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Barrington IL Medicaid Planning Lawyers

Understanding the Medicaid Laws and Eligibility in Inverness, Algonquin, and Throughout the Area

Illinois has approximately 3,117,939 people covered by Medicaid or the Children's Health Insurance Program. The program is particularly vital for those needing long-term care (LTC), as Medicare has comparatively limited coverage for this type of care. According to MetLife, the average cost for a semi-private LTC room is roughly $173 per day, which is over $63,000 per year. Those seeking Medicaid benefits often must construct a plan to qualify. Joseph M. Lucas & Associates, LLC has been advising clients on planning for Medicaid and other aspects of long-term care over 25 years.

Paying for Long-Term Care

There are four options in paying for LTC:

  • LTC insurance, typically purchased well in-advance of determined need
  • Medicare, which has a 100 day limit and requires a co-pay for the majority of the stay
  • Private payment
  • Medicaid

Enrollment Overview

Medicaid planning is a means of preventing the loss of all assets during a lengthy stay in a facility. Private insurance typically does not cover such "custodial" type care. Many have been devastated that had no remaining assets to pass along to their heirs; for this reason, you must plan years ahead and develop a solid Medicaid plan with assistance from a lawyer, ideally as one aspect of a broad-reaching estate plan. Medicaid "looks back" for a period of five years in efforts to detect and penalize individuals who hastily shift or transfer assets out of their names to reduce their assets.

Medicaid Rules and Restrictions

Applicants must be Illinois residents that are 65 years of age. The individual must have less than $2,000 (or $3,000 for a couple) in assets and income insufficient to afford private pay LTC costs. Those seeking eligibility are facing increased scrutiny relating to transfers or gifts of assets to other parties, and face denial to enrollment.

Those in a second marriage should be aware that the assets of both parties are always considered, despite prenuptial agreements, for Medicaid eligibility. Ownership of a motor vehicle is limited to a fair market value of $4,500. Life insurance policy values must not exceed $1,500 per individual. The allowance for burial costs is $1,500, although burial spaces already owned are exempt.

There is an exception which allows additional funds in a prepaid burial contract, which has an itemized listing of funeral-related goods and services. These types of rules can change; therefore, it is critical to review and possibly adjust for compliance.

Potential Medicaid Planning Approaches

Asset transfers should be initiated 60 months prior to an application for Medicaid. One tool is a Life Estate Deed, which may allow you to remain in your home, and not have it considered to be an asset. In Illinois, due to the financial load of LTC, one spouse may be eligible to receive Medicaid benefits while the other holds a reasonable amount of income to live on under the "community spouse resource allowance". In addition, there are options of creating a "trustee" (someone other than yourself) to manage transferred assets. You may be able to derive income from the trust in some cases; however, it is possible that you will be unable to access the principal funds.

The law firm of Joseph M. Lucas & Associates, LLC, based in Barrington, IL, has been providing guidance to their clients for three decades on issues such as wills, trusts, Medicaid planning, and much more. Those who are concerned about losing all their assets to a nursing home can contact our office at 847-381-8700 for a consultation.

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