estate recovery

Medicaid Planning: The Fundamentals

Below is a one page summary regarding Medicaid Planning in Wisconsin that we provide our clients with when discussing Medicaid Planning (the laws regarding Medicaid Planning may be different in your State). It should be noted that, much like tax and estate planning, an experienced professional should be consulted if you are thinking about engaging in any Medicaid Planning. It is an extremely complex set of rules and requires up-to-date knowledge (all of the below information is only current and accurate as of September 2015; after such date the information may no longer be current and accurate).

Prior to Applying for Medicaid: The Lookback Period

  • 5 years prior to the date of the Medicaid application
  • All gifts (or divestments) during that lookback period will cause a penalty
  • Penalty calculation:
    • Total amount of gifts (or divestments) divided by average cost of care
      • Average cost of care is $252.95/day
    • Example: You make a $20,000 gift to your child and apply for Medicaid 4 years later.
      • Penalty period: $20,000 divided by $252.95
      • Penalty period = 79.067 days (or just over 2½ months)
    • Therefore, you will not qualify for Medicaid assistance for at least 79 days from the date of application and will have to arrange for care or payment for care yourself.

While Receiving Medicaid: The Resource Limits

  • Resource Limits for Single Persons (or if both spouses apply for Medicaid):
    • Asset Limit: $2,000
    • Irrevocable Burial Trust: $3,000
    • Life Insurance – Face Amount: $1,500
    • Income: $45/month
  • Resource Limits for Couples (if only one spouse is applying for Medicaid and the other spouse remains in the community):
    • Assets: One-half of total countable assets
      • However, not less than $50,000 nor more than $119,220
    • Income: Minimum Monthly Needs Allowance (MMNA) is $2,655/month
  • Exempt Assets:
    • For the Medicaid Applicant –
      • A vehicle
      • Primary residence (if plan to return home or if spouse lives in home)
      • Burial space
    • For Community Spouse (non-Medicaid applicant) –
      • All of the Community Spouse’s retirement assets

After You Pass Away: Estate Recovery – Under certain circumstances, the State of Wisconsin can place liens on your assets and/or recover remaining assets from your Estate after your death.

Planning Opportunities:

  • Self-insure
  • Long-term care insurance
  • Gifting (or divestments) either outright or in trust
  • Other planning opportunities (for example, purchasing annuities, life care agreements, etc.)

I hope this helps!



© 2015 Matthew D. Brehmer and Crummey Estate Plan.