During your retirement years, there may come a time when you need help paying for health care expenses that are not covered by Medicare. Fortunately, Medicaid may be able to help. You need to know how to determine if you qualify and how to apply though. Toward that end, the Essex Junction Medicaid planning attorneys at Unsworth LaPlante, PLLC explain how to apply for senior Medicaid in Vermont.
Will You Need to Qualify for Medicaid?
Seniors often turn to Medicaid to help cover the high cost of long-term care (LTC). Nationwide, the average cost of a year in LTC for 2022 was over $100,000. If you are a Vermont resident, however, you can expect to pay considerably more than the national average given that the average yearly cost of LTC in Vermont was more than $130,000. The real problem, however, comes when you realize that you may be forced to cover those expenses out of pocket. Like many seniors, you may rely on Medicare to pay for most of your healthcare expenses; however, Medicare won’t cover LTC. Neither will most private health insurance policies unless you purchased a separate long-term care policy. Not surprisingly, over half of all seniors currently in an LTC facility rely on Medicaid for help paying their LTC bills.
Medicaid Eligibility Guidelines
To qualify for Medicaid benefits, you will need to meet Medicaid’s eligibility requirements for seniors, meaning you must meet the income and asset tests. The income limit is tied to the Federal Poverty Level and will change depending on the Medicaid category, your geographic location, and household size. The income limit is not where most seniors encounter a problem though. It is the extremely low asset limit that typically poses a problem for seniors who did not plan accordingly. In most states, an individual applicant cannot own “countable resources” valued at over $2,000. Medicaid does exempt certain assets, such as your primary residence and a vehicle; however, many seniors have accumulated a retirement nest egg full of non-exempt assets that easily exceed the countable resources limit. If your assets exceed the limit, your application will be denied and you will have to “spend-down” your assets before applying again, meaning you will be expected to use those assets to cover your LTC expenses until the assets are gone.
The eligibility requirements become even more complicated when an applicant is applying for assistance with nursing home care expenses because the Medicaid “Spousal Impoverishment Rules” come into play. The rules are intended to ensure that a spouse who remains in the community is not impoverished when his/her spouse enters a nursing home because of the Medicaid “spend-down” requirements. The “Community Spouse” is allowed to keep a certain amount of income and resources when the other spouse enters a long-term care facility. Furthermore, Medicaid’s five-year “look-back” rule prohibits you from transferring your non-exempt assets at the last minute in anticipation of the need to qualify for Medicaid.
Applying for Medicaid in Vermont
The process of applying for senior Medicaid in Vermont is simple enough; however, the eligibility guidelines may pose a problem if you did not include Medicaid planning in your estate plan. Before you apply, look over the Medicaid Application Checklist and the Supplemental Checklist for Medicaid for the Aged, Blind, and Disabled.
You can start the application process by applying online on the Vermont Health Connect website. If you prefer, you may also apply for Medicaid over the phone by calling 1-855-899-9600 or by filling out and submitting a paper application.
Contact Essex Junction Medicaid Planning Attorneys
For more information, please attend one of our upcoming FREE webinars. If you have questions or concerns about applying for senior Medicaid in Vermont, contact the experienced Essex Junction Medicaid planning attorneys at Unsworth LaPlante, PLLC by calling 802-879-7133 to schedule your appointment today.