Your Legal Corner: Illness and Medicaid – NJ.com

 Today Your Legal Corner will provide information on “Illness and Medicaid.”

Medicaid presently is the main form of payment for care in a nursing home facility.

With Valentine’s Day approaching, one cannot help but think of the many kinds of love. Most special to me is witnessing the love a caregiver parent has for his or her child.

The legal definition of a caregiver is an individual who takes care of a person that has a chronic illness or a disease. However, unlike my example, the caregiver is the adult child and the inflicted person is the parent. Care may be administered within the community or within a nursing home type facility.

Long term care in a nursing type facility requires the payment of extensive funds and often begins with the happening of a traumatic event.

MEDICARE

As the story goes, a traumatic event, such as a fall, occurs which requires the injured party to enter the hospital. Thereafter, the injured party is transferred from the hospital to a skilled care facility to receive prescribed rehabilitation.

When an individual is hospitalized for at least three days and then transferred to a skilled nursing facility for care or rehabilitative purposes, Medicare will pay the first 20 days in full, so long as the individual continues to require the course of treatment.

Additionally, Medicare will continue to pay for skilled care for the next 80 days but with a deductible to be paid by the patient, unless he or she has a secondary insurance policy. Important to note is the fact that Medicare will not pay for long term care when the rehabilitation has ended and the patient is still not able to return home. It is at this time elder law attorneys are contacted by the patient’s family for help.

We all are aware of the extensive cost of long term nursing home care. That is why it is best to have a plan in place in case of a sudden illness.

In New Jersey, there are two types of programs for long-term care: Medicaid only and medically needy.

MEDICAID ONLY

This program benefits people 65 years of age or older or those who are blind or disabled who require care in a long-term facility. Additionally, their assets must be less than $2,000 and a monthly income of $2,130 or less. If the patient qualifies, the program will generally pay for the long-term care facility and associated health care costs.

MEDICALLY NEEDY

The second program provides benefits to individuals whose monthly income exceeds $2,130 and whose assets do not exceed $4,000. This program does not pay as much as the Medicaid Only program. As with the other program, the individual must be disabled and have a medical need in order to qualify for Medicaid.

Medicaid is a joint state and federal program.

In Gloucester County, the Board of Social Services is responsible for coordinating programs on aging regardless of the funding source. They can be reached at 856-582-9200.

The Center for Medicare and Medicaid Services is the coordinating office within the federal government for Medicare and Medicaid services. For detailed information on these services see www.cms.hhs.gov.

Next week, YLC will update and discuss “Living in the Community and Medicaid.” Till then, God bless, keep smiling and remember who’s in Your Legal Corner!

Victoria M. Dalton is a dedicated Family/Elder Law Attorney with the Law Offices of Hoffman Dimuzio. Call 856-845-8243 for further information. Email correspondence to vdalton@hoffmandimuzio.com or see www.ylcdirection.com.