Medicaid in Indiana Information

MEDICAID IN INDIANA

The information addresses questions you may have and helps to explain some things for you to consider for you and your family in regards to Medicaid in Indiana.

When you are ready to discuss your family's plan and process with Medicaid, schedule a free, no obligation consultation - by phone, video call, or in-person - whatever you prefer.

Call 219-230-3600 to schedule a time that works for you.

The process to gain eligibility for a person seeking long-term support is long, very specific, and confusing.
That's when things work they way they are supposed to work.
Unfortunately, due to current system limitations, an additional challenge is a reality - processing delays.
Since Covid, the primary agencies involved in Medicaid, local Area Agencies on Aging (AAA) and Indiana FSSA, are a month or more behind in processing their individual portions of the Medicaid application.
More unfortunate, eligibility requires both "sides" be completed before an applicant can have benefits determined. For those seeking a Medicaid Waiver, there is another delay in availability of benefits after being found eligible as the AAA works it through their system.
Suffice to say, even though an applicant meets eligibility guidelines, services may not be available for several months.
This makes it even more critical that your application meets every criteria requirement and deadline. We have seen examples where applications have attempted to be denied even when mistakes are on the agencies' side.
Download the "5 Mistakes" summary to help you understand and avoid the pitfalls that could undercut your application.

How can Medicaid help a person in need, when does Medicaid help, and how does a person get Medicaid
can cause a great deal of confusion and concern for those seeking care.
Let us help you understand your situation.

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Call 219-230-3600
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A Quick Overview of Medicaid

Medicaid is a means-tested government support program. It is a broad "insurance" program that provides support for many different populations. For this discussion, the focus is on Medicaid for Aged and Disabled, which assists individuals 65 or older with long term care medical needs.
There are 2 separate components to meet eligibility requirements for Medicaid. An applicant has to be found "sick" and "broke."
Those terms are Medicaid defined. "Broke" does not mean zero. "Sick" is most often found based on the application of a matrix called Activities of Daily Living.

What is "Broke"

There are two factors in determining an applicant's financial eligibility:
- Countable Resources of $2,000 or less
- Income of less than approximately $2,500.
Countable Resources do not include everything a person owns. (see list)
Assets that are countable include bank accounts, investment accounts, applicant's IRAs (present rule), additional real estate and vehicles, among other assets.
Income is valued separately and includes earned and unearned sources. Income is not a countable resource in the month it is received. However, it becomes a Countable Resource the following month if not spent in month received.

Non-Countable Resources Examples

Real Estate where applicant lives.
A vehicle the applicant can use.
Funeral Trust for pre-paid funeral.
Everday Personal Property Items.
Property Associated with a Business.

What is "Sick"

In order to qualify for Medicaid support, a person needs to have a medical need for long term care.

The most common way this is accomplished is the AAA (e.g. Area IV, Northwest Indiana Community Action, Real Services, etc.) finds the applicant as a deficiency in three or more Activities of Daily Living. A person is determined to be deficient if someone needs to assist the applicant with a particular category.

Download an overview of ADLs.

If three "Activities" are deficit, the applicant reaches the "sick" or level of need for Long-Term Care services.
A doctor overseeing a person's care during a hospital stay can make a general assessment of the person's need if the doctor determines the level of care as reached a Long-Term Care need.
The AAA staff build the list of services from their portfolio of service based on the applicant's needs. These can include Meals on Wheels, emergency fall alert devices, attentive care, transportation, etc.

Medicaid Does Not Only Mean Nursing Home Care

In recent years, Medicaid has expanded its coverage to include in-home care and a certain "assisted living facilities" under its Medicaid Waiver Program. The eligibility requirements are the same. However, the support may allow a person to stay in his or her home, if it still a safe environment. Alternately, if a private home is not a viable option, Medicaid-supported assisted living facilities are becoming more common in many areas. These facilities allow individuals to have their own apartment, enjoy cafeteria style dining, and remain mostly independent with some assistance and support as needed.

Working with an Attorney for Medicaid Planning

The fear of spending one's life savings at the waning stages of life sometimes motivates people to take heroic and expensive efforts on the hedge they may end up in a nursing home. The reality is that such planning may never be needed. Additionally, it may substantially change your ability to choose how to spend your money, buy/sell property, and severely limit a surviving spouses independence, with regards to his or her quality of life.

Because the law and Medicaid rules are very confusing and planning techniques are very complicated, people will pay thousands, or tens of thousands of dollars, to put plans in place that they may not really understand.

This information is here as a tool for you to understand, pricing is mostly made up based on assumed property values, or a potential savings a person may "realize" for not paying for a nursing home privately for a month, or some other determination.

I have spoken with clients who paid $4,000 to update plan with some "important new language" they may have already paid several thousand dollars to set up originally.

Sometimes attorneys suggest an asset protection trust, which requires a person to give property away to the trust to be under the control of another party. Often, it is not explained that the trust owns the property. If it is a primary residence, it may mean a person or husband and wife may not be able to control the sale of the property or have unilateral control of the proceeds to purchase another property or use the funds for another living arrangement like assisted living.

"Protecting" assets from a nursing home might limit a person's options down the road. Those assets or funds might be needed to cover the expense of a duplex, apartment, or assisted living option that would be the best and desired choice.

The thing we want you to be aware of is that there is no standard fee across Elder Law and nor does the State or Indiana Bar dictate or limit what an attorney may charge to provide these services.
You may talk to an attorney who charges $5,000, $9,000, $12,000 or as much as $20,000 to get a person Medicaid eligible.
Additionally, there may be one of these charges for a portion of the process and another charge for other portions.
Ultimately, you should choose to work with an attorney who understands your concerns, the specifics of your situation, and addresses your concerns, providing a solution that you understand and a quoted fee is reasonable to you for the service provided.
You certainly have the capacity to check with other attorneys to get some options.
We absolutely believe that you should have clarity of your situation, you understand the options you have, the fees associated, and the limits/control you have of your property during the rest of your life.

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Additional Topics That May Be of Interest

Can The Government Take My Home to Pay Nursing Home Expenses

An overview and explanation to address one of the most common questions asked regarding the fear "losing" all their money at the end of their lives.

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There are mistakes that Medicaid "wants to see you get wrong."
In reality, Medicaid doesn't have feelings, it just feels like it is against seeking support.
One thing Medicaid hopes you do is for you give things away - a transfer assets for less
than fair market value.
The second mistake is missing deadlines.

When applying for Medicaid, it is important to understands income versus resources. This is the third common mistake Medicaid would like you to get wrong.
Many people think a person can have no assets or money, but that is not the case. In Indiana, a person may have a substantial monthly income. Additionally, some assets count and other don't.

Medicaid, and the process is not easy. The application itself is about 3% of the process. The last mistake that Medicaid wants you to get wrong is not thinking you qualify for Medicaid. Medicaid isa needs based tested program, if you check all the benefits, you qualify for the benefits. Every situation is unique, so a comprehensive review is a good step to start.

The information provided is for educational purposes only.
It should not be deemed as stand-alone, legal advice. There may be elements and concepts which could be used in planning.
However, such determination would need to be discussed with an attorney to see how it may or may not apply to your specific situation.
Also, your use of this website does not create or establish an attorney/client relationship.