This month Jesse Rose Roberts, our Director of Operations, dives in to the complexities of Affordable Care Act and explains how it can affect you, your wealth and your Medicaid application. If you’d like to know more about Medicaid benefits for long-term care, be sure to check the resources we’ve prepared for you.
We’ve all heard the conversation going on around the Affordable Care Act (ACA) and the efforts to repeal the program. But it’s effects on long-term care Medicaid has not been on the forefront of the conversation. Let’s talk a little more about how this might affect your situation if a loved one needs care, specifically regarding the Spousal Impoverishment rules that protect the couple’s wealth (home, savings, life insurance, annuities, etc.) for the “well spouse” who does not need care.
Let’s talk a little more about how this might affect your situation if a loved one needs care, specifically regarding the Spousal Impoverishment rules that protect the couple’s wealth
Before the ACA was signed into law, when a Medicaid applicant was in need of nursing home care there were rules in place for protecting wealth for the spouse who did not need care (also known as the “well spouse”). Which sounds good, but where does that leave those needing in-home care or assisted living care?
Increasingly, community care in-home or in assisted living is desired and found to extend life expectancy while improving quality of life. This can also be more affordable than a nursing home, so it is in the public’s interest as well.
Some states had rules that made it more difficult to get benefits for these community-based services and protect wealth for the spouse of the Medicaid applicant.
Some states had rules that made it more difficult to get benefits for these community-based services and protect wealth for the spouse of the Medicaid applicant.
When the ACA was written into law it became mandatory that Spousal Impoverishment rules be applied for all cases (nursing home and community care).
ACA set up the requirement but it expired after five years, in March 2019, as congress did not act this mandate is no longer required to be applied to home care and assisted living care paid through Medicaid.
The good news for now is that most states, including California, New York, Colorado, Ohio, and Washington state will continue to apply Spousal Impoverishment rules to community care cases, therefore continuing the much needed access to the program for many people.
At this point, only a handful of smaller states plan to roll back spousal impoverishment rules, making it more difficult for married applicants to become eligible for community based benefits.
We are happy to confirm that if your loved one needs care, there are still many ways to qualify for Medicaid and protect joint wealth up to and beyond the maximum of $126,420 (generally cited as the allowed amount for a “well” spouse to keep in their own name).
And thankfully, in most areas of the country, this applies whether or not that care is needed in a nursing home, assisted living or in their own home.
We are happy to confirm that if your loved one needs care, there are still many ways to qualify for Medicaid and protect joint wealth up to and beyond the maximum of $126,420
This is a complicated and often misunderstood part of the eligibility process, be sure you are well informed and have a good advocate for your case when applying for Medicaid using the Spousal Impoverishment rules.
If you’d like to know more about Medicaid’s eligibility rules, Eldercare Resource Planning offers free initial consultations. We’re here to help you understand the options that are available to become eligible for Medicaid’s valuable long-term care benefits, either at home or in a nursing home. To book your free appointment, call us at 415-854-8653 or fill in the contact form:
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