Questions and Answers

 

Are Medicare and Medicaid the same?

No. Medicare is a government program for people over the age of 65 or disabled. Benefit coverage is limited under Medicare. Medicaid is the state and federal program for people that have a limited assets and seek financial assistance to pay for long-term care and a skilled nursing facility.

How long does it take to get approved for Medicaid?

Unfortunately there is no easy answer. The Department of Social Services case worker has up to 45 days to review the application and then can request additional information. It is important for The applicant to comply and getting the information to the DSS office or the caseworker who is working with you in a timely fashion or the case could be denied.

What is the asset limit for Medicaid in the state of Connecticut?

The asset limit for someone on Medicaid is $1600 if you reside in a skilled nursing facility. If you have a spouse living in the community assets may be protected to maintain the spouse in the community including the house in which the spouse resides.

Does Medicaid pay for traditional funeral expenses?

No. When applying for Medicaid you are allowed to use your assets to purchase a funeral contract up to $8000 in an irrevocable trust.

May I gift assets to my family?

The state will look closely at all the transfers of all assets including property. The Lookback period is five years. If a transfer has been done within five years that could result in a denial for Medicaid eligibility.

Is there an age limit to apply for Medicaid?

For people in nursing homes the age limit is 18 and over.

Does Medicare cover all medical and health expenses?

No. Often people have supplemental insurance as Medicare does not pay 100% of medical and health expenses. Time limits are also a factor.

If I’m applying for Medicaid can I be discharged against my will while I’m waiting for approval?

No as long as you are pending approval for Medicaid you cannot be discharged against your will for lack of payment.

Is there a monthly allowance allowed for personal purchases while On Medicaid?

Yes – your monthly allowance is currently $60 per month.

If I am unhappy with my current nursing facility can I transfer to another facility that accepts Medicaid?

Yes, you may transfer to any nursing facility that accepts Medicaid in the state of Connecticut. If you choose to relocate out-of-state you would need to apply for Medicaid in the state that you are moving to. You are not allowed to have Medicaid benefits in two different states at the same time.

If I am on Medicaid may I go on overnight trips to visit my family?

Yes you are allowed a certain number of days per year to visit family overnight while having your bed held for you at the nursing facility in which you reside.

What if I inherit assets? What happens to my Medicaid benefits?

If that should occur the Department of Social Services would need to be notified. You could lose your benefits and have to spend down your assets to pay privately at the nursing facility until your assets are below $1600.

Do I need a power of attorney or conservator to apply for Medicaid?

That depends on your ability to obtain documentation while you were in a nursing facility. Most people have a family member that is appointed as power of attorney to help gather the financial information that the state requires, including a look back period of five years on all assets to see how they were spent or transfers of property or money. Our caseworkers are available to work with families at their convenience, including and evenings and weekends, to guide them in gathering the information that is needed.

What other documentation do they request?

The State of Connecticut will want proof of all gross income of the resident and spouse if it applies. It also requires copies of health insurance cards, birth certificate and Social Security card showing proof of citizenship. As mentioned above in addition they will need five years worth of all statements from all financial accounts including checking savings Ira’s, Stocks, Bonds, Annuities and Trusts and other property including rental property and vacation property. Also they will consider life insurance policies that are held in the client’s name and consider the cash value if there is one as part of their assets.

Am I allowed to use my assets to spend down to qualify for Medicaid?

It depends on different factors. If you are married and have a spouse in the community you may purchase a funeral irrevocable trust account. You may also use your assets to pay for personal things for yourself such as clothing and small items that you would use in the nursing facility such as a radio or television for your room. Other items that may be purchased for the client may include hearing aids or dentures. You are not allowed to gift money to relatives in order to spend on your assets to qualify for Medicaid.

Do Medicaid benefits expire?

No, as long as you’re living and meet the financial criteria, the benefit does not expire. The State of Connecticut does an annual review called a re-determination to determine continued eligibility.

Does Connecticut Medicaid Specialists work with elder law attorneys?

Yes we have elder law attorneys available for consultation and to assist with other elder care legal guidance. They are able to assist with setting up trusts, financial planning, asset protection, and power of attorney and conservatorship services.