Even if you have never before needed to rely on Medicaid to cover your healthcare expenses, you may need to when you are a senior. Why? The answer is simple – long-term care costs. Having never before turned to Medicaid, you probably know very little about the program. In fact, you may not even know how to apply for benefits. To help get you started, the Oklahoma City Medicaid lawyers at Parman & Easterday explain how to apply for Medicaid in Oklahoma.
Long-Term Care and the Need for Medicaid Eligibility
First, it helps to understand the position you may find yourself in as a senior. Like most people, you may have relied on employer-sponsored medical insurance throughout your working years. When you entered your retirement years, you naturally assumed that Medicare would pick up your medical expenses from that point onward. Medicare covers most healthcare expenses for seniors, but it does not cover one of the costliest expenses you are likely to encounter – long-term care. Moreover, your odds of needing long-term care (LTC) increase with each passing year. For this reason alone, it is always wise to plan ahead to cover LTC expenses. Your employer-sponsored healthcare coverage likely terminated when you retired. Even if you purchased a private healthcare policy at that time, it probably excludes LTC expenses unless you paid a separate premium for LTC coverage. With both Medicare and private insurance failing to help with LTC, unless you can afford to pay out of pocket Medicaid is often the only option left .
Applying for Medicaid in Oklahoma
Applying for Medicaid benefits in Oklahoma is not difficult. Getting an application approved without planning ahead can be the difficult part. You could start the application process on the Oklahoma HealthCare Authority website. On the website, you will find additional information on the various Medicaid programs and eligibility guidelines. You could also apply for Medicaid at your local Oklahoma Department of Human Services (DHS) office which may be located on the DHS website.
You notice I said “could.” Before you apply, however, you should have a basic understanding of the eligibility requirements. Medicaid is intended to help low-income families, pregnant women, children, the disabled, and the aged with healthcare costs. Because Medicaid is a “needs based” program, you must demonstrate a financial need for benefits. This means an applicant cannot have income or assets that exceed the program limits. As a general rule, your income cannot exceed the current limit for your household which is tied to the Federal Poverty Level for your area. In addition, an individual cannot have “countable resources” worth more than $2,000. For the average retiree on a fixed income, the countable resources limit is where the problem lies. If your assets exceed the program limit, Medicaid will deny your application and you will need to “spend-down” your assets before applying again. If you are applying for Medicaid to help you cover long-term care (LTC) expenses, what this means is that you are expected to sell those assets and use the proceeds to pay your LTC expenses during the waiting period. If you failed to plan ahead, you could lose your entire retirement nest egg in a matter of months as the average cost of LTC in Oklahoma is around $5,000-7,000 per month.
When a married applicant is applying for assistance with nursing home care expenses, the eligibility requirements become even more complicated. That is because the Medicaid “Spousal Impoverishment Rules” come into play. These rules ensure that a spouse who remains in the community is not impoverished when the other spouse enters a nursing home and must meet 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. The other Medicaid rule you must be aware of is the five-year look-back rule that allows Medicaid to review an applicant’s finances for the five-year period immediately prior to applying for benefits. Any asset transfers made during that period for less than fair market value will trigger a waiting period during which time the applicant will not be eligible for Medicaid benefits.
Contact Oklahoma City Medicaid Lawyers
Because of all these issues, we encourage you to contact us before you apply for Medicaid Benefits. For additional information, please join us for an upcoming FREE seminar. If you have additional questions or concerns about how to plan ahead to ensure you will qualify for Medicaid in the future, contact the experienced Oklahoma City Medicaid lawyers at Parman & Easterday by calling 405-843-6100 to schedule your appointment today.