the proceeds to pay your LTC expenses until the value of your assets falls below the program limit. With LTC costs averaging over $13,000 per month in Connecticut, it is easy to see how your retirement nest egg could be depleted rather quickly if you are forced to pay out of pocket for LTC.
Transferring excess assets out of your name when you realize the need to qualify for Medicaid benefits won’t work because Medicaid imposes a five-year look-back rule. The look-back rule allows Medicaid to review an applicant’s finances for the five-year period prior to applying for benefits. Any asset transfers for less than fair market value made during that time period will likely be discounted and the value of the asset imputed back into the applicant’s estate.
The key to ensuring that your application for Medicaid is approved when you need it is to consult with an experienced Medicaid planning attorney long before you actually need to qualify for benefits.
Contact a Hartford Medicaid Attorney
For more information, please download our FREE estate planning worksheet. If you have additional questions or concerns about applying for Medicaid in Connecticut, contact an experienced Hartford Medicaid attorney at Nirenstein, Horowitz & Associates, P.C. by calling (860) 548-1000 to schedule an appointment.