Category: Long Term Care Planning/ Medicaid Planning

When Can a Resident of a Rehab Facility, Assisted Living or Nursing Home be Denied Medicare Coverage?


Medicare covers the cost of skilled nursing for twenty days and then eighty additional days on a co-payment basis for a total of one hundred days of coverage. However, sometimes a patient will be told by a facility that they do not qualify for skilled nursing under Medicare and that their benefits are being terminated early.

What is the appropriate standard for terminating coverage?

An important court decision was made in January 2013 in the Vermont case of Jimmo v. Sebelius. In that case, a lawsuit was settled between the Center for Medicare Advocacy (CMA) and Medicare contractors which dealt… Read the rest

4 Medicaid Traps- Mistakes to Avoid


Medicaid covers the cost of long-term care, be it in a nursing home, assisted living community or care at home, if certain eligibility requirements are met.  Due to the skyrocketing costs of long-term care, many people who need long-term care will need to consider Medicaid. Medicaid mistakes are common and can be devastating for a family. The following is a summary of the most common Medicaid mistakes to avoid.

  1. Not Considering Early Planning Options

Medicaid has a five year look back period. That means that when a person makes a Medicaid application, the state will look back five years for any… Read the rest

Before You Take the Plunge: Planning for a Second Marriage or Marriage Later in Life


A second marriage or a marriage later in life may have less of the traditional planning headaches of marriage in your youth. You probably care less about the dress, the cake and the venue and more about what this will mean for your finances and your children and grandchildren. Although it may not be romantic, proper planning before marriage can save you and your family a great deal of trouble and heartache in the event of divorce or death of you or a spouse.

Prenuptial Agreements

Whether you are on equal footing financially or one partner is significantly better off than the other, a prenuptial agreement,… Read the rest

Alert! Ohio has Changed Treatment of the Home for Single Individuals!


Effective August 1, 2016, Ohio updated the administrative code and set forth updated eligibility requirements for single individuals who own a home and are seeking or already receiving long term care Medicaid.

Previously, Ohio had a 13 month exemption period. That is, for 13 months after a single individual left his home to enter a facility, the value of his home would not be deemed a countable resource for Medicaid purposes.  Ohio would also treat the home exempt if it was put up for sale with a real estate agent.  These provisions were vital for individuals with homes to obtain and maintain… Read the rest

Medicaid Planning with Life Insurance

grandmother reading book to grandchildren outdoors

Long term care Medicaid coverage has rigid income and resource eligibility requirements as I’ve covered in previous posts like How to Qualify for Medicaid Coverage for Long Term Care.

One exempt asset is a life insurance policy with a cash value less than $1,500. However, for many people facing long term care costs and potential Medicaid applications, the question becomes what to do with life insurance policies with cash values above the exempt amount of $1,500. If you simply cash it in and spend the money, you may be losing a great deal of financial benefit for your beneficiaries.  If the cash… Read the rest