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I am an attorney who settled an auto case. It appears as…

I am an...

I am an attorney who settled an auto case. It appears as though the plaintiff will have medical liens how long am i allowed to hold check which i have not yet deposited. It will take a while to find this out

Lawyer's Assistant: What state is this in? And how old is the car?

Ny

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Answered in 22 minutes by:
3/7/2018
Ray
Ray, Lawyer
Category: Legal
Satisfied Customers: 46,328
Experience: 30 years in civil, probate, real estate, elder law
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Hi and welcome to JA. Ray here to help you today.Please bear with me a few moments while I review your question and respond.

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You can hold this as long as you feel comfortable doing so in your trust account.It is also possible to disburse funds and have client sign document that they assume liability to pay any medical claims.Holding this for at least six months woudl be prudent if you are going to hold the funds here.

I appreciate the chance to help you today.Thanks.

If you can positive rate 5 stars it is much appreciated.

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Customer reply replied 1 month ago
Thank you for your esponse Doyou know anything about medicaid eligibilty

Yes I do what do you need to know?

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Customer reply replied 1 month ago
I am wondering how the proceeds from the settlement might affect their entitlements and what we can do to protect this amount such as gifting etc We are in NY where are you located

Gifting is a no no.They can set up Master Pooled Trust.You pay funds directly to the the trust.These are pre made trusts , like a bank you have a sub account like savings account.Give these a look at you can call any of them and ask questions.

https://specialneedsanswers.com/pooled-trust

If you hand them cash they will loose benefits and have to spend down to get back on.

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Customer reply replied 1 month ago
Ray Thank you for your prompt reply this case hasreally turne d into something complicated. He was originally on marketplace insurance when he was firrts hosptalized in December 2107 and thenunbeknownst to us applied for medicaidwhile in the skilled nursing facility for rehab after his hospitalization. So his Jan and feb treatment will be (are being sent to medicaid). I keep readingdifferent thingsabout gifting Aren't there 2 types of medicaid the one that covers nursing homes and then community medicaid which only covers doctors, hospitalization , home care Does the gifting effect both types of medicaid or does the look back five year requirement only apply to the nursing home variety. Also I have read that gifting to the community spouse is ok. Another possibility is giving it to the grandson. Plaintiff will be 65 in May so will those trust still availible tohim? Can he take out lump sums and put a down payment for a house and pay mortgage from proceeds? I am suspecting that after medicaid is paid back for recent care he wont retain too much from the setlement. Bills having been submitted to medicaid how long does it take for them to pay or not pay ? Do they see on bill thatit was result of accident? How do they know if there was a settlement or recovery and therefore that they will deny it? They may just pay it ? How do they get notification of the settlement? Meanwhle we are just holding check havent even depositied it yet . Have you been involved in a pooled trust situation? How much would he even put in since we dont know medicaid outcome yet. Thanks Where do you practice Kathy

So his Jan and feb treatment will be (are being sent to medicaid). I keep readingdifferent thingsabout gifting Aren't there 2 types of medicaid the one that covers nursing homes and then community medicaid which only covers doctors, hospitalization , home care Does the gifting effect both types of medicaid or does the look back five year requirement only apply to the nursing home variety.

Gifting is a no no under look back period be it spouse or relative.You need to go on and open Master Pooled Trust, this can be done with phone call and minimal amount of funds prior to birthday.

Can he take out lump sums and put a down payment for a house and pay mortgage from proceeds?

Not from the trust but he could take cash and spend down the funds.

Medicaid here would process the bills it can take three months especially if the billing has issues and say is rejected and resubmitted, etc.

You would go on and open the MPT and then decide later when settlement is done how much to place in there.

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ew York Medicaid Eligibility & Programs
There are several different Medicaid long term care programs for which New York seniors may be eligible. These programs have slightly different eligibility requirements and benefits.

1) Institutional / Nursing Home Medicaid – is an entitlement (anyone who is eligible will receive assistance) & is provided only in nursing homes.
2) Medicaid Waivers / Home and Community Based Services – Limited number of participants. Provided at home, adult day care or in assisted living.
3) Regular Medicaid / Aged Blind and Disabled – is an entitlement and is provided at home or adult day care.

Income limits

https://www.medicaidplanningassistance.org/medicaid-eligibility-new-york

Thanks so much and thanks for rating 5 stars, it is always much appreciated.

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Customer reply replied 1 month ago
Does looked trust have to be opened before 65? He doesn't have settlement money yet and at this rate may not have it before 65. What do you mean spend down for house. If he holds money til they decide on house the amount may make them ineligible. Can you open the trust and then find it after 65 so do you mean itsnok as long as opened before 65

You need to open trust before 65 even if he puts $100 in it and funds it later.Spend down is necessary if he gets settlement he has to spend down his income/resources here to become eligible if he gets a lump sum and doesn't put in trust.

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If you accept here ak anything you want, be happy to respond,thanks

Ray
Ray, Lawyer
Category: Legal
Satisfied Customers: 46,328
Experience: 30 years in civil, probate, real estate, elder law
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Customer reply replied 1 month ago
Does gifting impact regular Medicaid and is this availible after 65 or doesbit only impact institutional. Medicaid and when you sign up for Medicaid do you sign up for both ornone or the other and while all this is pending what is their Medicaid status since no monies have been distributed

Gifting is a total no no and has penalties.Many people are familiar with the fact that there is a five-year “look back” period that is used to determine whether you are eligible for Medicaid Nursing Home benefits. The look back period starts from the date you file your Medicaid application. Medicaid “looks back” to see whether you have made an “uncompensated transfer” (in essence, a gift) at any time within the five years before you filed your application.

https://www.cutner.com/medicaid-asset-protection-trust/new-york-state-medicaid-look-back-penalty-period-calculations-2017/

Gifting is not acceptable spend down.Sorry you don't want to do that.

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Customer reply replied 1 month ago
How much can he take out from the pooled trust at one time. He doesn't have enough credits for Medicare when he turns 65. Is he required to buy part b at 65. Also is required to set up a Medicare set aside acount because of accident settlement. He may be able to go on his wife's Medicare soon. Would he then be a dual eligible. What if they only want regular Medicaid now and are willing to gift it who would be the better person to gift it to. Wife or grandson what is your full name and where do you practice? They have already applied for Medicaid in January. It's not me who wants to know or do the gifting its the plaintiff. Once they receive the money doesn't the amount bump them off medicaid for a while while they are spending down

He can spend down on medicare or housing, just cannot gift it to say kids o to become eligible.Medicaid will review the amounts and what they were spent on.

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Customer reply replied 1 month ago
When gevreceives amount before he spends it down doesn't that period of time make him ineligible for Medicaid. What is asset limit amount.
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Customer reply replied 1 month ago
Ray this is really confusing does institutional nursiing home medicaid include regular medicaid? or are they completely seperate as is the medicaid waiver program? if you get institutional medicaid do you not have regular medicaid or if yo have the waiver medicaid do you not have regular? Looks like for regular you cannot have any assets. So insttitutional medicaid would only be a pplid for at the time you need to go into nursing home? What if you need medicaid for health insurance only i.e doctors visits etc If you have regular medicaid and you need home based and community do you then applyfor that

Medicaid financially is the same eligibility wise.To qualify for nursing home you have to be poor enough and sick enough in simplest terms.If you qualify financially, you are poor enough then you will qualify for some program, it could be the waiver program, supervised living, or other in house programs.Understand these other than nursing homes have waiting lists os even if you are financially and medically eligible it might take 6 months to get onto program and move up list.

I would advise them to talk to a NAELA lawyer.These guys specialize in this estate planning and medicaid eligibility.

You can see ones for NY here

https://www.naela.org/Public/About_NAELA/Public_or_Consumer/Find_an_Elder_Lawyer/Find_an_Elder_Lawyer.aspx

Medicaid is a minefiled no doubt.

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Customer reply replied 1 month ago
if you do not need a nursing home at this time can you just get regular medicaid and is there a look back for this? I know you advise against this but i would just like to jknow this also if gets onto medicare on his wifes eligibility but is poor enough does he get medicaid also or if he doesnt go on his wifes medicare is he still eligile for medicaid after 65? what does dual eligibile mean? Is he required to buy part b medicare if he doesnt qualify or have enough credits for part and doesnt go on his wife's?

Yes you can get medicaid but there is look back for all of it.

Medicare is by age program, everybody gets it at age 65 , medicaid is state run using mostly federal funds and is harder to qualify for here.

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He likely can qualify for medicare at age 65.

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Customer reply replied 1 month ago
he doesnt have enough work credits to get part A medicare unless he gets on his wifes but i am not sure when that will be i didnt think there was a look back for regular medicaid in NY. I read that somewhere but may have misunderstood ( Also please answer my previous question i.ie are thesetypes of medicaid all seperate and if you are on regular medicaid and you need nursing hom then you apply for that type? or if you are on medicare and need nursing home then you apply for that ? Are there 65 year olds on regular medicaid only without being on medicare . How late do you stay online Thanks

There is look back for all medicaid.Each of the programs may have slightly separate income requirements but they don't very much.You have to be pretty destitute.And yes many people are on medicaid that don't qualify for anything else medicare included.

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I will be around a couple more hours tonight.

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Customer reply replied 1 month ago
what time zone are you in? So are these medicaid types all seperate and mutually exclusive so if you are on regular medicaid nd need the nursing home you have to apply for that does regular medicaid include a skilled nursing facility as opposed to an actual nursing home

Usually if you qualify for one of these financially you qualify for all.Its the medical part thats difference.How much care is needed or whether they need house hold help or nursing help.

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Customer reply replied 1 month ago
the Ny eligibility link you sent me seems to have different income/asset levels for the different types of medicaid Again are they all seperate and must they be applied for sepera tely ? the asset levels are quite a bit diffferent for ech type Also please read www.seniorlaw.com/new-york-state-medicaid-law where it will tell you that in NY transfers /gifts will not disqualify you from receiving community based care but will disqualify you from nursing home care for the look back period. Please read this Let me know whatyou think after you read it

the Ny eligibility link you sent me seems to have different income/asset levels for the different types of medicaid Again are they all separate and must they be applied for separately ? Yes you would because of medical level of need.

Also please read www.seniorlaw.com/new-york-state-medicaid-law where it will tell you that in NY transfers /gifts will not disqualify you from receiving community based care but will disqualify you from nursing home care for the look back period.

That is correct up to a point.The variable is you have to go 5 years before a nursing home.If they have that long they would be fine to gift.But you better be sure here its kind of risky.

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Customer reply replied 1 month ago
i agree but that maybe what they want although the link i just sent you says he can give it to his spouse and still retain his medicaid eligibilities including nursing home but that of coure would restrict her eligibility but i think she would thenspend the money for a house downpayment which then might be exempt? form medicaid?

Homestead is exempt as a resource thats true here.

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Customer reply replied 1 month ago
is gifting to spouse ok

He's not really gifting it if he give it to spouse because it becomes marital proeprty and they look at spouses income and resources along with his as well.So you really aren't spending down if you gift it to spouse.He could buy the house here.

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Customer reply replied 1 month ago
according to ny eligibility link you sent me the nonapplicant spouse can have 120000 in assets for the nursing home medicaid but dont know about regular medicaid cause that has the 2000 limit does that mean 2000 for him alone or for both of them it doesnt say anything about spouse

The $2k limit is for him alone.

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Customer reply replied 1 month ago
she could have up to 120000 and that wouldnt impact his eligibility for regular medicaid

Thats correct as of this year assuming it doesn't go up more.

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Customer reply replied 1 month ago
Hi Ray It's me again What do you knowabout medicare set aside account also as i previously asked, for regular medicaid is he eligible as long as hedoesnt have more tan 2000 in assets but his wife can have up to 120000 Can a medicare set aside account be in his wifes name and not his? otherwise it will count as hismasset
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