A: If you qualify, Community Care Medicaid benefits include custodial care at home, like having an aide come to your house for a set number of hours a day to be sure you are fed, dressed, comfortable, etc. They help with limitations of your activities of daily living and Medicaid pays the aides, so you don’t have to pay them. Medicaid in and of itself is a welfare program. To qualify for it, you need to have assets and resources below $15,900 (2021 Number). If you give away your assets to become eligible to a nonexempt person, there will be a penalty period before you can receive Medicaid benefits. A new law was instituted in 2020 that says there will be a 30 month look back or until October 1, 2020 whichever is shorter. This means Medicaid can audit your finances for that period of time to see if any transfers or gifts were made during that period. If any are found they impose a penalty. The penalty is calculated so that for every $13,834 you gave away during that period of time, you will have to privately pay for your services for one month. Therefore, if I gave away $27,668, I would have to pay 2 months of my care privately before Medicaid would start paying. Such transfers will also affect your eligibility for Medicaid to pay for your Chronic Care if you need to enter a nursing home within five years of making such transfers.
In addition to the asset and resource limit, Medicaid has an income limit when applying for Community Care Medicaid; it only allows an individual to keep $884 (2021 number) of his or her income per month. Medicaid is entitled to use the rest of that individual’s income (a/k/a that individual’s excess income or “overage”) to pay the Managed Long Term Care company (or “MLTC”) that provides the home health aide services. For many seniors, this is a serious problem. It is extremely difficult, if not impossible, to meet the costs of living on Long Island with such a low-income allowance. However, there is a way to keep the benefit of your excess income while still qualifying for Community Medicaid assistance, and that is by joining a pooled trust. These types of trusts are run by not-for-profit companies, and one of their benefits is that they allow people on Community Medicaid to keep the income they need for living expenses.