Shannon Macleod, P.C.

Medicaid Eligibility

At the present time, the average monthly cost of a nursing home is $12,811 on Long Island and $12,198 in New York City. Medicare will only cover up to approximately 3 months of nursing home care. Medigap policies will cover co-insurance charges only when medicare has covered. Where does this leave your loved one if he has no long term care insurance?

Medicaid is a program for New York residents who cannot afford to pay for the high cost of medical care. The Medicaid program, however, has income and resource limits as conditions of eligibility. Furthermore, an application for nursing home care will require a 60 month history on all bank and security accounts since any transfers made during this period will affect eligibility.

To determine whether you or your loved one meets the requirements of the Medicaid program, or how you or your loved one may meet the requirements in the very near future, it is wise to seek the advice of an elder care lawyer with a Medicaid background.

Asset Protection

Asset Protection for Medicaid purposes is the practice of protecting your assets by transferring them to another person or to a trust in line with the Medicaid regulations and still qualify for Medicaid benefits. Certain transfers of assets may be considered "compensated" or "uncompensated", "permissible" or "impermissible" and "exempt" or "non-exempt" for Medicaid purposes.

It is advisable to work with a lawyer experienced in the Medicaid area who can assist you in rearranging your assets to make you eligible for Medicaid as soon as possible.

Nursing Home Placement

You and your loved one are approached by a hospital social worker with the information that everyone always dreaded. Your loved one needs continuing in-patient care in a nursing home. Or, maybe after you and your family have gone to great lengths to avoid having to place your loved one in a facility, placement becomes inevitable. What do you do next? Where do you even start?

The decisions that your loved and your family will immediately encounter are going to be traumatic and difficult for everyone involved. This is not easy; however, the decisions made will sit better with everyone involved if the proper steps are taken to make the transition to a nursing home as comfortable as possible. My suggestions are as follows:

  1. Be sure to open up diaolgue with your loved one. You will want to know what would make her most comfortable in this process. Make sure to let her know she is in control of the situation.
  2. Do at home research for possible facilities. The New York State Department of Health's website (www.health.state.ny.us/facilities/long_term_care/) can help you search for a facility in a particular area, provides a profile of each nursing home in NYS and allows you to see the facility's most recent survey results. Similar information can also be found on Medicare's website at www.medicare.gov.
  3. Arrange for a tour of any facility of interest. Ask alot of questions to eliminate surprises.
  4. The Admissions staff at the facility will question you about your loved one's coverage and/or ability to pay the the anticipated bill. At this point, you may want to discuss with your loved one getting an attorney involved.