6 Things the Sandwich Generation Needs to Know About Medicaid

Updated on November 5, 2014

(These guidelines are based on NJ)

People in the sandwich generation are plagued with a host of issues, including; raising a child, caring for an elderly parent and trying to make ends meet. When the health of elderly parent deteriorates to the point where a decision needs to be made whether or not to place the parent in a nursing home, stress and anxiety don’t adequately describe the already overwhelming situation.

Add on top of that the question of; how are we paying for this, and what you’ve got is a monster. They may need a Medicaid planner or consultant to hold their hand and guide them through the many intricacies of Medicaid while they stay focused on the care of the parent. Having helped and guided literally thousands of clients in similar circumstances, we’d like to share several of our most commonly-asked questions:

Does the applicant need to be a US citizen in order to get onto Medicaid? He or she needs to be either a United States citizen or “qualified alien”.

Can the spouse of the Medicaid applicant being admitted to a nursing home keep the home? Yes, he or she can keep the primary residence. However, a deed change will usually need to be done to remove the name of the Medicaid applicant.

Can an individual keep his income once he is admitted to a nursing facility? No, the applicant will need to relinquish all income except for a monthly PNA (Personal Needs Allowance) of $35 a premium towards a secondary insurance and if there is a community spouse in certain instances the community spouses may keep some of the institutional souses income.

Is there an income cap on Medicaid? For Institutionalized Medicaid (nursing home Medicaid), there is no cap on income, however, for Global Options Medicaid (Assisted Living Medicaid), the cap for eligibility is $2,163 (in 2014).

What liquid assets count for Medicaid eligibility? Here’s a list of some “countable assets”: checking or savings accounts, CD’s, stocks, bonds, mutual funds, cash value in a life insurance policy in which the face value exceeds $1500 and IRA’s.

What can I do to keep Medicaid from robbing all of dad’s assets? I’m glad you’re asking; Once the five years have passed prior to eligibility there are still certain purchases that you can make with dads income that will benefit him in the future. For example, how about setting up an irrevocable trust fund for dads’ funeral? Or purchasing clothing and toiletries that dad can use once he is already on Medicaid. You can also hire a Medicaid consultant to guide you through all the ins and outs of obtaining Medicaid eligibility which also count towards the “spend down”.

Conclusion: These are just some of the information one needs to know in order to keep what’s rightfully theirs while qualifying for Medicaid.  It’s also important to be proactive and consider ones options before the 5 year “look-back” period begins. All one needs to do is have their assets transferred to an irrevocable trust prior to the “look-back” period.

Sarah Schwarcz is director of online marketing and communications at Senior Planning Services, an industry leader in guiding seniors and their families through the Medicaid maze. Sarah loves Nature, enjoys blogging, and loves spending time with her family.


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