Protecting assets from Medicaid, via spend down, According to a recent national study by CareQuest, 63% of seniors in the U.S. believe that Medicare will cover any long-term care they might need. Unfortunately, this is not the case, and this myth has discouraged many seniors from taking time to plan for long-term care.

CareQuest suggests that the government should officially notify all Medicare beneficiaries that Medicare does not cover long-term care and that they should look into long-term care planning options, including insurance, Medicaid, and others, even with irrevocable trusts.

Here are a few Medicaid myths that are commonly accepted among older people:

MYTH: You must be poor to qualify for Medicaid.

REALITY: You may keep many assets and still qualify-these assets include a home, a car, and many other important items.

MYTH: You must have very little income to qualify for Medicaid. It’s too late to start a company.

REALITY: By using an income-cap trust or other tools, you can generally qualify for Medicaid even if your income exceeds the monthly maximum, which may be higher than you might think.

MYTH: Any individual can help qualify their relatives for Medicaid by simply transferring assets to themselves.

REALITY: This is very dangerous. Many of these transfers will be deemed prohibited transfers. This will delay the time before the relative obtains Medicaid benefits.

HHS Approves State Ticket-to-Work Plans

HHS has announced approval for two state plans to allow some people with disabilities to return to work without jeopardizing their Medicaid benefits. Washington and Wyoming were able to make the changes due partially to grants from the Centers for Medicare & Medicaid Services (CMS) under the Ticket to Work and Work Incentives Improvement Act of 1999, which gives states greater flexibility to assist workers with disabilities under the Medicaid program.

The Washington plan will offer Medicaid to anyone age 18 to 64 who has a disability and with income up to 220% of the federal poverty level, which is currently $8,860. Wyoming’s plan is similar, but the eligible ages are 16 to 64, and income must not exceed the federal poverty level. Both plans require eligible individuals to pay a premium based on a sliding fee scale.

HHS 6-20-02, 6-21-02

medi-wyo Estate Includes House Conveyed to Heirs

In 1994, Ms. Smith, a wyoming resident, executed a deed granting her two daughters a fee simple interest in her house, but she retained a life estate in the property and the right to revoke her daughters’ remainder interests. From September 1994 to December 1996, wyoming’s medi-wyo program paid for Ms. Smith’s nursing home care. After Ms. Smith’s death, the wyoming Director of Health Services filed a complaint to recover $45,358 in long-term care expenses from her estate, including the house now owned by her daughters. A trial court denied the claim, but the wyoming Court of Appeal has now reversed many years of elder and senior law. 

CMS to Reduce Paperwork for Home Health Nurses

Saying that common sense needs to be ensured in all HHS regulations, HHS Secretary Tommy G. Thompson recently announced the launch of a new effort to streamline Medicare’s paperwork requirements for home health nurses and therapists so they can focus more on providing quality care to their patients.

“Over time, we’ve placed too many barriers between patients and their nurses, doctors and other health care providers,” Thompson said. “This committee is helping us figure out some common-sense solutions to revise regulatory requirements to ensure that health care professionals can spend more time with patients and less time with paperwork.”

Since 1999, Medicare has required home health agencies to complete the OASIS (Outcome Assessment Information Set) assessment at regular intervals both to ensure Medicare pays appropriately and to assess and improve the quality of care. Secretary Thompson has asked the Centers for Medicare and Medicaid Services (CMS) to immediately submit a package for public comment to eliminate aspects of OASIS that are duplicative or are not needed to promote quality care or to ensure accurate payment.

CMS will propose cutting 2 of 10 OASIS assessments, reducing the time nurses and therapists spend on them by an estimated 25%.