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Kansas Medicaid and Long-Term Care Planning

Due to increasing life expectancies, the physical and mental disabilities and infirmities which too often accompany advanced age have greatly increased the possibility that an individual will reside in a long term care setting at least some time during his or her lifetime. This factor, coupled with the increasing average age of our population, has resulted in the burgeoning number of individuals who reside in long term care facilities.

The expenses of such care can be paid from long term care insurance, private resources or through governmental benefits. Unfortunately, only a small percentage of individuals have long term care insurance, let alone at a level sufficient to cover such needs. Governmental resource benefits carry with them specific qualification requirements. Absent a long term care resident being a military service veteran who has met the criteria necessary to qualify for the limited availability of such benefits under the Veterans Administration (VA), the only governmental resource benefits available to pay for such care are through the Medicare and Medicaid programs. For individuals aged sixty-five and over, Medicare will provide for such care, but only for only a quite limited period following a hospital stay.

This leaves Medicaid as by far the most frequent and accessible governmental resource providing for long term care needs. Medicaid currently pays for the costs of such care for approximately one-half of the residents in long term care facilities. Such high frequency is despite the quite restrictive nature of Medicaid eligibility rules. Although Medicaid will pay for long term care throughout the lifetime of an eligible recipient, it is a “need based” program. This means that normally the applicant, as well as the applicant’s spouse, must be possessed of quite limited resources to be able to qualify for Medicaid benefits. The Medicaid eligibility rules which govern the limited amount and types of private resources and income a Medicaid applicant and a Medicaid applicant’s spouse can possess and retain and still qualify for Medicaid benefits are quite intricate and contain many “traps” for the unwary. As a result, the reason a high percentage of long term care residents are on Medicaid is not due to the liberal availability of such benefits to the citizenry at large. It is a consequence of a substantial portion of the private resources of long term care residents and their spouses having been exhausted in providing for the high cost of such care prior to being able to satisfy restrictive Medicaid eligibility requirements.       

If this was not problematic enough, following the death of a Medicaid recipient, Kansas laws, like all states, require the State agency administering Medicaid to recover, from the limited amount and types of remaining assets permitted to be retained by a Medicaid recipient, an amount equal to the lesser of such remaining assets or the Medicaid benefits provided by the State during the recipient’s lifetime. This right of recovery also extends to the estate of a surviving spouse of a Medicaid recipient following the subsequent death of the surviving spouse.    

Fortunately, there are estate planning techniques permitted under Medicaid eligibility rules which can minimize not only the amount of resources that must be expended by the Medicaid applicant and the spouse of the Medicaid applicant prior to qualifying for Medicaid benefits, but also the reimbursement amount as well the State may recover following the Medicaid recipient’s death from the remaining assets of the Medicaid recipient and the estate of the Medicaid recipient’s surviving spouse. However, the proper implementation of these Medicaid planning techniques requires the assistance of attorneys who are highly knowledgeable and experienced in both Medicaid and estate planning issues, for they involve very arcane Medicaid eligibility and estate recovery rules, advanced estate planning techniques and not infrequently, complex income tax issues as well.  In addition, very sophisticated estate planning documents must be employed in the process if these Medicaid eligibility and estate recovery estate planning techniques are to be maximized following the legal disability or death of the Medicaid applicant and the legal disability or death of a spouse of the applicant.

Attorneys in our Estate Planning and Probate Practice Group have been at the forefront in both the designing and implementation of these Medicaid planning techniques. This is evidenced by the involvement of our Practice Group attorneys as presenters at numerous Medicaid planning seminars for attorneys and other professionals, their having held prominent positions both in Kansas Bar Association committees addressing Medicaid issues and the Kansas chapter of the National Association of Elder Law Attorneys (NAELA), and their representation of clients in significant Kansas appellate decisions involving Medicaid planning issues.

At Foulston Siefkin, we fully realize that proper Medicaid planning is not simply a matter of the applying our legal expertise to the client’s situation. It involves an appreciation of the significant financial pressures posed by the high cost of impending long term care and the severe emotional strain the prospect of such care can present both to the recipient and members of his or her family. It also consists of understanding that the complexity of Medicaid rules and estate planning techniques which address them can be quite daunting to clients, particularly for elderly individuals who may be suffering from at least some degree of diminished mental capacity. Thus, our Practice Group attorneys are not only poised to bring the highest level of expertise to bear in addressing the long term care needs and concerns of our clients. We also are diligent in being mindful of, and empathetic to, their financial and emotional circumstance in the process and will choose the most easily understood terminology possible in explaining Medicaid estate planning options appropriate to their particular situation.       

We welcome readers to download the Medicaid and Long Term Care Planning summary prepared by our Practice Group for an extended discussion on this issue. This summary is particularized for Kansas residents. Readers are also invited to visit our Practice Group page for information on Practice Group attorneys, estate planning services offered and information regarding other important aspects of the estate planning process.

Downloads

• Medicaid and Long-Term Care Planning

Related Areas

• Estate Planning and Probate
• Elder Law

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