Elder Long Term Care in Hastings, Greater Grand Rapids, Battle Creek, Kalamazoo and Beyond

Clients often confuse these two programs. Medicare is a federal health insurance program for seniors and individuals with disabilities, while Medicaid is a state and federal program that assists with long-term care costs based on financial need. Michigan has its own Medicaid program with its own set of rules.

Qualifying for Nursing Home Medicaid benefits in Michigan involves meeting several eligibility requirements related to both income and assets, as well as medical necessity. Here’s a breakdown of the key steps and criteria:

A. Medical Eligibility

• Need for Nursing Home Care: You must require a level of care that is typically provided in a nursing home. This is usually determined by a physician’s assessment or a Medicaid nurse’s evaluation.
• Assessment: Michigan Medicaid uses the Michigan Medicaid Nursing Facility Level of Care Assessment to determine whether you need skilled nursing care or help with daily living activities (e.g., dressing, bathing, eating).

B. Financial Eligibility

Medicaid has strict income and asset limits for applicants.

Income Limits

• To meet the income test for nursing home Medicaid, a resident’s income must be less than the nursing home’s private pay rate. Many nursing homes charge between $12,000 and $14,,000 per month for private pay

Asset Limits

• Single Applicants: The asset limit is around $2,000 for a single applicant. This includes savings, investments, and property that you own.
• Married Applicants: The spouse who is not applying (community spouse) can retain a portion of the couple’s assets, typically $31,584 to $157,920 (in 2025, depending on the couple’s assets). This is known as the Community Spouse Resource Allowance.

C. Exempt Assets

Certain assets are exempt from consideration when determining Medicaid eligibility. These may include:

• Primary Residence: Your home may be exempt if you plan to return to it, or if a spouse or dependent relative lives there.
• Personal Property: Furniture, clothing, and other personal effects.
• Vehicle(s): One car may be exempt if it is necessary for transportation.
• Funeral related assets

D. Look-Back Period

Medicaid has a 5-year look-back period. This means that Michigan Medicaid will review any asset transfers made in the last five years to ensure you didn’t intentionally transfer assets to qualify for Medicaid. If they find improper transfers, you may be penalized, meaning you will have to wait a period of time before qualifying for Medicaid.

Navigating Medicaid eligibility is complex. Longstreet Elder Law specializes in Medicaid eligibility to help you maximize your benefits while ensuring compliance with Michigan’s regulations.

The consequences of not having a Medicaid plan can be financially and physically overwhelming, especially for those who are eligible. Ensuring that you or your loved ones have Medicaid coverage is critical to avoiding these risks and accessing necessary care.

Qualifying for Medicaid while protecting your assets requires strategic planning, as Medicaid has strict eligibility rules, particularly concerning income and asset limits. However, several strategies can help you safeguard your assets while ensuring you meet Medicaid’s qualifications.

Longstreet Elder Law’s Medicaid team is skilled in strategies to protect assets, such as setting up trusts, gifting assets, or using other financial planning tools to ensure that your estate is structured in a way that maximizes eligibility for Medicaid without violating any rules.

Given the complexity of Medicaid planning, it’s recommended to consult with Longstreet Elder Law so that we can guide you through the process, ensure compliance, and help protect your assets legally.

NO! While timing is important, it is never too late to begin the Medicaid application process or explore options for long-term care funding, though it might be more complex when care has already started.

Longstreet Elder Law will provide valuable assistance in the Medicaid application process by offering guidance, ensuring compliance, and helping to protect your assets. Here’s how we can help:

1. Eligibility Assessment: Medicaid eligibility involves both financial and medical criteria. Longstreet Elder Law can help determine if you or a loved one qualifies for Medicaid benefits, including assessing income, assets, and healthcare needs.
2. Asset Protection: Medicaid has strict rules regarding the amount of assets an individual can have while applying for benefits.Longstreet Elder Law’s Medicaid team is skilled in strategies to protect assets, such as setting up trusts, gifting assets, or using other financial planning tools to ensure that your estate is structured in a way that maximizes eligibility for Medicaid without violating any rules.
3. Navigating Complex Rules: Medicaid rules and regulations can be very complex, with specific guidelines around income, assets, and the five year look-back period. Longstreet Elder Law is familiar with these rules and can help you avoid common pitfalls, such as accidental disqualification.
4. Planning for Long-Term Care: If someone needs long-term care, Longstreet Elder Law can advise on how to qualify for Medicaid coverage for nursing home care, in-home care, or assisted living. They can help you understand your options and how to pay for care without depleting your assets.
5. Help with the Application Process: The Medicaid application can be tedious and involve substantial paperwork. Longstreet Elder Law can assist with completing the application correctly, submitting the required documents, and following up to ensure that the application is processed smoothly.
6. Handling Medicaid Appeals: If an application is denied or if there is a need for a Medicaid services change, Longstreet Elder Law can help with the appeals process, ensuring that your rights are defended and your case is presented properly.
7. Avoiding Mistakes: Mistakes in the Medicaid application process can lead to delays, denials, or penalties. Longstreet Elder Law ensures that everything is filed correctly and in a timely manner.

By working with Longstreet Elder Law, you can navigate the complexities of Medicaid more efficiently and effectively, minimizing potential challenges and ensuring that you or your loved one receives the necessary benefits for healthcare and long-term care.