Secure Your Legacy, Protect Your Family
Medicaid Planning Services
“The Medicaid statute (as is true of other parts of the Social Security Act) is an aggravated assault on the English language, resistant to attempts to understand it.”
Friedman v. Berger, 409 F. Supp. 1225, 1225-12 (SDNY March 17, 1976).
Why is Medicaid so confusing? For one thing, Congress has been tinkering with the law since 1965, expanding it and putting restrictions on the program as political winds change. The other main cause of the Medicaid morass is the ponderous book of regulations that supplements the statute. Trying to apply the Medicaid statute and administrative rules to an individual set of facts is like trying to drive from west to east across DC during rush hour. There is a way to do it, but the uninitiated cannot reasonably be expected to find their way without help.
There are many Medicaid programs, but the attorneys at Quinn, Racuisn & Gazzola Chartered assist clients with one in particular: the Medicaid program that pays for nursing home care.
Services & Questions related to Medicaid Planning
“Middle Class Medicaid”
Nursing home care can be so expensive that it is out of reach even for seniors who are not impoverished. Once upon a time, people would plan for nursing home care by purchasing private longterm care insurance policies. While these policies still exist, they are quickly becoming economically non-viable.
But don’t worry – Medicaid has a program to cover nursing home care for eligible seniors. The formal title of this program is Medicaid Long Term Care (LTC), but it is also called “Middle Class Medicaid” because it was meant to serve a broader population. Consequently, the financial qualifications are less strict than Medicaid programs designed to alleviate poverty or help disabled adults.
Planning for Nursing Home Care in the DMV
In the DMV, where nursing home care can run upwards of $15,000 per month or more, most seniors will qualify for Medicaid LTC once they spend down their assets to below the minimum resource level. The spenddown will essentially reduce a Medicaid applicant to poverty. Yet, an experienced Elder Law attorney can help preserve as much of the client’s assets as possible, particularly when the client begins Medicaid planning more than five years before she needs to transition into an assisted living situation.
At Quinn, Racusin & Gazzola Chartered, we help clients plan for Medicaid LTC. When the time comes to enter nursing home care, we will submit the Medicaid application on your behalf and work with the responsible officials to make sure you get benefits to which you are entitled. Finally, if you authorize, we will represent your estate to defend against any Medicaid-related liens sought by the government after you die.
Help Staying in the Community
Medicaid LTC is a federally-funded program (mostly), administered by states and the District of Columbia, to pay for nursing home level care. The program does not normally pay for assisted living facilities or at-home nursing care. But what about the senior who does not want to transition to a nursing home? Fortunately, both Maryland and DC operate waiver programs designed to allow seniors to stay in their community.
The financial requirements of the DC and Maryland waiver programs are stricter than Medicaid LTC and the wait to receive benefits can be long. If you are not ready yet to transition to a nursing home and qualify for a waiver program in DC or Maryland, QRG attorneys can apply for benefits on your behalf to help pay for care.
What is PACE?
The Program for All-Inclusive Care for the Elderly (PACE) is a pilot program in the District of Columbia that uses Medicaid and Medicare funds to provide seniors with all the support they need to stay in the community. If you are 55 or older and live in DC Wards 7 or 8, you may be able to enroll in PACE (last updated April 2023).
Johns Hopkins runs a PACE program sponsored by the State of Maryland, but it currently only serves 200 members in the Baltimore area. When PACE in Maryland expands, QRG will be ready to help clients in Montgomery and PG Counties.