2019-2020 Health Care Guide

O vERvIEW Of ThE M EDICAID P ROGRAM

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his article focuses on the Medicaid program as it applies to elderly and disabled individuals. There are three common names for one program. 1. Medical assistance 2. Medicaid 3. Title 19 Medicaid is a welfare program jointly funded between the Federal and State government. It is designed to assist in paying for skilled nursing facility expenses and many other medical expenses for individuals who have minimal assets and inadequate income to pay for these expenses. The individual is normally responsible to pay for all of his/her own long term care expenses: generally, if the cost of this care exceeds the individual's income and the individual is asset- qualified, Medicaid supplements the individual's own payment. Within the Federal guidelines, each state is able to establish their own eli- gibility standards, determine the type, amount and duration of services, set the rate for payment of services, and administer their own program. This article will outline the eligibility requirements for Wisconsin as of 2019. A single adult qualifies if they meet the following criteria: The applicant can't retain more than $2,000 plus exempt assets 1. Home : Homestead property is exempt regardless of the value if the applicant intends to return home, or if a disabled child is liv- ing in it. 2. Car : One automobile per house- hold is excluded regardless of the value if it is used for transporta- tion of the eligible individual or couple or a member of the eligi- ble individual's or couple's

couple's household. 2. IRA of the community spouse How much money may a couple "Shelter"? The Spousal Impoverishment Act passed by the U.S. Congress in 1988 and the Omnibus Budget Reconciliation Act of 1993 (OBRA'93) provides the legal means for anyone to shelter assets and qualify for financial assistance through an entitlement program. This act protects married individuals from depleting their assets due to an extended nursing home stay. If the couple's combined assets are: $0 - $50,000 the "community spouse" may keep ALL $50,001 - $100,000 "community spouse" may keep .....$50,000+$2,000 $100,001 - $252,840 "community spouse" may keep .....HALF+$2,000 $252,841 + "community spouse" may keep ....$126,420 plus $2,000 for a total of $128,420 These figures are adjusted annually for inflation. Note: This article provides a limited space for information regarding Medicaid Eligibility. There are oppor- tunities for married couples to protect more that the above figures. Attorney Ryan Zenk offers free consults or call for your free booklet on "What is Spousal Impoverishment?" please call 262-670-8888 or 1 (866) 670-0888. For more information, please visit the Wisconsin Medicaid webpage. Article submitted by Barbara Horstmeyer, Benefit Specialist, Senior Planning Group . 1-866-670-0888

household. 3. Life Insurance : Life insur- ance is exempt if the face value of all policies is less than $1,500. If the face value exceeds $1,500, full cash value counts towards resource limit. Term insurance has no cash value and is excluded from countable assets. 4. Household goods and per- sonal effects : Generally no inquiry unless reason to sus- pect unusual value. 5. Pre-paid funeral arrange- ments : Each fiscal group member may have one or more irrevocable burial trusts, of which the total face value may not exceed $4,500. Any principal amount over $4,500 is a countable asset. Although Wisconsin law allows $3,000 to be irrevocable, Wisconsin’s Medicaid state plan allows an additional $1,500 to be con- sidered as though it were irrev- ocable by law for these burial trusts. This is why $4,500 is allowed. Married couples can own exempt assets listed above plus: 1. One automobile per household is excluded regardless of the value if it is used for trans- portation of the eligible indi- vidual or couple or a member of the eligible individual's or

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S E N I O R R E S O U R C E S

F or information on S enior S ervices in Wisconsin, visit our website www.seniorresourcesonline.com

2019