Tag: Waiver

Video

Hi folks, it’s Andy Stautz at Stautz Law. We’re back for another talk: on elder law, this time, or Medicaid law. And it’s a really basic question. So we often hear about Medicaid in the context of long term care. Because as many people know, Medicaid will pay for nursing home care for people who can’t otherwise afford it.  

What is a Medicaid Waiver?

Well, in addition to actual in-the-nursing-home care in Indiana, Medicaid will also pay for some people to stay out “in the community” — that is, at home, not in a traditional nursing home context. And that payment or that program is called a Medicaid waiver.  

When you hear Medicaid waiver, we’re talking about the same type of long term care costs, the same type of medical need. It’s just being met somewhere else. You know, maybe a family member acting as a as a home health aide. There are a variety of other services that can make that possible.  

Why is is called a Medicaid “Waiver”?

OK why is it called a waiver Medicaid waiver?  

You’re not waiving Medicaid, you’re on Medicaid. Well. To understand why it’s called a waiver, you need to know that the federal government, Washington DC, pays money to the states, in this case Indiana, to run their Medicaid program. And because the federal government is the one paying for it (more or less, you know, partially: there’re state contributions), but because the federal government is paying for it, they get to set the conditions of Medicaid.  

And the usual condition is Medicaid pays for your long term care in a long term care home. But . . . the federal government waives its right to insist on those requirements. And instead, you know, contribute money to the state Medicaid program, even for people who aren’t in that setting, in that nursing home setting. So it’s a waiver of the federal government’s right to, you know, require that every Medicaid recipient be in a nursing home.  

So that’s the short explanation. Obviously it’s a complicated topic, but all the usual Medicaid planning considerations: eligibility, look back period, all that . . . apply equally to Medicaid waiver. So in general, you should treat it the same and you know you need an experienced estate planning or elder law attorney to help guide you through that 

I’d welcome your call if you want to talk about it more. But today was just a brief informational chat. Hope to hear from you soon. Bye now.