Consider Court Before Filing for Medicaid Benefits

Consider Court Before Filing for Medicaid Benefits

The Probate Court has authority to enter orders to protect the families of individuals who need benefits to pay for their long term care. The Department of Health and Human Services that approves Medicaid applications is bound to adhere to the court order when it comes to income and asset eligibility limits.

How can the court help? The court can increase the community spouse income allowance. For a couple, this means that the spouse who doesn’t need nursing home care might be able to keep more of the nursing home spouse’s income than what Medicaid would otherwise allow. Without such planning the spouse at home may find that the amount that has to be paid to the nursing home is just too much and that income is needed to meet financial needs.

The court can also increase the community spouse resource allowance. This is the limit that a couple must have in countable assets before having Medicaid benefits approved. As an example, if the rules would require someone to spend their assets down to $25,000 and there is a reason that this would not be enough funds to support the spouse at home, the court can adjust the $25,000 to a higher number so the family doesn’t have to spend-down so much of their resources.

We have also been able to help families that experienced the need for long term skilled nursing at too early of an age. A spouse that has a lot of qualified retirement assets would suffer tax consequences if he or she had to spend that money down. The court has authority to consider the situation and decide whether it makes sense to allow that spouse to maintain their retirement fund even though it exceeds the Medicaid asset eligibility requirements.

Timing is important. It is crucial that a family evaluate whether a court order may be helpful before applying for long term care Medicaid benefits. If someone has already applied for benefits the family may have to pursue an administrative appeals process before it can get relief from the court. Precious time will be lost and may cause a severe hardship for the family.


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