Long term health care continues to rise each year for the elderly. Costs do vary by region and location, but annual costs for nursing home care in Idaho range from are around $50,000 to $95,000 as of 2017. Statistics show that about one-third of people who require long term care services, pay directly out of pocket for those costs. The remaining two-thirds pay for their care through Medicaid. With so many people reliant on Medicaid to pay for care, it’s likely you or a loved one will need to understand the rules of Medicaid. These rules are complex when it comes to determining how to qualify.

Who qualifies for Medicaid?

Medicaid assists low-income individuals, including seniors. Medicaid can help seniors with housing costs, including in-home care and nursing home care. However, to be eligible for coverage for nursing or in-home care, seniors must demonstrate that a need for the care or service exists. This is done by showing the senior meets certain income and asset limits. These limits change often.
As of 2018, to receive Idaho Medicaid Long-Term Care coverage, Idaho residents are limited to:
$2,000 in assets and $2,250 in monthly income.

For married couples, the rules are more complex and depend on whether the spouse remains in the the home or is also applying for Medicaid.

Can you protect assets by transferring them?

Medicaid Applicants often find themselves in trouble by making decisions without consulting someone knowledgeable in Medicaid rules. The biggest area of trouble Applicants find themselves in is in the area of asset transfers.

Applicants are subject to a five-year look-back period for the transfer of any asset for less than fair market value. Medicaid scrutinizes any transaction within the five year look back period, especially if it appears the transfer was to gain eligibility. If the transfer does not comply with Medicaid rules, the applicant could be disqualified from coverage for a period of time.

What about exempt assets?

Some assets are exempt from being included in the calculations for Medicaid eligibility. If the senior owns their home, the value of the home may be excluded toward Medicaid eligibility up to a certain amount. Equity up to an amount of $858,000(which may change) is exempt; anything over that amount will not be exempt.

Other assets that are considered exempt from being counted toward Medicaid eligibility, include:
Pre-paid burial and funeral arrangements, One vehicle, Household items and improvements, Personal effects.

How can I plan for Medicaid?

Many seniors often have income or assets over and above the limits. However, there are methods to help seniors gain Medicaid eligibility. One method is to put money toward exempt assets, another is irrevocable living trusts.

If the trust is created outside of the five year lookback period , the transfer of funds into the trust is not subject to the Medicaid rule requiring a period of ineligibility for transfers within five years of application.

The rules regarding assets, income and how to calculate Medicaid eligibility are complex and cannot be adequately summarized here. There are many planning strategies and hurdles to qualify for Medicaid. Anyone attempting to figure out the rules should first contact an experienced Idaho elder law attorney. Post Falls Law is dedicated to helping citizens of Post Falls and Kootenai County prepare for Medicaid and other elder law issues. Contact us today for your free, personalized consultation.