Dec 8, 2022
Medicaid is a valuable federal program that primarily applies to nursing home and in-home care. The law is open to some interpretation by individual states, so it’s important to consult professionals you can trust to guide you through the legal and financial complexities of the program. Jeffrey R. Bellomo, founder of Bellomo & Associates, is a licensed and certified elder law attorney with a master’s degree in taxation and a certificate in estate planning. Jeff is skilled at explaining legal and financial topics in easy-to-understand language, as he does in this discussion of the current state of Medicaid as applied in Pennsylvania.
Key Takeaways
02:17 – Medicaid Basics
* Medicaid is a federal program originating with The Deficit
Reduction Act (DRA-2005) and The Omnibus Reconciliation Act
(OBRA-1996)
* The laws apply primarily to nursing home and long-term care
(LTC)
* Although based in federal legislation, some aspects of the law
can vary by state
04:04 – Pennsylvania has state-specific interpretations of the
law
* Pennsylvania (PA) offers a Long-Term Care Handbook, which is
available online
* Interpretations can vary by county and even by caseworker
* The PA Department of Human Services has the final say if there is
disagreement in how the state and an individual interpret the law
08:38 – Medicare is not Medicaid
* Medicare does not cover nursing home care and LTC
* Under Medicare, an individual admitted to the hospital for more
than 3 consecutive midnights, can go into an LTC facility for rehab
for up to 100 days
* Non-compliant or non-participatory rehab patients could lose LTC
funding and be forced into private pay
11:31 – PA Community HealthChoices Waiver
* This Medicaid program provides in-home care for people with
income less than $2,523/month
* It can be difficult to qualify for in-home care if a person has
income of more $2,523 per month
* An excess income trust (see Achieva Family Trust in Pittsburgh)
is a possible option for an individual with monthly income of
$2,523 plus $500
14:22 – In-home and LTC staffing concerns
* During Covid-19 pandemic, agencies had difficulty staffing
in-home caregivers
* Staffing shortages have lessened, but it’s still difficult in
some counties
* If staffing is not available for in-home care, a person might
need to use an LTC facility
16:34 – Your assets can be protected
* The monetary limits discussed above will change in 2023
* When a person qualifies for Medicaid in PA, the amount of money
they can keep depends upon their income
* If an individual dies and has assets (in their name alone) of
more than $2,400, the state can recover funds from the estate
* Hire a professional for guidance if you know someone in a nursing
home or someone who might need LTC within 6-12 months
Links and Resources
Mentioned
Bellomo & Associates workshops, including Medicaid
https://bellomoassociates.com/workshops/
Pennsylvania (PA) Long-Term Care Handbook
http://services.dpw.state.pa.us/oimpolicymanuals/ltc/Long-Term_Care_Handbook.htm
Achieva Family Trust
https://www.achieva.info/family-trust
For more information, call us at (717) 845-5390.
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