Warning: Medicaid Eligibility Varies from State to State

By Lara Schneider-Bomzer

Have you ever been on the phone with a friend living in another state and the topic of long term care health needs comes up?

Your friend in New York tells you that she has a neighbor who immediately received Medicaid home care benefits after transferring all her assets out of her name. She says that her neighbor created no penalty period of ineligibility by doing this.

When you get off the phone, you think that you should speak with your daughter about transferring your assets since you could use some help paying for the home care that you need. After all, Connecticut law must be the same as New York law, right?

WRONG! Even though New York is “just the state next door,” the Medicaid laws and Medicaid transfer penalties are drastically different under certain scenarios.

While your New York friend’s neighbor can transfer all her assets without creating a penalty period and receive eligibility for Medicaid home care benefits, if you did the same thing in Connecticut, you would create a penalty period and therefore, a period of ineligibility for Medicaid home care benefits. Connecticut law differs from New York law dramatically in this instance.

Another difference in the state laws

In New York, a community spouse may file for “spousal refusal” when the ill spouse is applying for Medicaid nursing home benefits. This means that after the ill spouse transfers all his assets to the community spouse, the state will not look at the community spouse’s assets in determining eligibility for the ill spouse.

In Connecticut, a community spouse cannot file for spousal refusal which means that the community spouse’s assets will be counted against the ill spouse when applying for Medicaid nursing home benefits. This can make all the difference in whether you’re granted benefits or not. Again, this is very different from New York.

The moral of this story

Don’t assume that a friend in a neighboring state will be treated the same as a Connecticut resident when it comes to Medicaid eligibility. There are significant variations in Medicaid programs across the states. This is just another reason why it is so important to meet with a qualified elder law attorney before taking any steps in your Medicaid planning.