Fear of Losing Assets Hampers Medicaid Expansion

Healthcare Training Resource
February 27, 2014 — 877 views  
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There are worries that Medicaid payment recovery from the estates of deceased beneficiaries will put off several lower-income individuals from enrolling into the program. Ever since 1993, the Federal Law has sought states to recover Medicaid payments from the estates of Medicaid beneficiaries who started receiving benefits at the age of 55 or above and have since expired. The recovery applies to payments for long-term health care, nursing home, and home and community services.

Minimum Thresholds

This recovery program has come under the scanner in the context of Obamacare expanding its footprints. The eligibility of Medicaid has been stretched to include those who earn 133 per cent of the federal poverty levels, except the disabled or elderly. This threshold could also be 138 per cent because the law has called for a new procedure of calculating income, which will make it so. In any case, these are just minimum thresholds and states have the power to  include more people.

Newspaper reports have cited examples of people who are eligible for Medicaid but have opted out because they are afraid of losing their homes or assets after their death. Before the Affordable Care Act kicked in, eligibility for Medicaid was through income and assets parameters. But under Obamacare, the eligibility overlooks the assets and considers income. This means people who have a home and other assets and a decline in income care eligible for Medicaid.

Exemption from Assets Recovery

Recovering assets from the family of a deceased Medicaid recipient is not allowed if the spouse is alive or if there are minor children or dependents with disabilities. Families can also apply for exemptions under hardship to avoid recovery of assets. Exemption can be sought if your current insurance policy has been cancelled and other policies are beyond your reach. In such circumstances, all you have to do is to fill an exemption form, authorities explain.

The recovery program right now differs from one state to the other, and while some states reclaim payments to cover all Medicaid service costs, other states recover payments for long-term care. Oregon and Washington have changed policies to claim assets of those who sought Medicaid only for long-term health care. Some Republican governors are requesting approval and funding from the federal government to put in place an alternative Medicaid expansion plan, as they continue to protest Affordable Care Act.

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