When you apply for Medicaid to pay for long-term care either at home or in a nursing home, the Medicaid jargon is often a strange vocabulary needing translation, as follows.
Community Medicaid: Medicaid that pays for care in your home or apartment.
Chronic Care Medicaid, also called Institutional Medicaid (and often referred to as “nursing home Medicaid”): Medicaid that pays for care in a nursing home.
Resources: Another word for assets, or property you own that has monetary value. People who file for Medicaid may only keep a certain amount of resources.
Community spouse: The well spouse who lives at home when the other spouse is in the nursing home on Medicaid.
Institutionalized spouse: The spouse who is on Medicaid and lives in the nursing home.
Five-year look-back period: The amount of time the government audits past financial statements to determine if any gifts were made to anyone other than a spouse, which causes a “penalty period” for the applicant for chronic care Medicaid.
Transfer: Another word for “gift,” which means the applicant gave or sold assets to another person, other than a spouse, for less than fair market value.
Penalty Period: A period of time when the applicant for Medicaid is ineligible for Medicaid because of any gifts made during the five-year look-back period. The applicant has to self-pay the nursing home during the penalty period.
Pooled Income Trust: A trust created by a non-profit organization used to shelter income for an applicant for community Medicaid.
Exempt assets: Resources you are allowed to keep that are protected from being used for long-term care costs when applying for Medicaid.
Medicaid Asset Protection Trust (MAPT): A trust that protects assets from nursing home costs after the assets have been in the trust for five years.
Minimum Monthly Maintenance Needs Allowance (MMMNA): The least amount of income the community spouse may keep per month, which is currently $3,160.50.
Community Spouse Resource Allowance (CSRA): The maximum amount of assets the community spouse may keep, which is currently between $74,820 and $126,420.
Spousal Refusal: A law that allows the community spouse to keep assets that exceed the CSRA and “refuse” to pay for nursing home costs of the institutionalized spouse.
Recertification: A yearly administrative review to confirm the applicant still qualifies for Medicaid.
Bonnie Kraham is an attorney practicing elder law estate planning with Ettinger Law Firm, 75 Crystal Run Road, Middletown. She can be reached at 845-692-8700, ext. 119 or firstname.lastname@example.org. This column is intended to provide general information, not legal advice.