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Glastonbury Medicaid planning attorneysAre you a senior who suddenly finds the need to apply for Medicaid? If so, you are not alone. The high cost of long-term care often causes seniors who have never before needed to rely on Medicaid to turn to the program for help. If you find yourself in just such a position, the Glastonbury Medicaid planning attorneys at Nirenstein, Horowitz & Associates, P.C. explain how to apply for Medicaid in Connecticut.

Why Would I Need to Qualify for Medicaid as a Senior?

First, it helps to understand the position you may find yourself in as a senior. 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. Medicare does cover most healthcare expenses for seniors; however, Medicare does not cover one of the costliest expenses you are likely to encounter – 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. Your employer sponsored healthcare coverage likely terminated when you retired. Even if you purchased a private healthcare policy at that time, it probably excludes LTC expenses as well unless you paid a separate premium for LTC coverage. With both Medicare and private insurance failing to help with LTC, Medicaid is often the only option left unless you can afford to pay out of pocket.

How Do I Apply for Medicaid in Connecticut?

Applying for Medicaid benefits in Connecticut is not necessarily difficult; however, getting an application approved without planning ahead can be difficult. You can start the application process on the State of Connecticut Department of Social Service website. On the website, you have the option of taking a short quiz to see if you are likely eligible for benefits. You can also fill out the entire application online or you may contact the DSS Benefits Center at 855-6-ConneCT (855-626-6632) to have one mailed to you. Once you complete the application, including the submission of any documentary evidence requested to support your application, a decision must be made within 45 days.

Before you apply, however, you should have at least a basic understanding of the eligibility requirements. Medicaid is intended to help low income families, pregnant women, children, the disabled and the aged with healthcare costs. Because Medicaid is a “needs based” program, you must demonstrate a financial need for benefits. This means that an applicant cannot have income nor assets that exceed the program limit. As a general rule, your income cannot exceed the current limit for your household which is tied to the Federal Poverty Level for your area. In addition, an individual cannot have “countable resources” that are worth more than $1,600. For the average retiree on a fixed income, the countable resources limit is where the problem lies. If your assets do exceed the program limit, Medicaid will deny your application and you will need to “spend-down” your assets before applying again. If you are applying for Medicaid to help you cover long-term care (LTC) expenses, what this means is that you are expected to sell those assets and use the proceeds to pay your LTC expenses during the waiting period. If you failed to plan ahead, you could lose your entire retirement nest egg in a matter of months considering the fact that the average cost of LTC in Connecticut is over $13,000 per month.

When an applicant is applying for assistance with nursing home care expenses, the eligibility requirements become even more complicated because the Medicaid “Spousal Impoverishment Rules” come into play. The rules are intended to ensure that a spouse who remains in the community is not impoverished when his/her spouse enters a nursing home as a result of the Medicaid “spend-down” requirements. The “Community Spouse” is allowed to keep a certain amount of income and resources when the other spouse enters a long-term care facility. The other Medicaid rule you must also be aware of when applying for Medicaid is the five-year look-back rule that allows Medicaid to review and applicant’s finances for the five-year period prior to applying for benefits. Any asset transfers made during that period for less than fair market value will likely trigger a waiting period during which time the applicant will not be eligible for Medicaid benefits.

The key to understanding the Medicaid eligibility requirements, and to meeting those requirements, is to consult with an experienced Medicaid planning attorney long before you actually need to qualify for benefits.

Contact Glastonbury Medicaid Planning Attorneys

For more information, please join us for one of our upcoming FREE seminars. If you have additional questions or concerns regarding how to apply for Medicaid as a senior in Connecticut contact the experienced Glastonbury Medicaid planning attorneys at Nirenstein, Horowitz & Associates, P.C. by calling (860) 548-1000 to schedule an appointment.

Barry D. Horowitz, Estate Planning Attorney
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