Listen to Lawrence…New Medicaid Regional Rates

January 21, 2021
As we welcome in 2021, I want to thank all of you for helping me get through 2020 and all its pandemic fears and isolation. Beyond my personal family and friends, staying connected with you, our literally thousands upon thousands of clients and friends of Davidow, Davidow, Siegel & Stern, made this year tolerable and actually kind of fun. I hope in turn, these LISTEN TO LAWRENCE emails kept you connected as well and helped ease the way. Hey, if you learned something along the way that would be great too. I certainly did!
Here’s to a happy and healthy 2021!
So with the turning of the clock, what’s new?
Each year, the New York REGIONAL RATES are adjusted for inflation. Regional rates? What am I talking about? I am talking about how Medicaid assesses a penalty for transfers made within a look-back period.
If you have been reading my emails, you know that the look-back period when trying to qualify for Nursing Home Medicaid is 5 years and for Community Medicaid (i.e., home care) is 2 1/2 years (the latter being true if you apply after 4/1/21). Or in other words, when you apply for Medicaid, an audit of your financial life will be done for the above amount of time. If a gift was made within the look-back period, Medicaid will assess a penalty.
How do they assess the penalty? The answer is by dividing the amount of the gift by the REGIONAL RATE. The REGIONAL RATE is supposed to represent the average cost of a nursing home in, well, the region you live. The amount of the regional rate is updated each year and the chart that follows is the 2021 figures.
New Medicaid Regional Rates
Let me give you an example. Let’s say you live on Long Island and 3 1/2 years ago you transferred your $500,000 house to your kids or to an irrevocable trust (who you transfer it to does not matter for this calculation). Yesterday you had a stroke and need a nursing home. Are you Medicaid eligible?
The answer is no! The transfer was caught in the 5-year look-back and a penalty will be assessed calculating how long you will have to wait to be eligible. How is the penalty calculated?
In this case, the value of the transfer caught in the look-back was $500,000 divided by the 2021 regional rate of $13,834.
500,000/13,834 = 36.14
Therefore, in this example, your Medicaid penalty will be about 36.14. Or in other words, you will not be eligible for Medicaid for about 36 months.
This is how the regional rates work and this is the result if you apply for Medicaid now. Among the alternatives may be to NOT apply for Medicaid for another 18 months, or until your 5 year look-back is over.
I hope this helps. Please forward this information to your friends and relatives.
As always, please send me your questions. If you are thinking about it, others are probably too, so my answers will no doubt help you and many others.
Let’s stay connected.
Stay safe!