By Hugh Qualls
Hospital Administrator

To vax or not to vax—that is the question! Much news of late regarding whether certain vaccinations are necessary. The science is fairly clear on this: benefits far outweigh risks, but of course parents must ultimately decide what is best for their children. Unfortunately, unvaccinated children suffer the worst during flu season, as we witness almost daily at the hospital. School attendance here and elsewhere dips dramatically this time of year, often due to the speed at which flu viruses spread among adolescents. Flu shots and regular hand washing are your best defense against getting sick. Finally, smokers are more likely to catch this bug and suffer worse symptoms—another good reason to quit today.

Must confess my own confusion regarding what Medicaid does and does not cover for long term care; from many conversations with families considering such care for loved ones, I am not alone. In an effort to educate us all, I share the following excerpts from a March 2019 article about common Medicaid myths on the website (highly recommend you visit the site to learn more; links to further explanations and examples as well).

Myth #1: You need to be broke to qualify for Medicaid. Medicaid helps needy individuals pay for long-term care, but you do not need to be completely destitute to qualify. While in general a Medicaid applicant can have no more than $2,000 in assets in order to qualify, this figure is higher in some states and there are many assets that don’t count toward this limit. For example, the applicant’s home will not be considered a countable asset for eligibility purposes to the extent the equity in the home is less than $585,000, with the states having the option of raising this limit to $878,000 (in 2019). In all states, the house may be kept with no equity limit if the Medicaid applicant’s spouse or another dependent relative lives there. In addition the spouse of a nursing home resident may keep one half of the couple’s joint assets up to $126,420 (in 2019; see website for more information on Medicaid’s asset rules).

Myth #2: To qualify for Medicaid, you should transfer your money to your children. Medicaid law imposes a penalty on people who transfer assets without receiving fair value in return. This penalty is a period of time during which the person transferring the assets will be ineligible for Medicaid, and the length of the penalty period is determined, in part, by the amount of money transferred. The state will look at all transfers made within five years before the application for Medicaid. That doesn’t mean that you can’t transfer assets at all—there are exceptions (for example, applicants can transfer money to their spouses without incurring a penalty). However, before transferring any assets, you should talk to an elder law attorney (see website for more information on Medicaid’s asset transfer rules).

Myth #3: A prenuptial agreement will protect my assets from being counted if my spouse needs Medicaid. A prenuptial agreement only works to keep property separate in the event of death or divorce. It does not keep your property separate for purposes of Medicaid eligibility.

Still confused? Don’t worry, you are not alone. The stress associated with placing a family member in a nursing facility combined with the worry about how to pay for it all is enough to overwhelm anyone. Hawthorne is fortunate to have multiple resources to help, whether at Care & Share or here at the hospital. Jeri Lynne is our Medicaid Coordinator; contact her at ext. 1258. She will help you with the required paperwork and documentation.

Mentioned this at the start but please think again about getting a flu shot. We have already had more positive flu tests this year than all of last season—and winter is weeks away yet.