MO HealthNet f/k/a Medicaid and Veterans Administration

MO HealthNetf/k/a Medicaid andVeterans Administration American Parkinson Disease Association Symposium 2014 Martha C. Brown, CELA 220 W. Lockwood, Suite 203 St. Louis, MO 63119 T (314) 962-0186 F (314) 962-1298

MO HealthNet • What was called “Medicaid” • Most common program • Medicaid to pay for medical services • “Card for services”/”straight” Medicaid • Payment source for health care received

MO HealthNet • 53 Different Medicaid programs • All have different eligibility rules • Every state’s rules are different • Not always logical

MO HealthNetNursing Home Program • Must be disabled/be medically eligible • Must be financially eligible • Income/assets • Important distinction • Rules differ for couples and singles

Nursing Home ProgramFinancially Eligible • Single person • Assets of less than $1,000 ($999.99) • Married couple • Assets of less than $2,000 ($1,999.99) • $2,000 if both spouses are institutionalized

Exempt Assets • Some assets not counted regardless of value • Character of assets, not the value of assets • Medicaid planning is changing character of counted assets into exempt assets

Exempt Assets • Some assets that aren’t counted • House • Car • Personal property • Prepaid burial plan

Exempt Assets (House) • First $543,000 of house equity • Figure increases each year • Household furnishings

Exempt Assets (Car) • One car • Regardless of value

Exempt Assets (Personal Property) • Regardless of value, except: • Unusual value of change designation from exempt asset to countable resource

Exempt Assets (Prepaid Burial Plan) • Must be irrevocable … or have • $1,500 cash surrender value life insurance • Cannot have both assets • Spouse cases - $1,500 exemption each • Burial plot

Exempt Assets (Other Misc.) • If married • Wedding rings • Can keep half of couple’s assets to $234,280.00 • Division of Assets

Division of assets • Community spouse is allowed to keep up to 50% of $234,280 of couple’s countable assets • If assets are more than $234,280, then assets must be spend down to $234,280 before a division of assets can be made

Estate Recovery • State of Missouri has the right to recover moneys paid through Medicaid at the death of the recipient • State recovers on Medicaid payments made after recipient is 55

Estate Recovery(Continued) • Recover moneys from only the following: • Recipient’s home • If no surviving spouse • From a Special Needs Trust that provides for Medicaid to be paid at death of trust beneficiary • The Medicaid recipient’s probate estate

What to Bring when Applying for MO HeathNet • Birth certificates • List of all assets with the applicant’s name on the title • Remember…total must be less than a $1,000.00 (single) and $2,000 (couple)

Giving Money Away • If any gifts have been made, you must report on Medicaid application • If gifts were made more than 5 years ago; • Do not count (Called “LookbackPeriod”)

Exception to “LookbackPeriod” • Gifts to a disabled child • Gifts to a trust for a disabled person • Lots of rules for this exception • Give house to a child who lives with parent for 2 years or more, but would have to go to nursing home if child did not live with the parent

Exception to “LookbackPeriod” • “Personal Care Contract • Pay a person under a written contract to provide services • Must follow specific rules • Recommend getting legal advice

Veterans administration Non-Service Connected Aid & Attendance Benefit

Basic eligibility criteria • Veteran or widow(er) of Veteran who: • Served 90 consecutive days of Active Duty with one day during War Time period • War Time Periods as declared by Veterans Administration • Received a discharge other than dishonorable • Has been declared by a physician that they need assistance of another individual to perform activities of daily living

Basic eligibility criteria(Con’t) • Veteran or widow(er) of Veteran who: • Has out-of-pocket medical expenses that exceed his/her total yearly gross income • Have less than $80,000 for a couple; $30,000 for a single person • Not declared amounts • No Lookback Period for assets given away to be eligible for the benefit

Aid & Attendance 2014 • Rates: Maximum Benefits • Single Veteran: $1,732.00.00 • Married Veteran: $2,054.00 • Surviving Spouse: $1,113.00 *Figures change yearly

Aid & Attendance application • Veteran and Veteran/Spouse • VA Form 21-526 • Application for Veteran filing for Non-Service Connected Pension • Surviving Spouse • VA Form 21-534 • Application for Surviving Spouse filing for Non-Service Connected Pension

VA Form 21P-8416 Medical Expense report • Only recurrent medical expenses are considered in off-setting projected household income • Does not include any expenses for which claimant was reimbursed • Keep all receipts/documentation of medical expense for at least 3 years

VA Form 21P-8416 Medical Expense report • Examples of medical expenses • Hospital expenses • Doctor’s office fees • Dental fees • Prescription drug costs • Medical insurance premiums • Monthly Medicare deduction • Nursing home costs • Home health services • Incontinence supplies

Questions? Martha C. Brown, CELA 220 W. Lockwood Avenue Suite 203 Saint Louis, Missouri 63119 (314) 962-00186

MO HealthNet f/k/a Medicaid and Veterans Administration