In this case, C.L., a resident of a nursing home, applied for Medicaid benefits. The state’s Medicaid agency, the Division of Medical Assistance and Health Services (DMAHS), denied her application. DMAHS determined an annuity C.L. purchased, which she understood to be irrevocable, was instead found to be revocable by the agency and counted as a.. read more →
A.V. suffered from Alzheimer’s disease and dementia. In January 2021, A.V. moved into a skilled nursing facility. That April, she filed her first application for Medicaid benefits, seeking a community spouse resource allowance for her husband, J.V. In June 2021, the Cumberland County Board of Social Services (CCBSS) denied the claim, advising A.V. and J.V… read more →
Long-term care comes at a tremendous financial price, especially around-the-clock nursing home care. The cost of a private room in a nursing home in New Jersey is at least $12,000 per month, and may be more. Most people end up paying for long-term care and/or nursing home care out of their savings until they spend.. read more →
The Director of the Medicaid agency in New Jersey held that income in a Qualified Income Trust which was used to pay the room and board fee for a resident of an assisted living facility was not countable in determining the resident’s eligibility for Medicaid benefits. H.H. v. Monmouth County Board of Social Services – Final.. read more →
In order to qualify for Medicaid benefits, an applicant may not own more than $2.000 in countable assets. All assets are countable, with few exceptions. Annuities purchased by Medicaid applicants are countable resources unless they are irrevocable and meet certain other requirements. In this case, Jane Cushing purchased a single-premium, immediate annuity from the Croatian.. read more →
A Massachusetts court held that the state is not entitled to recover Medicaid benefits from a community spouse’s annuity. Dermody v. The Executive Office of Health and Human Services (Mass. Super. Ct., No. 1781CV02342, Jan. 16, 2020). Robert Hamel purchased an annuity that named the state as primary beneficiary to the extent any Medicaid benefits are.. read more →
M.M. filed for Medicaid benefits on three occasions. In June 2018, M.M. filed her first Medicaid application. Benefits were denied due to excess income; that is, her income exceeded the monthly cost of the assisted living facility (ALF) where she resided. She received $6,141.93 per month from an annuity she purchased for $73,673.11 in May.. read more →
A New Jersey appeals court ruled that payments to the spouse of a Medicaid recipient from an annuity purchased with the spouse’s “resource allowance” were properly considered “income” to the spouse under the Medicaid rules. J.G. v. Division of Medical Assistance and Health Services J.G., who was married to M.G. for 67 years, suffered from Alzheimer’s.. read more →
In a 2 to 1 precedential decision by the United States Court of Appeals for the Third Circuit reversing an earlier federal district court judgment, the court ruled that “short-term annuities” purchased by applicants for nursing home Medicaid cannot be treated as an “available resource” that prevent Medicaid eligibility. Zahner v. Secretary, Pennsylvania Department of Human.. read more →
Two years ago, in 2013, a federal judge in New Jersey granted a preliminary injunction to Elizabeth Flamini, a Medicaid applicant who successfully sued for an injunction preventing the State of New Jersey from counting an annuity owned by Mrs. Flamini’s husband Angelo as an available resource in determining Medicaid eligibility. Flamini v. Velez ,.. read more →
(In Zahner v. Mackereth (U.S. Dist. Ct., W.D. PA, Jan. 16, 2014), a federal district court ruled that long-term annuities, that is, annuities with payment terms of 5-years or more, purchased by Medicaid applicants were not transfers for less than fair market value and, therefore, were not subject to a penalty period, but that shorter-term annuities.. read more →
In Brill v. Velez (U.S. Dist. Ct., D. N.J., No. 1:13-cv-05643 (NLH/AMD), June 27, 2014), a federal district judge ruled that an applicant’s claim against the State of New Jersey for denying Medicaid benefits based upon the purchase of an annuity survived a motion to dismiss even though the State reversed the denial because the applicant.. read more →
A federal district court in New Jersey ruled that a Medicaid applicant was not entitled to a preliminary injunction to prevent the State from counting her annuity as an available resource. Matrangolo v. Velez (U.S. Dist. Ct., D. N.J., No. 13-6289 (MAS) (LHG), May 30, 2014). Plaintiff Marie Matrangolo, an 88-year-old woman who has been a.. read more →
The annual roundup of the top 10 11 elder law decisions from across the country for 2013 as prepared by staff at the ElderLawAnswers website is reproduced below. Almost all the cases hinged on the interpretation of state or federal Medicaid law. Those purchasing annuities or transferring property in exchange for a promissory note did.. read more →
For the first time, the Division of Medical Assistance and Health Services (DMAHS), New Jersey’s Medicaid agency, held that an applicant for nursing home Medicaid was eligible for benefits despite the fact that she made a substantial gift within the look-back period and owned an $80,000 annuity. M.W. v. Division of Medical Assistance and Health.. read more →
A federal district court in Western Pennsylvania held that the purchases of single premium immediate annuities with short payment terms by applicants for Medicaid constitute improper transfers of assets even if the annuities otherwise comply with the federal Medicaid laws in all respects. Zahner v. Mackereth, Civil No. 11-306 (W.D. PA, January 16, 2014). This.. read more →
As the U.S. Court of Appeals, 2nd Circuit, held in Lopes v. Dep’t of Social Services, 696 F.3d 180 (2d Cir. 2012) and the U.S. Court of Appeals, 3rd Circuit, held in James v. Richman, 547 F.3d 214 (3d Cir. 2008) when resolving the same issue, the U.S. Court of Appeals, 8th Circuit, has now.. read more →
A federal district court judge in New Jersey granted a Medicaid applicant’s motion for a preliminary injunction, thereby enjoining the State from counting an annuity owned by her husband as an available resource in determining her eligibility for Medicaid. Flamini v. Velez, Civil No. 1:12-cv-07304 (D.N.J. July 19, 2013) Elizabeth Flamini entered a skilled nursing.. read more →
A federal district court in New Jersey holds that an annuity purchased by the spouse of a Medicaid applicant with the couple’s countable resources which exceeded the resource limit under Medicaid is not a transfer for less than fair market value for purposes of Medicaid eligibility. Carlini v. Velez (U.S. Dist. Ct., D.N.J., No. 12-7290 (JEI/KMW),.. read more →
After John Lopes was admitted to a nursing home, his wife, Amelia, purchased a irrevocable, nontransferable, single premium annuity for $166,878.99 from The Hartford Life Insurance Company. The annuity contract provided for monthly payments of $2,340.83 over a period of approximately six years. In a letter, the annuity company confirmed that no part of the.. read more →
Medicaid is a joint federal and state program that provides a funding source to pay nursing home costs for elderly and disabled persons. The Medicaid program was created under Title XIX of the Social Security Act of 1965, codified in the U.S. Code, Title 42, Section 1396 et seq. New Jersey’s Medicaid regulations are found.. read more →
Here are my selections for the top ten (10) twelve (12) New Jersey elder law / public benefits / Medicaid cases decided in 2010: (1) R.C. v. Division of Medical Assistance and Health Services and Hudson County Board of Social Services, OAK DKT. NO. HMA 08047 – 10 (Hudson County, October 22, 2010): Judge Awards.. read more →
Ohio’s First District Court of Appeals has joined other state and federal courts across the country in ruling recently that Ohio improperly imposed a penalty period on a Medicaid applicant whose wife purchased an annuity during the look-back period. The Court held that Ohio’s regulations regarding the purchase of annuities are improperly restrictive, and are.. read more →
In Lopes v. Starkowski (U.S. Dist. Ct., Dist. Conn., No. 3:10-CV-307, August 11, 2010), the U.S. District Court for the District of Connecticut held that the State of Connecticut cannot treat the income stream from an annuity as an available asset for the purposes of Medicaid eligibility. After John Lopes was admitted to a nursing.. read more →
Following is an exchange posted on a electronic bulletin board devoted to the discussion of issues involving pension and compensation claims submitted to the Department of Veterans Affairs (VA): Question: My client applied for pension benefits from the VA. The client was deemed medically qualified for VA Aid and Attendance benefits, but denied pension benefits.. read more →
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