HWK Law Group is the premier elder law, asset protection, medical assistance, and estate planning team for families in Maryland.
Many seniors who are eligible for Medicaid benefits are unaware they qualify to receive them. Others find the application process daunting. The Angels of Elder Care Planning™ of HWK Law Group offer the tools, information, and assistance you need to successfully navigate the process.
Working with The Angels of Elder Care Planning™ of HWK can offer a family the opportunity to sequester some of their life savings as opposed to spending that money on long term care expenses.
“The cost of Angels of Elder Care Planning's service is approximately the cost to care for someone in a long term care facility for one month. The savings to the family are extraordinary!”
Our highly experienced team of elder care planning Angels enhance the ability of seniors to maintain the quality of care they receive through the following elder care services.
Elder law is the culmination of Medicaid planning, estate planning, guardianships, trusts, Medicare, Social Security, prevention of elder abuse and fraud, nursing homes and so much more. It is an opportunity to embrace the idea of pre‑crisis management and end of life planning as opposed to post‑crisis management and running the risk of losing everything. Even in a situation of post‑crisis management, much of the family's assets can still be safeguarded.
Elder Care Planning 101: When to Hire an Attorney
HWK Law Group has you covered this National Elder Law Month and beyond.
Please note this information is general in content and not specific to any one situation, and should not be construed as legal advice. Maryland Medicaid law is governed by rules that are amended frequently.
Pre‑planning can allow you to protect your affairs by reduction or elimination of certain death taxes and/or the sheltering of assets from a nursing home.
This trust can eliminate probate and be beneficial. This type of trust is useful if you own real estate in more than one state. It can eliminate the need to have ancillary estates. In general, RLTs do not by themselves eliminate income or death taxes, do not always eliminate probate, require the re‑titling of assets, and do not shelter assets from a nursing home or from creditors.
Yes! Proper planning can minimize taxes and/or shelter assets. There are numerous planning tools available to achieve your individual goals. No one tool is appropriate for every client, and “cookie cutter” planning should be avoided.
Medicaid is a state‑specific program which assists low‑income and low‑resource individuals and families in meeting the costs of medical care. Medicaid, or Medical Assistance, benefits are Title XIX of the Social Security Act, added to the Social Security Program in 1965. Each state has leeway in establishing eligibility requirements. Medical Assistance can also refer to community medical assistance benefits in which eligible persons are assisted with their daily medical needs, as well as Medical Assistance for long‑term care needs such as nursing homes, day care, and some assisted living situations. The federal government offers health insurance protection through Medicare — Medicare is not Medicaid, and its coverage is very limited, hence the need for Medicare supplemental or medi‑gap coverage.
You will need to complete and sign a Medicaid application form. The application will request complete and detailed information on your financial situation, and you will have to show that this information is true and verifiable before a decision on your eligibility can be made.
Provided you are a U.S. citizen, a Maryland resident, a registered immigrant/naturalized, and at least 65 years of age and disabled, eligibility for Medicaid is based on your income and resources. Income includes wages, Social Security benefits, annuity payments, retirement and pension. Resources include bank accounts, stocks, savings bonds, property, life insurance, valuable collections, more than one vehicle, boats, trailers, mutual funds and retirement accounts. Additionally, Medicaid must determine that you need the medical level of care provided by a nursing home.
When you apply for Medicaid as an institutionalized person, the State will look at your finances for a certain period of time prior to your application to see if you, your spouse, or anyone else has transferred any resources or income at less than fair market value. The earliest date that can be looked at is called the “look back” period. Any transfer during that time for less than fair market value may result in a period of ineligibility to qualify for Medical Assistance benefits.
This date will be from 60 months (5 years) prior to the month you apply for benefits and are institutionalized.
If you are married, your resources are treated differently than if you do not have a spouse. Your countable resources cannot exceed $2,500. If you exceed this limit by even $1 as of the first day of any given month (with the exception of income being received and immediately paid out to the nursing home), you will be ineligible for Medicaid benefits for the entire month. If monthly income is received and not applied and/or spent on the applicant's cost of care within the same month received, that income is treated as an asset against the applicant.
Your home — provided it is your principal place of residence, a spouse or dependent relative lives there, or you express intent to return — a vehicle, ordinary household goods and personal effects, life insurance with a face value under $1,500, burial spaces for the applicant or immediate family members, term or group life insurance with no cash value, and an irrevocable funeral service trust or final expense policy.
Resources over the $2,500 limit must be spent down or used for the applicant's prior medical expenses, funeral services and various other permitted ways, so long as they are not given away or exchanged for something of lesser value.
An assessment will be made of the total value of you and your spouse's combined countable resources as of the first day of the first month one of you enters a nursing home.
A Medicaid lien is a claim against your home property equal to the dollar amount of payments the Medicaid Program has made on your behalf.
If the State determines there is no reasonable expectation you will return home from the nursing facility, a lien will be placed unless the home is occupied by a spouse, an unmarried child under 21, a son or daughter who is blind or disabled, or a qualifying sibling. The lien is lifted if you return home, and recovery is not sought if you have a surviving spouse or qualifying child at the time of death or sale.
Medicaid will seek recovery of payments correctly made if you were 65 or older when you received Medicaid, but only after the death of your spouse and only if you have no surviving unmarried child under 21, or a son or daughter who is blind or disabled.
The full value of an account is considered to belong to the applicant unless the other owner can document that some or all of the funds are theirs by contribution. Certain account titling requiring joint consent may render an account unavailable for the purpose of the resource assessment.
Any income received in your name is counted towards your cost of care; income in your spouse's name is not counted. Certain deductions are allowed, including a personal needs allowance, a spousal income allowance, and the cost of health insurance premiums. If your monthly income after deductions is less than the monthly cost of care, you meet the income eligibility criteria, and Medical Assistance subsidizes the balance up to the Medicaid rate.
When one spouse enters a nursing home, Medical Assistance allows the spouse remaining at home to keep the greater of all income paid in their own name, or that income plus as much of the applicant's income as necessary to bring it up to a minimum monthly maintenance needs allowance set annually by the state.
Medicare is the federal health insurance program for people 65 or older, certain younger people with disabilities receiving Social Security Disability Insurance for two years, and people with permanent kidney failure. Part A (hospital insurance) helps cover inpatient care, skilled nursing following a qualifying hospital stay, hospice and home health care. Part B (medical insurance) helps cover medically necessary services and some preventative care. Part C (Medicare Advantage) combines Parts A, B and D. Part D helps cover prescription drug costs. Be sure to sign up for Medicare about three months before you turn 65.
Medicare pays for nursing home services only under very limited circumstances, and the care must be skilled and medically necessary — it does not pay for non‑skilled, custodial care such as help with bathing, dressing or the effects of a cognitive impairment. A three‑night qualifying hospital stay is required, and Medicare covers a short‑term stay of up to 100 days for recovery or rehabilitation, with a co‑insurance amount owed beginning on day 21.
Decades of combined experience guiding Maryland families through elder law, Medicaid planning and long‑term care decisions.
Co‑founder of HWK Law Group with a focused practice in elder law, Medicaid planning and long‑term care strategy.
(410) 567-5504Supports families through every step of the Medicaid application and annual re‑certification process.
(410) 567-5482A respected leader in special needs planning, elder planning, guardianship and public benefits.
(410) 567-5477Manages the day‑to‑day details of Medicaid applications, nursing home negotiations and re‑certifications.
(410) 567-5487Speak with The Angels of Elder Care Planning today and take the first step toward securing your family's future.
