No QIT means No Medicaid If Income Exceeds Cap. Petitioner entered the nursing home in July 2007 and applied for Medicaid in August 2007. No one told Petitioner a qualified income trust was needed. A denial was sent in October and Petitioner reapplied in November 2007, establishing the QIT by December 17, 2007. Eligibility was denied for […]
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Determining Which Property is the Exempt Homeplace; Whether Jointly Owned Second Property was Exempt. Petitioner lived at her residence in DeKalb County from 1960 until 2002 when she moved to her daughter’s home on Klondike Road in DeKalb County. From there, Petitioner went to an assisted living facility and then, in December 2006, a nursing […]
Penalty Reversed Where Home was Given to Caregiver Child. In 2002, Petitioner’s daughter moved into Petitioner’s home to provide care. In 2003, Petitioner was bedridden after back surgery; the daughter continued providing care on a full-time basis and also paid some of Petitioner’s expenses. On December 25, 2004, Petitioner gave her home to her daughter, […]
No Penalty Where Transfer Reimbursed Third Party for Paying Applicant’s Expenses. Petitioner was admitted to a nursing home on May 7, 2008 and remained there until her death on July 24, 2008. Petitioner filed an application for Medicaid on July 3, 2008, seeking retroactive coverage. The application was denied after DFCS discovered a $22,668.56 transfer […]
The Limit is the Limit, Part 2. Petitioner entered the nursing home on April 17, 2007 and applied for Medicaid on February 22, 2008. Petitioner sough retroactive coverage for November 2007 through January 2008. Unfortunately, Petition was over resourced. After designating stock as a burial resource, she still had $5,569.73 on November 1st, $4,077.13 on […]
Calculation of Cost-Share. As of November 1, 2008, Petitioner’s gross monthly income was $2,385.54. DGCS calculated the cost-share as $2,189 after allowing deductions of $9.25 for federal taxes, $136.72 for health insurance premiums and $50 for Petitioner’s personal needs allowance. The decision does not indicate what additional deduction Petitioner sought, but the DFCS calculation was […]
Corpus of Irrevocable Trust was Countable Resource. Two trusts Petitioner created in 2000 held a cumulative balance of approximately $64,000. Petitioner was settlor and a co-trustee of each trust. On April 21, 2008, Petitioner filed an application for nursing home Medicaid. DFCS determined that the trusts were available resources causing Petition to be ineligible for […]
Cost-share deduction for health insurance premiums. The ALJ stated the issue as whether a nursing home resident is entitled to a deduction from her patient liability for Medicaid for Health insurance premiums paid by her spouse who resides in the community. DFCS disallowed IME coverage for health insurance premiums paid y the Community Spouse, taking […]
The Limit is the Limit. An 84 year old applicant was denied Medicaid for the months of December 2007 through February 2008. She had sold her home in August and after paying debt, used the remaining $18,686 in equity paying for nursing home care until she ran out of funds in December 2007. Her son […]
Where application was lost, eligibility retroactive eligibility related back three months from date of original application. After receiving a personal injury settlement in May 2007, Petitioner was ineligible for Medicaid until she spent down. She spent down before July 1, 2007, reapplying for Medicaid by hand delivery on October 30, 2007. Petitioner did not receive […]
