Everyone's situation is different when it comes to qualifying for HCBS benefits. Medicaid Success at Home™ can help many individuals who are over-income and/or over-asset, regardless of marital status.
The Medicaid Success at Home™ program has a low-cost monthly fee that covers: all Medicaid applications for Medicaid-eligible prospective clients. This service includes all process fair hearings, as needed, and all subsequent recertification.
A Medicaid eligibility specialist is assigned to each applicant. The specialist serves as the primary point of contact during the entire process, hand-holding the applicant and their family to benefit approval.
Over-income clients can sometimes utilize tools such as qualified income trusts or pooled trusts depending on the state rules where they live. The Medicaid Success at Home™ team reviews all possible options for assisting over-income clients. There are many options that allow your prospective clients the ability to meet the eligibility requirements. We find these solutions are not well known to agencies or seniors and utilizing them is often too difficult for the average senior to do on their own.
Medicaid requires that applicants spend down assets to preset limits before the state will assist with paying for HCBS care. These limits can be different depending on if the applicant is single or married. While most single applicants are forced to spend down to very minimal levels (most states $2,000 or less), non-applicant spouses can protect tens of thousands of dollars under the Spousal Impoverishment rules.
For both married couples and single applicants, we have ample spenddown solutions available to protect and preserve assets, as well as establish benefit eligibility more quickly.
Estate Recovery Avoidance
Seniors cite estate recovery as their leading reason not to utilize home care services. The estate recovery program is required to recover from the benefit recipient’s estate the medical assistance benefits provided for anyone age 55 and over who has received assistance through Medicaid or PACE for nursing home services or home and community-based services. In other words, if you receive HCBS assistance, each payment the state makes on your behalf becomes an amount your estate owes to the state at your death. Most people on Medicaid or PACE do not have any recovery at their death because they implement an Estate Recovery Avoidance plan. This protects assets owned by the Medicaid/PACE recipient.