We get a lot of calls from people who have questions about Medicaid. It is no wonder with the average cost of a Nursing Home in Georgia approaching $5000 or more a month. Very few families have the funds to privately pay the Nursing Home for very long.

Most calls come when Mom or Dad has just been admitted to a Skilled Nursing Facility for rehab and they realize that the stay may be permanent. These families are scared, and in crisis, and need facts. Pretty often they know someone who "helped" a family member get Medicaid, or they overheard someone talking about Medicaid at work. This type of hearsay can lead to additional stress and confusion. I want to address the top 5 Medicaid Myths that we hear in our practice.

The basic income and asset levels for an individual to be eligible for Medicaid in Georgia are: maximum income of $2,022 per month and total 'countable' assets of less than $2,000. The Department of Children and Family Services, which determines eligibility for Medicaid in Georgia has access to just about every other federal and state agency that maintains data on financial and property assets, so just leaving something off of an application and hoping to still qualify will not work.

1. Dad has more that $2022 in monthly income. He cannot get Medicaid. The Georgia income cap for Medicaid is $2022. Anyone with monthly income over $2022 must create a Qualified Income Trust (QIT), also known as a Miller Trust, and properly fund it each month during which they wish to be eligible for Medicaid. All of the applicant's income minus the allowable deductions will be transferred to this special account, then to the Nursing Home each month.
2. Dad can get Medicaid, but the state will kick Mom out of their house. Medicaid Estate Recovery is a program that allows the state to put a lien on a Medicaid recipient's estate after death in order to recover the funds that the state paid toward their care. The lien can only be placed if the assets in the estate total more than $25,000. If the well spouse or a disabled adult child lives in the family home, the lien cannot be placed until after they vacate the house.
3. Dad can give me up to $13,000 with no penalty. Many people are aware that the IRS allows annual individual gifts of up to $13,000 without gift tax return or tax due; however, any such gift would be penalized by Medicaid. Medicaid does not allow people to give away their assets so they can qualify for assistance. If assets are transferred during the previous five years, Medicaid will impose a penalty period during which time it will not pay a person's nursing home bill. Those needing Medicaid must spend their money only on legitimate purchases or services for themselves or their spouses until their assets are reduced sufficiently to qualify for assistance. Medicaid usually does not penalize someone for past tithing to churches and contributions to charities, if there is a "pattern of giving," but even that must stop when on Medicaid.
4. Mom can "sell" me their house for a token amount to remove it from Medicaid consideration. If an asset is transferred for less than Fair Market Value (FMV), then the difference between FMV and the transfer value creates a penalty as described in number 1 above. One must know the fair market value. For a house, you can get that amount from the county tax assessor's office. For other items that do not have a readily determined value, consider an appraisal. The most important lesson here is to save documentation of any sales or trades.
5. If I add my name to Mom's accounts, only half of it will count towards her assets. As previously stated, in order to qualify for nursing home Medicaid coverage, a recipient may not have more than $2,000 in countable assets. DFCS will assume that any funds held in a joint account belong to the person applying for Medicaid. It is possible to prove otherwise, but you will have to show the source of the money. Children should not put a parent on their bank accounts if the money does not belong to the parents, as Medicaid will count that money against the person applying for assistance.