In the midst of this killer pandemic with deaths and unemployment soaring and seniors and the disabled most vulnerable, our state decided it’s OK to make Medicaid for home care unavailable for an untold number of its citizens. And the state approved an increase in long term care insurance premiums making it impossible for many to afford this coverage. Did they think we wouldn’t notice?
The harsh change in Medicaid law starts quickly but you can still protect yourself if you don’t delay! This came by slipping a vaguely written amendment to Social Services Law section 366 into April’s State Budget concerning Community Medicaid for home care. The amendment covers the Look Back Period – how far back Medicaid examines your finances, which you may know as five years. They want to know you’re not giving money away just to be eligible for Medicaid. However, Look Back never applied to Community Medicaid only to Nursing Home Medicaid. Home care approval was much quicker, vital for care since home care agencies can’t care for you for free waiting months for Medicaid approval.
Now all has changed. The amended law mandates a Look Back for Community Medicaid too. It’s 30 months but no doubt will be increased. So if you gave to your kids in the 30 months before applying, home coverage is delayed for some time, plus extra time it now takes to approve you. The more you gave, the longer the delay. Unless we get this repealed, this goes into effect on Oct. 1. Only two months away. Delaying the start date has already been vetoed by the governor so start planning now. Around the clock home care can cost as much as a nursing home, which will push more people into nursing homes where at least care will start immediately.
Here’s some important clarification on how this will work. First, the Department of Health said it will not apply this retroactively. So if you helped your son buy a home before Oct. 1, for example, you will not be penalized for home care Medicaid. But if you’re thinking about helping your daughter buy a car in a while, you would be well advised to consult an elder law attorney to see if it’s best to do that before Oct. 1.
Second, many Community Medicaid recipients utilize pooled trusts, which allows them to use excess income for expenses like mortgage or utilities. Though transfers to the trust are technically a gift, DOH says trusts are still allowed. Aside from these two issues, there are still uncertainties that need to be sorted out.
State Sen. James Skoufis, strong advocate for seniors and the disabled, states:
“Between long term insurance rates continuing to increase and the provision in the budget that makes it more difficult for seniors to be eligible for Medicaid and home care, our most vulnerable are continuing to get the short end of the stick. The passage of this harmful provision in the state budget is a perfect example of why the entire budget process needs an overhaul; the current process drowns out the very voices that were elected to fight for constituents’ needs in Albany. I’m co-prime sponsoring the Budget Equity Act, which would amend the State Constitution to allow the Legislature to play an equal role with the governor in shaping the budget, an important step in ensuring these types of eligibility changes don’t get into the budget in the first place. In the meantime, I will continue fighting like hell to undo this unacceptable provision.”
While this battle rages on, please contact your state legislator and ask for support in repealing this horrendous new law. And please remember, the time for you to plan is now.
Sanford R. Altman is a senior advocate and attorney focusing on elder law, estate administration and estate planning and a member of Orange County Office For The Aging Advisory Board and Alzheimer’s Association Advisory Council. sanfordaltmanlaw@gmail.com Age Loudly The Podcast!