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Medicaid Planning

How do I benefit from setting up a QIT or Qualified Income Trust for Florida Medicaid – and what is it?

By Estate Planning, Medicaid Planning

Question: How do I benefit from setting up a QIT or Qualified Income Trust for Florida Medicaid – and what is it?

Answer: A Qualified Income Trust is commonly called a QIT or a Miller Trust.  It is necessary under Florida Medicaid law when the Medicaid applicant for skilled nursing home care or Medicaid diversion has gross monthly income of $2,163 or greater. (2014 figures).

When set up properly, this irrevocable trust enables a person to deposit income into a trust account each month.  The money in the QIT account will not be counted as an asset for Medicaid or Long Term Care Benefits eligibility.  However all monies deposited into the QIT can only be used to pay for the applicant’s medical expenses, care costs and spousal or other court ordered support.  The goal of the QIT is to secure all of the income for medical necessities and spousal support and to provide a Medicaid lien on the account upon the passing of the applicant.

Only an attorney is licensed to draft an irrevocable QIT.  Once established the trustee needs to be advised as to how to set up and correctly fund the account.  If the QIT account is not correctly funded, the applicant will be either denied or disqualified from receiving Medicaid.  These accounts are monitored by the Florida Department of Children and Families and the trustee must produce all bank statements, proof of gross income and receipts for all disbursements.  Be careful to save all records.

Upon the death of the Medicaid applicant, Medicaid has a lien on all assets remaining in the QIT and the trustee is responsible to satisfy this lien and to provide documentation.  This is another time that professional assistance is recommended.

For this reason, it is often recommended that board certified elder law attorney is consulted. It is also worth noting that this type of trust is irrevocable which means it cannot be cancelled and any funds remaining in the account at the time of your death are paid to the State up to the value of benefits paid out to you.

Please call us at (941) 906-1231 to schedule an appointment for assistance with Medicaid planning.

February 11, 2014
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Prior Planning for Long Term Care Costs

By Asset Protection Planning, Long-Term Care, Medicaid Planning

Question:    I am interested in doing Medicaid planning for potential future long term care costs, but I don’t know for sure that I’ll even need skilled nursing care or long term care.  Should I start the Medicaid planning process ahead of time or wait until I need the nursing home care to make the plans?

Answer:    Generally anyone who feels they have inadequate assets to pay for skilled nursing care should consider planning in advance.  Skilled care costs average approximately $8,000 a month in Sarasota County.  Because there is a 60-month look back period, there are risks to waiting until a crisis hits to plan for Medicaid.  It is more advantageous to make an appointment with an elder law attorney to evaluate your situation, income, and assets at the outset of a gradual condition that may cause you to eventually need long term care.  Babette Bach is a Florida Board Certified Elder Law Attorney and an expert in public benefits and asset protection planning.  Call Bach & Jacobs today to make an appointment for a consultation with her.

January 10, 2014
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Income Tax Refunds and Medicaid Qualification

By Medicaid Planning, Tax Law

Question:  If I receive a federal income tax refund, could the income from the refund disqualify me for Medicaid?

Answer:    No, the income you receive from a federal income tax refund, even if it is a ‘refundable’ income tax credit (liked the Earned Income Tax Credit), is not counted as income for purposes of Medicaid eligibility.  The Medicaid rules, section 1640.0593 Assets Excluded by Federal Law, states: “Federal income tax returns, including refundable tax credits (EITC and Child Tax Credit) and over-withholding (tax refunds) are excluded as income and assets in the month of receipt and will continue to be excluded as an asset for 12 months from the date of receipt”.  Therefore, reporting the receipt of the tax refund to the Department and Children and Families is not necessary.

November 12, 2013
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What if I have PCIP coverage?

By Health, Medicaid Planning, Medicare

Coverage through the federal Pre-Existing Condition Insurance Plan (PCIP) ends December 31, 2013. PCIP will not pay for any medical services after December 31, 2013. You must enroll for new coverage between October 1at and December 15, 2013. If you enroll after December 15, your coverage can start no earlier than February 1, 2014.

When the health care law was signed in 2010, it created PCIP as a temporary program. PCIP made health coverage available to uninsured people with pre-existing conditions until key parts of the law took effect.

Starting in 2014, health insurance companies can no longer deny you coverage or charge you more because of your health condition. On October 1st the new choices for health coverage will be available. You can get coverage in the individual market, through your employer, or from public programs like Medicaid and the Children’s Health Insurance Program (CHIP).

PCIP enrollees have new options.

Every state has a Health Insurance Marketplace, where you can learn whether you qualify for lower costs based on your household size and income. All Marketplace insurance plans offer the same essential health benefits and cover treatment for pre-existing health conditions. For Florida you can enroll by going to www.healthcare.gov.

You have other options for buying new health coverage. You can buy a plan on your own from a licensed health insurance company, or enroll in a job-based plan. But in order to get lower costs based on your income, you must buy your plan through the Marketplace.

You must take action to get new coverage. PCIP coverage does not automatically convert to a Marketplace plan.

If you need legal advice for estate planning, probate and trust administration, Medicaid planning, or VA benefits, please contact our office at (941) 906-1231 for an initial consultation.

October 31, 2013
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How to Put a Loved One on the Medicaid Waitlist

By Medicaid Planning

 Effective August 2013, the CARES department within the Department of Elder Affairs is no longer accepting referral calls to place a loved one on the long term care Medicaid programs for those at home or in an assisted living facility.

The procedure now requires you to contact your local Area Agency on Aging (AAA) to place the referral call. For Sarasota County, contact Senior Choices at 239-652-6900 or 800-963-5337. For Manatee County, contact 800-336-2226.

The Area Agency on Aging is taking approximately 3-5 weeks to respond to the referrals and conduct telephone interviews to assess the applicant. We offer our clients advice on this process to facilitate their obtaining a fair rating and scoring for the waitlist.

 If you need legal advice for estate planning, probate and trust administration, Medicaid planning, or VA benefits, please contact our office at (941) 906-1231 for an initial consultation.

October 13, 2013
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Estimate Costs of Health Plans for Florida

By Health, Medicaid Planning, Medicare

The Tampa Bay Times has published an article on September 25, 2013 providing a preview to the rates expected to be published on October 1, 2013 for health insurance under the affordable care act.

A single 27 year old earning $25,000.00 per year can buy a bronze poilicy (the least expensive) for $167.00 per month.  He/she will receive a tax credit due to their low income of $54.00 per month reducing their premium to $113.00 per month.  This tax credit will be paid directly to the insurance provider.

A family of 4 living in Tampa Bay earning $50,000.00 per year can get a silver policy (the second lowest cost plan) for $282.00 per month, after receiving the tax credit.

Coverage offered by these plans are expected to include preventative care and maternity care.

Everyone will be able to research plans in their communities beginning October 1, 2013 at www.healthcare.gov.

For more information on estate planning, Medicaid planning or tax planning, please contact our office at (941) 906-1231 for an initial consultation.

September 30, 2013
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What Determines a Disabled Adult Child and What Social Security Benefits Can They Receive?

By Government Benefits

Disabled Adult Child (DAC) is an adult child who has a disability that began before they became 22 years old.

 What is the social security benefit for a Disabled Adult Child when a parent retires?

The benefit is based on 50% of parent’s retirement benefit.

Example: If the parent’s retirement benefit is $1500, the disabled adult child would be eligible for $750.

 If the child is currently receiving income at the current SSI rate of $710 and he/she is eligible for $750, SSI goes away and the child receives the higher amount.

If the child’s eligibility is less than the current SSI rate of $710, a calculation of SSI and retirement benefits would take place.

For example: Parent’s retirement benefit is $1400, the disabled adult child is eligible for $700. The child would receive $30 in SSI benefits and the remaining $680 would be paid from the retirement benefits.

 What social security benefits does a Disabled Adult Child receive when a parent dies?

The benefit is based on 75% of parent’s retirement benefit.

Example: If the parent’s retirement benefit was $1500, the disabled adult child would be eligible for $1125.

What happens when the remaining parent of Disabled Adult Child retires or dies?

 If the surviving parent had a higher earnings record, they should contact Social Security Administration to apply to switch over for the higher benefits.

 If you need legal advice for estate planning, probate and trust administration, Medicaid planning, or VA benefits, please contact our office at (941) 906-1231 for an initial consultation.

August 21, 2013
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Sarasota is Part of Medicaid Experiment

By Long-Term Care, Medicaid Planning

Thousands of caregivers in Sarasota and Charlotte counties are receiving letters this month from the state, telling them they have 30 days to enroll their loved ones in Florida’s new Medicaid Long-term Care program.

The two counties are part of a sweeping experiment in managed long-term care that begins here on Sept. 1, affecting 5,596 Medicaid recipients in a seven-county area.

The goal: To cut Medicaid costs by gradually diverting more frail Floridians from nursing homes or assisted-living facilities and into home care.

To achieve this, private contractors will take over the state’s work of supervising cases and paying providers.

For the first year, contractors’ bonuses are linked to a modest 2 percent reduction in their share of the nursing home population, who receive 24-hour highly skilled care. The expectation is that these companies can move more Medicaid patients over time to less costly assisted-living facilities — or even back to their own homes, the cheapest option.

Click here to read the whole Herald Tribune article.

July 9, 2013
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Babette B. Bach, Esq. to Speak for the Jewish Foundation of Sarasota-Estate Planning Sarasota

By Estate Planning, Firm News, Medicaid Planning, Medicare

Babette Bach will be the keynote speaker for a seminar March 20, 2013 at the Jewish Foundation in Sarasota. Topics will include estate planning and the basic recommended documents to have in place, Medicare and Medicaid Planning.

Ms. Bach is looking forward to speaking to the members of the community on such an important topic. She appreciates the invite to lecture.

If you need legal advice for estate planning, Medicare, Medicaid planning, or VA planning, please contact our office at (941) 906-1231 for an initial consultation.

March 14, 2013
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Florida Senate Rejects Medicaid Expansion

By Medicaid Planning

A Florida Senate committee voted yesterday, March 11, 2013, against expanding Medicaid to roughly 1 million of the state’s poorest under the federal health overhaul and instead proposed a voucher plan that would require patients to pay premiums and co-pays.

Chairman Senator Joe Negron wants the state to create its own health insurance plan for the expanded Medicaid population and require recipients to pay a sliding scale premium based on their income.  However, he has admitted that this may take years to implement whereas the federal proposal is ready to begin January 1, 2014.

March 10, 2013
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