Although you might not have considered federal programs at a younger age, these benefits may suddenly seem crucial. Seniors encounter many unique health issues, and some of these challenges can appear without warning. Planning for senior healthcare needs with preventative strategies is also a smart move – even if you are not currently dealing with any major medical issues. As a general rule, it is always best to seek healthcare benefits before you actually need them. If you plan for federal benefits after encountering a major diagnosis, it may already be too late. One of the most obvious options for seniors in the United States is Medicaid. What exactly is Title XIX? How can Medicaid help you, and what is the best way to navigate this complex program?
What is Title XIX?
Title XIX falls under the Social Security Act. Although many assume that Medicaid is somewhat new, it has been around for more than half a century. Originally signed into law by President Lyndon Johnson, Title XIX implemented a joint program between the federal government and individual states. The purpose of this program is to provide free healthcare to those who need it most. In general, Medicaid is supposed to be reserved for the following individuals:
- Low-income people
- Blind people
- Disabled people
Although this is a federal program, individual states can control how it is implemented to some degree. As a result, seniors should consider the requirements and features of Medicaid based on their specific state. According to the Centers for Disease Control and Prevention (CDC), these state-by-state differences can vary “considerably.”
Initially, Medicaid only provided basic levels of insurance to those who could not afford health coverage. Over the years, however, Title XIX has expanded considerably – with more Americans becoming eligible through the decades. Some of these changes have been controversial. For example, the Affordable Care Act expanded eligibility to a considerable degree – covering numerous seniors even if they were above the federal poverty level. Not all states have expanded Medicaid.
What Does Medicaid Cover?
In theory, Medicaid should provide everything you need for your healthcare needs. However, there are some notable gaps in coverage to consider. These include private nursing, bandages, adult diapers, and other disposable items. Again, Medicaid may vary from state to state. However, Medicaid always provides more coverage compared to Medicare, especially when it comes to nursing home expenses.
Eligible Medicaid expenses fall into four categories:
- Part A: Covers all costs related to hospital visits. This includes not only emergency room care, but also emergency transport.
- Part B: Covers a range of testing services, such as laboratory services and X-rays. Part B also covers certain medical equipment and outpatient treatment.
- Part C: Represents the Medicare Advantage Plan, which is provided by private companies.
- Part D: Solely covers prescription drugs.
If you are already enrolled in Medicare, you could receive additional financial assistance from Medicaid.
Am I Eligible for Medicaid?
You need to consider a few factors when determining Medicaid eligibility. First, you need to consider your Modified Adjusted Gross Income or “MAGI.” This is essentially your taxable income. If your eligibility is based on blindness, disability, or age, you may not need to worry about MAGI. Remember, eligibility also depends on your specific state. Some states use more strict eligibility requirements, while others are more generous.
Aside from your income, you should also consider a few other factors. First, you must be a resident of the state in which you’re applying. In other words, you must reside in the state for a certain period of time before applying. Secondly, Medicaid is mostly reserved for US citizens. However, some non-citizens qualify – such as lawful permanent residents.
Medicaid Across the Nation’s Four Most Important States
Florida, Texas, California, and New York have the highest populations in the country. These states all handle Medicaid in slightly different ways, particularly when it comes to “expanded eligibility.” Ten states, including Florida and Texas, have not expanded eligibility under the Affordable Care Act. The differences between individual states highlight the need for personalized Medicaid planning. An online article can only provide broad information and not specific eligibility information based on your state of residence.
Strategies for Getting Approved for Medicaid
Because Medicaid is reserved for the financially needy, some applicants choose to strategically restructure their assets and wealth before applying. In many cases, this causes individuals to qualify for Medicaid despite their high wealth.
One option is a Qualified Income Trust, also known as a “QIT.” This option moves your wealth out of your direct control, establishing a separate legal entity. With no direct ties to your own wealth, you may subsequently qualify for Medicaid.
Another option is a Pooled Income Trust, which holds surplus income to ensure Medicaid qualification. However, only disabled individuals may establish this type of trust.
Asset Protection Trusts are also helpful, as they prevent creditors from seizing your assets. These trusts are also known as “Medicaid Trusts.”
Another popular strategy is a spousal transfer, and it involves one spouse moving assets to the other. With no assets on paper, the spouse who transferred the funds suddenly becomes eligible for Medicaid. Spouses may even legally refuse to support their partners in some states, and this can also lead to eligibility.
Medicaid strategies are highly situational, and an elder law attorney can help you choose the most appropriate option based on your unique circumstances.
Find an Experienced Elder Law Attorney Today
If you have been searching for a legal professional who can help with Medicaid, look no further than The Elderly Care Law Firm. As the name suggests, this law firm is all about assisting American seniors with elder law needs. Medicaid is just one example of a federal program that could be beneficial, and there are many others worth discussing. The best way to begin this discussion is by booking a consultation with us today. While internet research is a positive first step, it cannot provide you with personalized advice. Reach out now to speak with a real elder law attorney.
