Applying For Medicaid

By: Anthony Cooper

One concern talked about by many individuals we know is the cost of nursing homes care. Nursing home care can be expensive, and your lifelong savings may be at risk if you suddenly need to enter a long-term care facility. According to the North Department of Human Services, the average nursing facility rate is $366.68 per day as of January 1, 2023. In general, there are three (3) ways to pay for nursing homes: self-pay, long term care insurance, and Medicaid.

Self-Pay: At an average, a nursing home costs over $132,000.00 a year. Most individuals will run out of money quickly.

Long-Term Care Insurance: Long-Term Care Insurance is the preferable way to pay, but it can be very difficult to get. Individuals need to purchase long-term care insurance before they turn 65 years old. After 65, rates steeply increase. Additionally, the daily benefits paid under an insurance plan may not be enough to cover the entire nursing home cost.

Medicaid: Medicaid is a program based on federal rules but administered by the states. If a person qualifies medically and financially, that person will receive benefits. In general, to be eligible for Medicaid in North Dakota, you must be a resident of the state of North Dakota; a U.S. Citizen, permanent resident, or legal alien; in need of health assistance; and with a low income. Note: Medicaid is the only federal or state program that will pay for long-term care. Medicare does not.

Planning and applying for Medicaid can be very complex. For example, single individuals in North Dakota are allowed to keep only $3,000 in assets when they apply for Medicaid, along with a reasonable burial policy. If assets are over this amount, it must be spent down. Married couples with one spouse staying at home with the other in a long-term care facility are allowed to keep one vehicle, the home, and a reasonable burial policy. The spouse in the nursing home keeps only $3,000 and the community spouse gets to keep half of the couple’s countable assets but not to exceed approximately $148,620.00 (as of 2023, ND Dept. of Human Services). Additionally, Medicaid has a 60-month lookback policy. This means that a Medicaid case worker will examine your financial records going back 60 months from the date you applied. They will also inquire about any transfer of property that took place 60 months prior to the Medicaid application. A transfer for less than fair market value during the 60-month look-back period may be disqualifying. As such, your application may be denied, or a penalty period applied.

What can we do for you? One of the main concerns is what happens to your assets if you enter a long-term care facility and apply for Medicaid. Your assets can simply be your home that you hope to convey to a family member or friend after you pass. Although the answer depends on your unique situation, we at the Boppre Law Firm have knowledgeable, experienced counsel that will guide you every step of the way. Check us out online or call us today.