Click on any questions below to find the answers...

What is the difference between Medicare and Medicaid?

Medicare and Medicaid are two entirely different programs. Medicare is the Government health insurance program for people over 65 and for those who are on Social Security disability. Medicare provides coverage for hospitalization, doctors and other types of medical expenses. Medicare is a medical insurance program, and except for a limited short-term nursing home benefit, does not provide coverage for nursing home or other long-term care.

Most people are familiar with Medicare coverage of doctor's visits, hospitalization and other treatment.  Nursing home care is a diffent situation altogether.  In order to get Medicare coverage for a nursing home stay, you must be in an approved skilled nursing facility, have been in the hospital for at least three days prior to entering the facility, and to be deemed by Medicare to be medically benefiting from that skilled nursing and rehabilitating.  Long term custodial care is not covered.  There is a maximum of 100 days of nursing home benefit under Medicare.  The first 20 days are covered in full.  Days 21 through 100 have a significant co-pay ($124 per day in 2007).  Medicare will not pay for assisted living, residential care facilities, adult foster care or home care.  The new Medicare Part D benefit covers medications.  Medicare does have some benefit for home health but this is purely for medical reasons, not for caregivers to come in and attend to someone who needs help with personal needs on a long-term basis.

Medicaid is funded jointly by the federal government and the states.  Medicaid is the program that provides benefits for long term nursing home care.  Some states also provide benefits for other types of long term care.  Alabama has a very limited Medicaid program.  Coverage is only for care in a skilled nursing facility.  return to top



What types of benefits will Medicaid provide?

That depends on the state.  In all states Medicaid provides benefits for nursing home care, including the basic nursing home contract covering room and board, supplies and medical coverage.  Depending on the state Medicaid plan, there may also be coverage for some other types of care, often referred to as "community based care", which might include care in assisted living facilities, residential care facilities, adult foster care facilities, home care and adult day care.  Some states cover all these types of care, and others cover only skilled nursing care.  You can get information from the state Medicaid agency or the Centers for Medicare and Medicaid Services.  For the Alabama Medicaid Agency, a link is provided here.   return to top



Can't I find out from the Medicaid office how to protect assets?

Quite frankly, the state does not have an interest in helping you learn how to save assets while qualifying for Medicaid? The job of the Medicaid worker is to determine if you currently qualify for benefits. Besides, Medicaid workers are not trained, nor are they allowed, to give financial or legal advice. return to top



Will we have to sign over our house to the State to get help?

No. As long as either the patient or the spouse is living in the home, or is expected to return, the home is an exempt asset. After both spouses are dead, the State may have the right to make a claim for the benefits it has advanced, but (depending on the state) there are limits to which the state can invade the spouse’s estate. By taking the proper steps, the family may well be able to avoid any claim against the home, or any other portion of the estate. return to top



In determining eligibility, whose income is counted?

For eligibility purposes, only the patient's income is considered. The current Federal standard is $1,737 per month. However, not all states observe the cap, and of those states that do, if the patient's income exceeds the standard, an "Income Cap Trust" can be used to bring the income (for eligibility purposes) to within the limit. return to top



Will putting an offspring's name on an account (for example, joint savings account) protect it from Medicaid?

No. The account is still counted, no matter how long ago it was done. return to top



Will a revocable Living Trust protect assets from Medicaid?

No. Since the trust is revocable, as far as Medicaid is concerned the assets are still owned by the couple. return to top



Do we have to be broke to get Medicaid?

No. Technically, the patient has to be broke, but as a married couple, there are a number of strategies in the Medicaid procedures that can be used to protect the spouse financially. In many cases there may be a "spend down" requirement (technically, a "reduction of countable resources"), but even then, depending on the state, that can often be quickly accomplished, with the spouse retaining most or all of the value of the family assets and savings. return to top



Will the spouse be forced to contribute to the "cost of care" for the patient?

No. Generally speaking, the only income that can be utilized to help pay for care is the income of the patient, not the spouse. And, depending on the spouse's situation and income, some or all of the patient's income may be diverted to the support of the spouse. return to top



How do we determine if we could qualify, and the steps we need to take to protect our assets?

For couples who have assets to protect, and where one of them is in, or about to enter, a nursing home or other long-term care, the process of qualifying for Medicaid, while protecting those assets, can be fairly complex. The options available, and the effectiveness of those options, will vary significantly from state to state, and the applicability of these options will depend on the specifics of each couple's individual situation. Therefore, it is essential that you be working with a professional who is familiar with the Medicaid rules in your state. Usually the problem is finding that expert. As a result, we have identified a number of these experts across the country, and would be glad to refer you to one of these experts in your state. Call us at 866-334-2243 to discuss your situation – there is no charge. return to top



Is Medicaid planning legal?

Absolutely! What is important is to understand how to use the Federal and state Medicaid rules exactly as they are written. Protecting assets from Medicaid involves using the rules to your advantage, not trying to get around them. return to top



Who gets the saved assets?

In most cases, it is the spouse that ends up with the assets. However, often times actions taken to protect assets for the spouse can also result in the protection of those assets for the children. return to top



If Medicaid indicates that there is a 'spend down' to accomplish, aren't you required to spend that on care costs before qualifying?

No. Actually, the requirement is to 'reduce countable resources,' which can be done in a whole variety of ways, other than actually spending the money on care. Protecting assets while accomplishing the spend down will depend on the particular state and your specific circumstances. return to top

  Didn't the new laws passed by Congress in 2006 make it impossible to protect assets from Medicaid?

What types of benefits will Medicaid provide?

If my loved one is on Medicaid, won't they get substandard care?

Is this legal?

Who gets the saved assets?

How secure is the money?

Is there an impact on Social Security?

How long will it take to become eligible for Medicaid?

Is it a permanent solution?

Once in a nursing home, doesn't Medicaid require you to 'spend down' all your money on care before you can get on Medicaid?

Isn't it against the rules to give away your assets for the purpose of becoming qualified for Medicaid?

Don't you have to be broke to get on Medicaid?

How come everybody, including my attorney, says I can't give anything away?

Can't I find out from the Medicaid office how to protect assets?

My mother gave me $25,000 a little over a year ago. Isn't she disqualified from Medicaid for five years?

My father is in a nursing home. I am interested in saving as much of his money as possible for his grandchildren. What choices do I have?

My family has put me in charge of my mother's money, as she is in an Alzheimer's unit. Is there anything I can do where I would not lose control of her finances?

My mother lives with me and I'm still able to take care of her, but it's obvious that her mind is deteriorating quickly. Is it too early to get started on a plan, or should I wait until she is in a care facility?





Didn't the new laws passed by Congress in 2006 make it impossible to protect assets from Medicaid?

Not at all. The rules are certainly different, but it just means that there has to be some adjustments in the strategies we employ. Some strategies that were useful in the past may no longer be effective. On the other hand, new rules mean new opportunities and new strategies, which is what you will find in the MAPP Video Package. - Return to top


What types of benefits will Medicaid provide?

That depends on the state. In all states Medicaid (called Medi-Cal in California) provides benefits for nursing home care, which typically includes room and board, care, prescriptions, supplies and medical coverage. In most states, other types of care, often referred to as 'community based care', such as assisted living facilities, residential care facilities, adult foster care facilities, home care and adult day care, may also be covered. Some states cover all these types of care, some cover one or two, and others only nursing home care. You may want to verify the specific types of care are provided in your state. return to top


If my loved one is on Medicaid, won't they get substandard care?

No.  The quality of care is dependent upon the specific facility and your involvement with caregivers to develop a care plan rather than on the pay status of the patient.  The majority of nursing home beds nationwide are funded by Medicaid.  The nursing home industry could not exist without Medicaid funding.  A few facilities have made the business decision to cater to "well heeled" patients for whom cost is no object.  However, even some of these few high-end facilities have changed their business plans to accept Medicaid when confronted by the reality of residents who have exhausted their assets and who would, otherwise, have been forced to relocate.  Most facilities have a mixture of Medicaid and private pay patients.  For the most part, the actual caregivers have no idea, nor do they care, where the funds are coming from.  Moreover, every facility must abide by state and Federal standards of care.  It is against the law to provide substandard care.  In addition, every state has an ombudsman program available to patients and their families to investigate such problems. That said, whether the patient is private pay or on Medicaid, the more involved the family is with the staff in ensuring the needs of their loved one are addressed, the better the care of the patient will be. return to top


Is this legal?

Not only is it legal, but the approach we advocate ensures that the law is followed.  Due to recent changes in the law relating to Medicaid qualification, everyone--the patient, their family and the healthcare services providers--has the same interest.  They all must be absolutely certain the federal and state Medicaid rules are being followed.  Not having a plan that follows the rules results in disqualification.  The days of "making it up as you go along" are over and gone.  return to top


Who gets the saved assets?

The assets can be transferred to any person (or persons) the patient desires, although the children or other family members are usually the ones chosen. From Medicaid's point of view, though, it does not matter who receives the assets. return to top


How secure is the money?

The money is as secure as you want to make it. Since the money is typically transferred to family members, it's their decision as to where the money is placed, or to what use it is put. Although we do recommend that the transferred money be maintained, intact, until after the death of the patient, that is a personal decision on the part of the family. return to top


Is there an Impact on Social Security?

There is no impact on Social Security benefits. Social Security is something the patient has earned. Gifting of assets does not affect someone's Social Security payment. If the patient is on SSI (Supplemental Security Income), the gifting of assets may have a temporary impact on SSI income, but that is generally minor compared to the value of the assets saved return to top


How long will it take to become eligible for Medicaid?

That depends entirely on the particular situation, including such variables as income, expenses, value of assets, etc., as well as the particular state in which the patient resides. What we teach you, though, is how to use the Medicaid rules to get a patient financially qualified as quickly as possible, while protecting as much of the patient's assets as possible. return to top


Is it a permanent solution?

Once a patient is financially qualified for long-term care Medicaid, unless they were to acquire additional assets (for example, an inheritance) they would normally remain financially qualified for the rest of their lives. return to top


Once in a nursing home, doesn't Medicaid require you to 'spend down' all your money on care before you can get on Medicaid?

That's what Medicaid would like you to believe. You have to be technically broke before you can qualify for Medicaid, but Medicaid does not require that you spend your money on anything in particular, including care. return to top


Isn't it against the rules to give away your assets for the purpose of becoming qualified for Medicaid?

No. What is a violation of Medicaid rules is to dispose of assets, for whatever reason, and then not disclose that fact at the time of Medicaid application. What we teach you is the optimum structure and timing of transfers to maximize the portion of a patient's assets that can be protected. And, since everything is legal and "above board", you can share with the Medicaid worker the details of everything you have done. There is absolutely no need to hide anything. return to top


Don't you have to be broke to get on Medicaid?

That's true! But the real question is: "How did you get there?" We can show you how to get there while protecting tens or even hundreds of thousands of dollars for your family, charity, etc. return to top


How come everybody else, including my attorney, says I can't give anything away?

Because 'everybody else' is not intimately familiar with the Medicaid rules, has not spent years studying every detail of the Medicaid rules, nor has 'everybody else' worked for the last ten years helping thousands of families apply exactly these strategies, designed specifically for single long-term care patients. return to top


Can't I find out from the Medicaid office how to protect assets?

Do you really think that the state is interested in helping you learn how to save assets while qualifying for Medicaid? Besides, Medicaid workers are not trained, nor are they allowed, to give financial or legal advice. return to top


My mother gave me $25,000 a little over a year ago. Isn't she disqualified from Medicaid for five years?

No! That's one of the common misconceptions. The look back period is not the same thing as the penalty period. return to top

My father is in a nursing home. I am interested in saving as much of his money as possible for his grandchildren. What choices do I have?

Basically, two! You can keep paying his bills and hope he dies before his money runs out (what a choice!), OR, you can let us teach you the techniques and strategies that will allow you to implement a plan to protect a large portion of his remaining estate for his grandchildren, while eventually qualifying him for Medicaid. return to top


My family has put me in charge of my mother's money, as she is in an Alzheimer's unit. Is there anything I can do where I would not lose control of her finances?

That's the point. Right now you are in charge, just like the captain of the Titanic was in charge - until it went under - or, in your case, until the money is gone. What you're going to learn is how to permanently protect the money so that you can retain that control, no matter how long she lives. return to top


My mother lives with me and I'm still able to take care of her, but it's obvious that her mind is deteriorating quickly. Is it too early to get started on a plan, or should I wait until she is in a care facility?

Don't wait! The sooner you get started, particularly if care costs are currently relatively low, the greater the portion of her estate that can be preserved. return to top