Medicaid Payments to Family Members for Home Care

Anthony “Tony” Turbeville is a Medicaid approval advisor and educator who has served as president and CEO of Platinum Benefit Services in Lakeland, Florida, since 2000. In this role, Antony “Tony” Turbeville processes Medicaid applications for attorneys and nursing homes who do not have the capacity or desire to handle the complex application process in-house.

Medicaid is a federal program that offers healthcare coverage to low-income individuals and families. Often, family members who provide personal care for their loved ones can be paid by Medicaid for their service. To pursue this option, an individual must first apply for Medicaid. After the person is approved, they must enroll in a specific Medicaid program that funds home care and allows “consumer direction.” Also called self-directed care, consumer direction indicates that the Medicaid member can choose their own care provider rather than being assigned one by Medicaid.

The Medicaid beneficiary must then officially hire the family member as a personal caregiver, as well as submit timesheets to Medicaid for services rendered. Upon approval, payment is made by Medicaid or through a third-party service.

 

Over the Decades, Medicaid Has Expanded Its Social Safety Net

Anthony “Tony” Turbeville, president and CEO of Florida-based consulting firm Platinum Benefit Services, Inc., offers assistance to attorneys who provide Medicaid planning to clients entering nursing homes or assisted living care. Antony “Tony” Turbeville and his firm, working with proprietary Status Tracker software, have eased the frustrations and streamlined the complexities of the Medicaid application process for some 10,000 clients.

For well over half a century, Medicaid has helped Americans in need of quality medical care. President Lyndon B. Johnson signed the Social Security Act Amendments that resulted in the formation of Medicare and Medicaid in 1965. Both programs have expanded over the years not only to cover greater numbers of people but to broaden the set of benefits they offer.

Medicaid was originally established to provide medical insurance to lower-income individuals. Today, groups covered under the program include pregnant women, low-income families, and people with disabilities or who require long-term care, regardless of age.

Because Medicaid is a federal-state partnership program, each state can adjust its Medicaid services to the needs of its population, which means that the types of programs available and the eligibility criteria vary from state to state.

Transferring Assets and Medicaid Eligibility

Anthony "Tony" Turbeville is a Florida advisor and educator who works with clients of diverse asset and income levels in strategies for qualifying for Medicaid. Antony "Tony" Turbeville has extensive knowledge of asset transfer strategies when it comes to obtaining long-term care Medicaid.

One common strategy centers on transferring funds to children, as a way of falling within qualification thresholds, which can be as low as $1,600 in personal assets. Unfortunately, Medicaid law places a penalty on those who transfer assets to others and do not receive fair value in return.

This penalty is ineligibility for Medicaid coverage over a set period of time, which is correlated to the amount of money transferred. This involves dividing the amount transferred by what is Medicaid-defined as the average nursing home private-pay cost within the state. As a general rule, the state takes a look at all such transfers transacted in the five years before the Medicaid application.

There are types of fund transfers that will not trigger a Medicaid ineligibility period. These include transferring money to a spouse, or another party for the spouse's benefit. Trusts that are for the sole benefit of a disabled or blind child, or disabled individual who is under 65, are also allowed.