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Medicaid is an income-based or needs-based government assistance program that provides healthcare benefits to U.S. citizens. Although the program was created by the federal government, it is funded by federal, as well as, state and local taxes. The program essentially helps eligible recipients in paying for covered medical expenses. In Texas, the Medicaid program is overseen by the Texas Health and Human Services Commission.

Even if You Are Healthy, You May Need Texas Medicaid

Simply because you are particularly healthy at the moment doesn’t mean you won’t need long-term healthcare at some point. The truth is, you don’t have to be sick to need Texas Medicaid planning. While you may not have health issues now, you simply cannot predict how healthy they will be in 30-40 years. An unforeseen injury or illness could result in health issues that require long-term care. In fact, more than two-thirds of all people over the age of 65 need long-term care at some point in their lives. It would be a mistake to fail to benefit from Medicaid planning.

Health Insurance is Not Always Sufficient

Regrettably, far too many people miscalculate the actual potential cost of long-term care, which is usually quite expensive. The average annual cost of nursing home care, for a semi-private room in a Texas nursing facility is estimated to be between $40,841 – $43,472. Add to that the likelihood that nearly half of the Texas citizens age 65 and older need long-term care for approximately five years. For many families that cost can be prohibitive. The unfortunate reality is that Medicare and private health insurance is typically not enough to cover these costs

Some of these Medicaid resources which may be helpful to you in learning about Medicaid in Texas include:

  • Medicaid and CHIP: Medicaid and the Children’s Health Insurance Program (CHIP) provide coverage for medical expenses for children and individuals with disabilities who meet certain income requirements.
  • Medicaid for an adult caring for a child: Coverage for adults caring for a child who lives with them, has Medicaid and is either age 17 or age 18 and attending school full time.
  • Medicaid Buy-In (MBI) Program: Program offers low-cost Medicaid health care services to individuals who pay a monthly fee.
  • Community First Choice: A federal option that gives states the opportunity to provide home and community-based services and support to Medicaid recipients with disabilities.
  • Medical Transportation Program: This program can schedule non-emergency rides for individuals who have no other transportation options for getting to their Medicaid health-care visits.
  • STAR Medicaid Managed Care Program: STAR is the program through which most Texas residents obtain their Medicaid coverage. With STAR Medicaid, you select your own managed care plan.

Program Documents for Texas Medicaid

The Benefits of Medicaid Planning

The purpose of Medicaid benefits is to assist low-income Texas residents in paying for medical services. Because Medicaid is a needs-based program, recipients can have no more than $2,000 in assets. The goal of Medicaid planning is to keep you from exhausting all of your resources in order to be eligible for benefits.

Also, if an applicant for Medicaid gives away property or assets right before submitting an application, those transfers of property can be seen as fraudulent and result in your benefits being delayed or denied. However, with careful Medicaid planning, you can avoid the appearance of fraudulent transfers. When it comes time to determine eligibility, here’s a resource that may help:

In determining Medicaid eligibility, assets are basically divided into two categories — either countable or exempt.  Countable assets are those that could be used to provide for your care and they including the following:

  • Cash
  • Bank deposits
  • IRA’s, Keogh plans, pension funds and annuities
  • Securities
  • Cash surrender value of life insurance policies

Exempt assets usually include the following:

  • Residence, up to a certain value
  • Household items
  • Burial policy or a certain amount of cash set aside for burial expenses.
  • Automobiles
  • Personal Items such as clothing and jewelry

Even though the above assets are not counted toward eligibility, they may still be subject to recovery after your death.

Medicaid trusts can be a great strategy for Medicaid Planning

A Medicaid Trust is a specific type of trust used to protect an applicant’s assets so that you can remain qualified for Medicaid benefits. This means you can leave your property to your children as opposed to spending it only on long-term care. If you have questions regarding Medicaid programs in your state, Medicaid eligibility, or any other Medicaid planning needs, please contact The Vermillion Law Firm, LLC for a consultation either online or by calling us toll free at (972) 366-7201.

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