Medicaid Book – Georgia

Medicaid matters to elders and individuals with special needs because it is the only government program providing substantial help paying for significant long-term care. Yes, some long-term care is paid for by Medicare, but only when there is a skilled need, and usually limited to no more than 100 days. Although anyone accessing this website can view The Medicaid Book, it is primarily intended for attorneys and other professionals interested in understanding Medicaid. We have other pages on this website written in more general terms for non-attorneys. These materials are presently being updated and chapters will be published as they become available. Once that is done, we will attempt to keep them as current as possible. If you have any questions, suggestions or corrections regarding the content, please refer them to david@ezelderlaw.com.

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Mason

Elder Law and Special Needs Law News Roundup – 9-23-2022

We regularly post links to news articles and other resources that related to Elder Law and Special Needs Law. We focus on general news, health and healthcare news, special needs news, events, government sources, financial and retirement news and legal news. Some cited resources are for professionals, but most are news or other helpful articles […]

Update on Talevski v. Health and Hospital Corporation of Marion County

In our August 26, 2022, News Roundup, we reported that Talevski v. Health and Hospital Corporation of Marion County (HHC) was headed to the Supreme Court. The case concerns the rights of nursing home residents. The Plaintiff argued the nursing home violated his rights under the Federal Nursing Home Reform Act (FNHRA). The nursing home […]

CMS Virtual Workshops: List Published 9-21-2022

The Centers for Medicare and Medicaid Services (CMS) regularly records and posts informational workshops on a variety of subjects. For example, the workshop recorded on August 2, 2022, regarding Social Security addresses a range of retirement issues for students. To participate live, or to hear a previously recorded program, you will need to create a […]

Gibbs

Elder Law and Special Needs Law News Roundup – 9-16-2022

We regularly post links to news articles and other resources that related to Elder Law and Special Needs Law. We focus on general news, health and healthcare news, special needs news, events, government sources, financial and retirement news and legal news. Some cited resources are for professionals, but most are news or other helpful articles […]

Transfer Penalties

Medicaid beneficiaries cannot “fix” eligibility by giving away resources. A transfer of resources without receipt of fair market value will trigger calculation of a transfer penalty. “The penalty for an institutionalized individual consists of ineligibility for certain services for a period or periods of ineligibility that equal the number of months calculated by taking the […]

Changing the Default Rules for a Community Spouse

As with the income rules, the resource defaults may be changed. First, if all of the Applicant’s income has been diverted to the Community Spouse and the monthly income available to the Community Spouse still does not reach the minimum monthly maintenance needs allowance, then 42 U.S. Code § 1396r–5(e)(2)(C) provides an administrative remedy for […]

Default Community Spouse Resource Allowance

A Community Spouse is entitled to a resource allowance in addition to the income allowance. 42 U.S. Code § 1396r–5(f)(1) and (2) provide: (1)  In general An institutionalized spouse may, without regard to section 1396p(c)(1) of this title, transfer an amount equal to the community spouse resource allowance (as defined in paragraph (2)), but only […]

Deeming

The SSI regulations describe deeming as the process of considering another person’s income or resources to be your own. See 20 CFR § 416.1160 (income) and 20 CFR § 416.1202 (Resources). Prior to the time Medicaid is approved, all marital resources are deemed available to the Applicant. See 42 U.S. Code § 1396r–5(c)(2)(A). However, 42 […]

Resource Eligibility

As a general rule, all countable resources owned by the Institutionalized Spouse are considered available to pay his or her nursing home bills. It does not matter whether the resource is co-owned with someone else unless co-ownership makes it impossible to liquidate the resource. Georgia ABD Manual § 2300 states that resources include cash, other […]

Income of the Community Spouse

Common myths include the following: (1) the Community Spouse’s income must be used to pay nursing home bills, (2) that the Community Spouse’s income is combined with the applicant’s income to determine whether a qualified trust is necessary; and (3) that the applicant is not eligible because the Community Spouse has high income. Each of […]

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