To give a brief background for this conversation, what is emergency Medicaid, and what are its criteria in your jurisdiction? Emergency Medicaid qualification is often sought when advance planning was not done, or when it was done but there are still assets considered available to pay for long-term care, coupled with an individual who has an immediate need for long-term care due to an inability to safely reside at home. This often comes into play when a person has been hospitalised and then was discharged to a skilled nursing facility for rehabilitation (also known as ‘skilled care’), during which period the person was receiving occupational or physical therapy. Generally, Medicare or private health insurance will cover at least a portion of the cost of skilled care. However, after a certain period of time, the individual will be discharged from skilled care, based on a number of factors including their level of improvement as well as the number of days of coverage available under their private insurance. Once a person is notified that they will be discharged from skilled care, there is very often a short period of time in which plans must be made to either have the person safely discharged back into the community or, alternatively, transferred to unskilled, long-term care at the nursing facility. This is when Medicaid comes into play. Once a person is deemed to be receiving unskilled care, their Medicare or private health insurance will no longer contribute to the cost of longterm care. Therefore, people are left to look to their own assets to pay for the private pay cost of care (estimated to cost between $9,000-$15,000 per month in Rhode Island) or, if their assets are insufficient to pay for this cost of care, then they must look for assistance to pay for the care via Medicaid. Asset Protection and Emergency Medicaid Qualification EXPERT INSIGHT 79 Payment for long-term care is a common concern in elder law, as is a client’s potential to qualify for emergency Medicaid, which will vary depending on the type and value of their (and their spouse’s) available assets. This month we hear from elder lawyer and previously featured author Samantha McCarthy as she takes a closer look at emergency Medicaid applications and the assets relevant to their qualification. Expert Insight
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