GLOSSARY FOR ELDER LAW

• Planning for Long-term Care – Medicaid Planning
• Guardianship

assets – resources and income

community spouse resource allowance – the amount of property that the spouse of a nursing home Medicaid recipient is entitled to retain

exempt income – certain types of income that do not count in determining whether a person is above the income allowance

exempt resource – a resource that is disregarded in assessing eligibility for Medicaid.

excess income – monthly income that exceeds the income allowance for Medicaid homecare

fair hearing – the administrative appeal of a denial of an application for Medicaid benefits

income – any property received in a given month

income allowance – the amount of monthly income that a person is allowed to retain and still qualify for Medicaid homecare. A recipient of nursing home Medicaid must pay all of his/her monthly income toward the nursing home bill, except for $50.

long-term care – nursing home or home-care services for a person with a chronic disability

lookback period – the period of five years preceding an application for nursing home Medicaid, over which period the local Medicaid agency examines the applicant’s financial transactions in order to identify disqualifying transfers

Medicaid – a federal program administered and partly funded by the state that pays the medical bills and costs of long-term care for persons whose assets are below prescribed maximum levels

Medicare – the federal program that pays health care costs of all persons 65 years and older who are in the Social Security system.

• Part A – pays hospital bills and the costs of skilled nursing facilities to a very limited extent
• Part B – pays doctor’s bills
• Part C – Medicare Advantage plans
• Part D – prescription drug insurance

managed long-term care plan – an agency that provides managed care services to Medicaid recipients, under a contract with the state

minimum monthly maintenance needs allowance – the amount of monthly income that the spouse of a Medicaid recipient is entitled to retain

NAMI (Net Available Monthly Income) –  the amount of his/her monthly income that a person who is eligible for Medicaid must pay toward his/her costs

penalty period – the period of ineligibility for nursing home Medicaid benefits as a result of disqualifying transfers made during the lookback period

pooled income trust – a program run by a charitable organization under contract with the state, to which you can assign your income that exceeds the monthly income allowance and arrange for the trust to pay your expenses, thereby causing that income to be exempt income for purposes of Medicaid eligibility

resource – anything that you own

resource allowance – the amount of resources that a person is allowed to retain and still qualify for Medicaid

spousal refusal – the statement signed by the spouse of a Medicaid applicant, refusing to make the spouse’s assets available for the care of the applicant, in order that the applicant not be disqualified by the spouse’s assets

supplemental needs trust (“SNT”) – a trust that is structured so that the assets therein are exempt assets.  A SNT can be a third-party trust, established with the funds of someone other than the beneficiary, or a first-party trust, established with the beneficiary’s own funds if they are contributed to the trust when the beneficiary is under the age of 65.

transfer – the gifting away of a resource