Nashville View

Medicaid Qualification Process

Attorneys Helping Nashville Residents with Their Health Care Needs

As we age, planning our futures and those of our loved ones becomes a more imminent issue. Considerations such as what will be necessary in the event that someone becomes disabled or needs assisted living arrangements are important to elderly individuals. Part of that planning involves determining whether someone qualifies for assistance through Tennessee’s Medicaid program, as well as how that affects their estate as a whole. The Nashville Medicaid planning attorneys at Martin Heller Potempa & Sheppard, PLLC help people understand the process and plan for their future. Our firm offers compassionate and knowledgeable legal services regarding issues related to divorce, disability, and other unforeseen circumstances, like needing nursing home care. If you need help with the Medicaid qualification process or with another estate matter, contact our office today to find out how we can help you protect your future.

The Medicaid Qualification Process

Medicare is the federal single-payer, national social insurance program that allows people who are over 65 years old and who have paid into the system for 10 years to obtain medical benefits upon retirement. Medicare is not available for everyone, and even if you qualify, it does not cover the costs if an individual needs the care of a nursing home or assisted living facility. Medicaid, however, known as TennCare in Tennessee, is a program that provides benefits to low-income individuals who qualify based on their financial standing. Individuals who have a long-term disability and those whose earnings fall below a certain amount are often eligible for Medicaid benefits, but this eligibility is not automatic. Medicaid can cover the costs of nursing homes, assisted living facilities, and other long-term care services when they are deemed to be medically necessary.

There are different groups of individuals who can qualify for Medicaid, each with differing income limits. Income for qualification is based on an individual’s own resources, including assets such as bank accounts, property, and cars. Some groups who qualify for Medicaid in Tennessee include:

  • Pregnant women
  • Children under 21 years old
  • Individuals who receive Supplemental Security Income benefits
  • Individuals who reside in a nursing home with a monthly income below $2,205, or who receive other long-term care services funded by TennCare

There are certain estate planning tools available to make sure that you get the financial support that you need for your medical care. Qualified Income Trusts, also known as Miller Trusts, may be established for a Medicaid applicant whose income exceeds the amount set for eligibility. Miller Trusts hold only an individual’s monthly income as assets, and they are not taken into account for the purpose of the income cap limit for Medicaid, allowing applicants to receive benefits for necessary nursing home care.

Other estate planning considerations should also be done in advance, such as setting up any living wills, powers of attorney, or necessary trusts. It is advisable to start making these types of arrangements at least five years prior to requiring long-term care. These actions can also help reduce ‘estate recovery’ costs for your family after you are gone. Estate recovery refers to when an individual’s estate reimburses the state for Medicaid costs expended during their lifetime.

Contacting an experienced estate planning attorney who can discuss your options and the effects of each document, as well as answer questions that you have regarding the Medicaid qualification process, is important in making sure that you know your options.

Seek Guidance from an Elder Law Attorney in Nashville

Medicaid planning may seem overwhelming, but the elder law attorneys at Martin Heller Potempa & Sheppard, PLLC can help you determine which steps are best for your and your family’s future. Our Nashville firm assists clients throughout Davidson and Williamson Counties, including in Franklin, Hillsboro Village, Cool Springs, and Hermitage, with all types of estate planning matters. If you need legal advice regarding a Medicaid issue or a will or trust, contact our attorneys at 615-800-7096 or online.