As you know, the Supplemental Security Income (SSI) program, administered by the Social Security Administration (SSA), is a needs-based government benefit program which provides monthly cash assistance to aged, blind or disabled individuals who have limited income and resources. Individuals over age 65 automatically meet the “aged” requirement. Adults who assert eligibility as “blind” or.. read more →

Conceding defeat in the courts, the National Association of State Medicaid Directors (NASMD) has sent a letter to the Center for Medicare and Medicaid Services (CMS) requesting that the agency revisit its treatment of community spouse annuities. In the Omnibus Budget Reconciliation Act of 1993, Congress delegated the treatment of annuities in the Medicaid program.. read more →

As I had reported in a March 4, 2009 blog post, New Jersey Administrative Law Judge (“ALJ”) Walter M. Braswell, in E.F. v. Division of Medical Assistance and Health Services and the Union County Board of Social Services, OAL DKT. No. HMA-7536-08 (Union County, February 26, 2009), held that an annuity purchased by a community.. read more →

In Weatherbee v. Richman, 595 F. Supp. 2d 607 (W.D. Pa. 2009), the U.S. District Court for the Western District of Pennsylvania reversed the denial of Medicaid benefits to a nursing home resident (“institutionalized spouse”), holding that the income from an irrevocable, non-transferable, non-assignable, single premium, immediate annuity payable to the spouse of the nursing.. read more →

An Opinion and Order was entered on October 20, 2009 by Administrative Law Judge Joseph A. Paone, in the consolidated matter of the Estate of F.L. v. Division of Medical Assistance and Health Services and the Union County Board of Social Services, OAL Docket No. HMA 13756-08.  The ruling in the Estate of F.L. case.. read more →

In June 2009, plaintiff, Daisy Jeanne Prall, applied for nursing home Medicaid benefits with the Ocean County Board of Social Services. To be eligible for Medicaid, plaintiff and her spouse, Christopher Prall, cannot own resources which exceed $111,560; $109,560 is the community spouse resource allowance and $2,000 is the institutionalized spouse resource allowance. Although the.. read more →

As I blogged here, the New Jersey appellate court, in N.M. v. Division of Medical Assistance and Health Services, 405 N.J. Super. 353  (App. Div. 2009), certif. den., 199 N.J. 517 (2009), held that an annuity purchased for the sole benefit of the community spouse after the effective date of the Deficit Reduction Act of.. read more →

As I had reported in my March 4, 2009 post, found here, a New Jersey administrative law judge (“ALJ”) in the E.F. v. DMAHS case had held that an annuity purchased by a community spouse with retirement assets from the community spouse’s IRA was exempt in determining the institutional spouse’s nursing home Medicaid eligibility. I.. read more →

In only the second administrative law case of its kind decided in New Jersey, an administrative law judge (ALJ) recently decided that an annuity purchased by a community spouse with retirement assets formerly held in the community spouse’s IRA was exempt in determining the eligibility of the institutional spouse for nursing home Medicaid benefits. I.. read more →

In a case of major importance in the Medicaid estate planning area, the Appellate Division of the New Jersey Superior Court held, in N.M. v. Division of Medical Assistance and Health Services, 405 N.J. Super. 353  (App. Div. 2009), certif. den., 199 N.J. 517 (2009), released yesterday, that the value of an annuity purchased for.. read more →

The Benefits of Immediate Annuities An immediate fixed annuity may be the answer for those seeking a steady stream of income in retirement. When you purchase an immediate fixed annuity, you give a lump sum to an insurance company. The insurance company then pays you a set amount each month for the rest of your life… read more →

As I reported here and here, federal district and appellate courts in Pennsylvania have ruled that an annuity purchased with a couple’s excess resources and payable to the community spouse is not countable in determining the institutionalized spouse’s eligibility for nursing home Medicaid benefits. Recently,  an administrative court, for the first time, reached the same.. read more →

The U.S. District Court for the Western District of Pennsylvania, in a case entitled Weatherbee v. Richman, ____ F. Supp. _____ (C.A. No. 07-134, January 22, 2009), has issued an opinion essentially following the reasoning of the United States Court of Appeals of the Third Judicial Circuit in James v. Richman in a case involving an.. read more →

In a recent study, “Three Phases of Retirement and Planning for the Unexpected,” the Society Of Actuaries (SOA) identified three stages of retirement and offered advice on how to prepare for each stage of retirement. The SOA said that retirement is often depicted as life on the golf course, holidays with the grandchildren, and traveling.. read more →

An annuity is a type of insurance product in which an insurer, in exchange for charges (akin to premiums), makes a series of income payments at regular intervals over a set period. Senior citizens and other consumers often obtain annuity coverage for use as future retirement income. Because nearly $15 trillion dollars is invested by.. read more →

The The Times Leader newspaper, a daily newspaper located in Wilkes-Barre, Pennsylvania, recently posted a report on its internet homepage on the James vs. Richman lawsuit. The James case was originally filed in federal district court in Pennsylvania, and concerned an application for Medicaid benefits submitted by Pennsylvania residents. The James case substantially changed the.. read more →

The pace of decisions in Medicaid appeals has picked up recently, with several significant decisions being rendered in courts and administrative agencies in New Jersey. As a result, there has been a spike in interest by attorneys who seek to identify and understand the estate planning strategies that can successfully accelerate eligibility for Medicaid benefits.. read more →

What emerging case law is demonstrating about Medicaid planning techniques: SITUATION PLANNING TECHNIQUE Applicant does not have a community spouse Use a promissory note with a “gift and loan” strategy. G.L. v. DMAHS, Docket No. HMARP 05080-2008N (Middlesex County), Final Agency Decision Oct. 23, 2008. Applicant has a community spouse Use funds above the resource.. read more →

In James v. Richman, 465 F.Supp.2d 395 (M.D.Pa. 2006), aff’d, 547 F.3d 214 (3rd Cir. 2008), an institutionalized spouse who was a nursing home resident brought a lawsuit against the Pennsylvania Department of Public Welfare (DPW) alleging that the DPW’s decision to deny his eligibility for Medicaid benefits violated the federal regulations governing annuities under.. read more →

The federal Deficit Reduction Act of 2005 (DRA), which became effective on February 8, 2006, made major changes to the federal Medicaid law. One such major change in the federal law is in the treatment of annuities owned by the spouse of a Medicaid applicant (called the “Community Spouse” in the law) . Under the.. read more →