{2:30 minutes to read} I learned about Community Medicaid through a personal experience. A few years back, my mother had a hip replacement. At that time the doctor said the other hip would need to be replaced within a year. We assumed that everything would go according to schedule and mom would be up and walking again in the not-so-distant future.

Unfortunately, things didn’t turn out as planned. While her first hip replacement was successful, her recovery was difficult. The combination of her reaction to the pain medication and anesthesia precluded her from having the second hip operation. As it turned out, she wasn’t able to walk and ultimately became bedridden.

One of her greatest desires was to age in place, but to stay at home would have required a 24/7 aide. To pay for an aide privately would be exceedingly expensive. My sister, brother, and I really didn’t know what to do.

Luckily, we learned about Community Medicaid, which allows people with disabilities to stay at home and have their aides paid for by Medicaid. In order to have the state pay for the aides, we hired an attorney that helped us apply for Medicaid. Here are some important facts to keep in mind:

• To qualify for Community Medicaid, you must have less than $14,850 in assets and your monthly income must be less than $825. If an individual’s monthly income exceeds the limit, a pooled trust can be used to qualify.
• When applying for Community Medicaid, the look back period is limited to just one month of financial scrutiny versus the five years that is required with Institutional Medicaid. This means that assets can be transferred without an imposed penalty up to one month before they apply for Community Medicaid.
• Retirement assets are exempt, and, if you own a house, co-op or condo, the equity must be under $840,000.

My mom has a nice pension and a good monthly income, which goes into a pooled trust, less the $850 that she keeps in her checking account. Every month, I pay the bills through the trust. This has enabled my mother to stay at home.

Here’s a great article that provides more details about utilizing a pooled trust to stay at home and avoid a nursing home.

We have also protected my mother’s largest asset, her home. We hired an attorney to put it in a trust. Normally, after someone utilizing Community Medicaid passes away, the estate has to reimburse Medicaid for the costs of the aides. However, with the use of a trust, those assets are protected, and the individual’s legacy can live on in the form of an inheritance to their heirs.

Community Medicaid is a perfect vehicle for retired civil servants and union members who typically have good pensions and own a home but not always enough assets to hire aides. Utilizing these resources has allowed my mom to live as full a life as possible into her late 80s.

Please don’t hesitate to contact me if you have any questions about Community Medicaid or financial organization.

Peter Gordon
New York Financial Organizers, Inc.
peter@nyfo.nyc