Q: My parents are in their late 70’s. My mother is in good health, but my father has suffered a series of strokes over the past years which have left him weak and in need of some assistance with his daily activities. As a family we feel strongly about keeping Dad at home, however we are concerned about Mom’s health as she is his primary caretaker these days. Mom and Dad own their home and each receive social security and a pension. Other than that, they do not have much in savings. I have heard that Medicaid will cover this type of care so long as the recipient is under the income and asset limit set by Medicaid. Is there a way to preserve Dad’s income for Mom and secure services for him at the same time?
A: Yes. The situation that you have described is a situation in which many elderly couples find themselves. The good news is that an elderly person’s high income does not automatically disqualify them from receiving Medicaid Homecare Benefits. With careful planning and the use of a Not-for-Profit Pooled Income Trust many elderly persons are able to age in place, get the homecare services that they need, and preserve their monthly income for payment of household bills. For starters, in order for a person to be eligible for Medicaid Homecare services they must be over 65 and disabled. In addition, because Medicaid is a means tested program, the homecare applicant must not exceed certain income and resource thresholds. For 2023, a Homecare Medicaid Applicant is permitted to keep $1,677, plus a $20.00 disregard (totaling $1,697) of his income and remain eligible for Medicaid services. Typically, Medicaid would be entitled to any income received by an applicant in excess of this amount as a reimbursement. For many couples like your parents who rely on their entire income to live, turning over this “excess” income would leave them impoverished and for that reason, Medicaid does not seem like a viable option.
However, under the New York State Medicaid Rules, individuals who are otherwise eligible for Medicaid have another option. New York permits an applicant to deposit their excess income (everything in excess of $1,677 in 2023) into a trust fund which is referred to as a “pooled trust.” These pooled trusts are created by not-for-profit agencies and are a terrific way for persons to take advantage of the many services available through Homecare Medicaid while still preserving their income for use in meeting their monthly expenses. Functionally, the way that these trusts work is that the applicant sends a check to the fund monthly for that amount which exceeds the allowable limit. Together with the check the applicant submits household bills equal to the amount sent to the trust fund. The trust deducts a small monthly fee for servicing these payments and then, on behalf of the applicant, pays those household bills. As you can see, this process allows the applicant to continue relying on his monthly income to pay his bills, and at the same time, reduce his countable income amount to the amount which is permitted under the Medicaid rules. It seems as though Medicaid Homecare services together with a Pooled Trust may be just the right option for your family. You may want to contact an Attorney who is knowledgeable in this area to help you and your family navigate through this process.
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