Hyers & Associates

Ohio Medicaid Products

Request Assistance »The Medicaid spend down process can be a very difficult procedure for Ohio families. Without proper planning, a healthy spouse and/or the estate’s beneficiaries will often be left with few remaining assets.

Fortunately, families facing this crisis have options available to them.  Some insurance products can be used in conjunction with the advice of an elder law attorney in order to protect assets.

The Deficit Reduction Act

In passing the “Deficit Reduction Act of 2005″, Congress made it more difficult to qualify for Medicaid benefits than under the previous regulations. Once adopted by the individual states, the new rules present challenges to those who attempt to transfer, hide or otherwise dispose of assets in order to keep them from Medicaid recapture.  A brief synopsis of the new legislation illustrates many important changes. The “look back” period has been extended from three years to five years. The divestment penalty period has changed, potentially resulting in longer waiting periods for qualification. The decreased limit on the allowable home equity allowance is now $500,000. Additionally, last minute gifting from the estate has been eliminated. In essence, the federal government has closed perceived loopholes in the system.

Products Designed to Avoid Recapture

Insurance companies understand that seniors desire to shelter and transfer their remaining assets to beneficiaries. Accordingly, insurance carriers have created products designed to avoid Medicaid recapture. Currently, there are a small number of companies offering effective policies in the Medicaid marketplace. The following offers a snapshot of the various plans that might assist Ohio families.

The Irrevocable Funeral Trust

Oftentimes, this is a policy and plan used before any other. According to Medicaid regulations, the cash value in almost all life insurance policies is considered a countable asset. Simply put, the cash value of life insurance must be spent down before an individual might be considered for government assistance. Currently, the life insurance cash value used to fund an Irrevocable Funeral Trust is not subject to recapture up to certain limits.

Current laws allow persons on Medicaid to retain assets for a proper funeral. Unfortunately, these amounts are usually woefully inadequate. However, a life policy used with an Irrevocable Funeral Trust allows for a lump sum deposit of $15,000 per individual.  At passing, funds are paid to the funeral home of your choice. Using this technique, a family should have sufficient funds to pay for the funeral of the deceased.  These funds are not subject to the spend-down process.

In some cases, the existing cash value in a countable life insurance policy can be transferred tax free in order to fund an irrevocable funeral trust.  This method would protect a portion of an asset that would otherwise need to be spent down by the estate before govt assistance might be available.

The Medicaid Annuity

A once more popular product is referred to as the “Medicaid friendly” annuity policy. Before recent legislation, the use of annuities was quite common. New restrictions make them less available than before, but in certain situations they might be beneficial to a husband and wife.

The annuity plan must have special language preventing transfers worded in the policy. If the correct policy is used, there are instances when the annuity might not be counted during the Medicaid spend down process.  The annuity income can be available to a well spouse for his or her living expenses. However, if the account is incorrectly setup, then it may be of little benefit to the well spouse and/or estate.

Medicaid Crisis Planning With Life Insurance

The latest innovation in asset protection is a form of single premium life insurance. Designed to transfer a creditor-protected stream of income to beneficiaries, this new life policy may not be considered as a countable asset for Medicaid purposes.

This is a guaranteed issue life insurance policy meaning no medical underwriting is necessary for the insured. The policy has several unique factors. It is designed to be non-assignable, irrevocable, non-commutable and to have no cash value. Furthermore, no loans, surrenders, beneficiary changes or other adjustments are allowed to the policy once it is in force (after the allotted 20 day “free look” period.)

The policy has much of the same language as the aforementioned Medicaid Annuity and Irrevocable Funeral Trust policies. The single premium policy is designed to help individuals qualify for government assistance programs earlier. In theory, an individual may be able to protect and pass on a portion of their estate and still be eligible for government assistance. Thus, this product may only be helpful for the preservation of an estate in certain situations.

Planning Ahead

In summary, Ohio seniors have some options available to them in order to protect their assets, their estates and their loved ones. By employing certain preventive measures, many families can avoid the mental and financial anguish associated with long term care expenses and the Medicaid spend down process. The best way to protect an estate might simply be through the purchase of a long term care policy while the estate owner(s) is still in good health.

*The following in not intended as legal advice. Every Medicaid spend down situation is unique and may require the assistance of an elder law attorney. Insurance products are not guaranteed to avoid recapture. While many policies are working as intended, future changes in legislation or future litigation may render these plans obsolete. Most families consult with an elder law attorney for advice.