PLANNING FOR LONG-TERM CARE – MEDICAID PLANNING
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 the local Medicaid agency examines the applicant’s financial transactions in order to identify disqualifying gifts
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.
Medicare Part A – pays hospital bills and the costs of skilled nursing facilities to a very limited extent
Medicare Part B – pays doctor’s bills
Medicare Part C – Medicare Advantage plans
Medicare 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 gifts 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 and income available for the care of the applicant, in order that the applicant not be disqualified by the spouse’s assets and income
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.
alleged incapacitated person (AIP) – the person who is the subject of a guardianship proceeding, for whom the appointment of a guardian is sought by the petitioner
annual report – the report that a guardian must file in May of each year with the court, setting forth the circumstances of the incapacitated person and rendering an account of the guardian’s financial transactions in the previous calendar year
commission – the document of court appointment of a guardian
court evaluator – a person appointed by the court in which a petition for a guardianship has been filed, whose duty it is to investigate the AIP’s circumstances and to report to the court
court examiner – a person appointed by the court which appointed the guardian, whose duty it is to examine the reports of the guardian and report to the court as to the performance of the guardian
guardian – a person appointed by a court to have authority over the affairs of an incapacitated person
guardian of the person – a guardian given authority over the personal life of the incapacitated person
guardian for property management – a guardian given authority over the financial affairs of the incapacitated person
hearing – the proceeding in the court at which testimony and other evidence is presented in support of, and sometimes in opposition to, the petition
incapacitated person (IP) – a person for whom a guardian has been appointed because he/she has been determined by a court to be unable to manage his/her own affairs
incapacity – the status of a person being likely to suffer harm because of inability to provide for his/her personal needs and/or property management and inability to adequately understand the nature and consequences of such inability
initial report – the report that a guardian must file within 90 days after his/her appointment, setting forth the circumstances of the incapacitated person
petition – the pleading that initiates a proceeding for the appointment of a guardian
petitioner – the person who applies for the appointment of a guardian for the AIP