Speaker 1
Hello, and welcome to your next chapter. So, so excited to be here today. This is an incredible, very serious, very topic that I get called about. And all my tours ask me, you know, how do we work with Medicaid? How does that work? What is the process? So I’m super excited to have our guests here today to help walk us through it, give us some answers to some questions and some resources and information. So I’m going to have you introduce yourself and tell us a little bit

Speaker 2
about yourself as well. So I’m Christine Talarski. I’m from Connecticut Medicaid Specialists and we have been helping people and seniors with applying for Medicaid for well over 20 years. I’m a social worker by trade so I have a background working in skilled nursing facilities and hospitals. So I help them navigate that puzzle of trying to apply for Medicaid and seeing what benefits that they’re eligible for.

Speaker 1
That’s amazing. That’s amazing. So let’s dive right in. What is Medicaid and how does it cover nursing home costs?

Speaker 2
So Medicaid is a government program that is a type of insurance. And that helps pay for long-term care for people that are unable to pay privately for that in a skilled nursing facility. So it would cover things like room and board, their meals, their medications.

Speaker 1
Nice, nice. And it’s national, correct? Yes, it is. Correct. Yes, it is.

Speaker 2
Yep, yep. Every state is different and has their own guidelines. There could be different asset limits and income limits.

Speaker 1
Yep. Great. So do you have to be in this? I’m throwing a question out there because I know I get this as well.

Speaker 1
Let’s say you’re coming in from South Carolina, for example. How long do you need to be a resident of Connecticut to be able to get Medicaid? One day. Oh, nice. OK, very nice.

Speaker 2
You cannot have you cannot have Medicaid in two different states at the same time. So if I’m working with someone and they’re from another state, we need to get a letter from their Department of Social Services worker in the other state saying that they’ve been discontinued benefits in that state so that they can apply and get benefits in the state of Connecticut.

Speaker 1
Wow, that is great to know. Great to know. What are the income requirements to qualify for Medicaid and get nursing home coverage?

Speaker 2
So the monthly income requirements for Medicaid, if you’re in a skilled nursing facility, there is no income limit. There are income limits for programs in the community. So if you’re applying for something like the Connecticut Home Care Program, the income limit for a individual is $2,382. If you’re married and you have a spouse, then the income limit is $4,764. If you’re in a skilled nursing facility, then your income, which they would call their, they typically use the phrase applied income, the income that you have goes towards the cost of your care. And then the Department of Social Services and Medicaid will help pay for the

Speaker 1
difference in that cost. What if you have expenses and such? Do you get any money left over?

Speaker 2
So for people that are in a skilled nursing facility and they’re on Medicaid, they get to have a personal allowance of $75 a month. And that is allowed for their personal allowance per month.

Speaker 1
And if you’re in a nursing home, really, everything’s being taken care of.

Speaker 2
So everything is being cared, your care, your meals, medications, medications, the doctors that come in to see you, that’s all being cared for. So sometimes when people have that $75 allowance each month, sometimes the families will use it and buy clothes for someone, or if they have a sweet tooth and they like chocolates, They may, you know, use it to buy little things or treats for their loved one that’s at the facility.

Speaker 1
Because personal care products are covered as well, like adult diapers and that as well. So currently that’s 75, which a lot of times when people hear that, they’re like, you know, I mean, you and I, $75 to live off of. But because so much is being covered by the nursing home, really, like you said, for clothes, for treats and stuff like that is really.

Speaker 2
If you want to have a prescription, you know, if you want to get the heart for current delivered to you. Sometimes people like the newspaper.

Speaker 1
But what if you have, I’m sorry, what if you have like, you know, a car still or, you know, credit card bills that are still out there? What happens then? Is it still the 75? And what can what what does how how does that take care of?

Speaker 2
So, yes, so it’s still the 75. If you’re in a facility long term and you have a spouse in the community and you have a car, then that car is protected. And that can be used. The spouse in the community can use that car.

Speaker 2
Sometimes they’re using it if there’s a need for transportation because a husband or wife wants to go with the client to a doctor’s appointment or things to that nature. When you’re applying for Medicaid and you have credit card bills, then if you aren’t able to pay them, then really you’re not able to pay them. OK. And they can’t really they can’t go after your family.

Speaker 2
or anybody to pay them.

Speaker 1
Yeah. So generally just the same process is if I were in my own house and I couldn’t pay my credit cards, you got to kind of take those same steps, talk to the credit card company and kind of figure it out. Yeah.

Speaker 2
Right, right. I mean, yeah, a lot of times, unfortunately, you know, it may be a loss for them. Yeah, yeah.

Speaker 2
Credit card company, because a lot of times people may depend on those, you know, when they’re in the community because they’re living on such limited income And then something happens and they go into a skilled nursing facility and they say, well, geez, I’ve racked up all these credit card bills because I had to pay for food or I had to pay for medical bills. And if you don’t have the money to pay for it, what can you do? I mean, if you have a house and you can sell a house and pay off some of your debt, that’s great.

Speaker 2
But for a lot of people that may not have property and they live in an apartment or they live in senior housing.

Speaker 1
That’s a good segue. What happens with your assets? Let’s say you do have, you know, a pretty substantial house. What happens with that? You know, if you have to go, do you private pay until you’re Medicaid eligible or what happens with that?

Speaker 2
For someone who is single or widowed or divorced, if you go into a facility and you have a house, then the typical standard is that they will put the house on the market. And then you have to sell the house for fair market value. Sometimes people will say to me, well, can I pay a dollar?

Speaker 2
Can I transfer it for $80,000? And it’s a $300,000 house. You have to sell it for fair market value.

Speaker 2
And that’s very important. Once you sell the house, you can use the proceeds from the sale of the house to pay for your care at the skilled nursing facility. You can pay for a funeral. You can prepay for an irrevocable funeral. In the state of Connecticut, it’s up to $10,000.

Speaker 2
And then you can set up an revocable funeral contract, which is separate.

Speaker 1
Yeah. And you can’t give any of the money to your kids or anyone like that.

Speaker 2
It becomes a real problem when you do that because then that puts you in a penalty period. And when you’re applying for Medicaid, there is a five-year look back. So if you were to sell your house now and then want to transfer money from the sale of the house to your children, that becomes a problem because then when you do apply for Medicaid and it’s in that five-year look back, then you’re going to have get hit with a penalty. And then what that means is that they would refuse to grant you Medicaid to help pay for the care of your and the nursing facility.

Speaker 1
And what’s a penalty period? Like how long is that? And it depends on how much it really depends

Speaker 2
on how much is given. So sort of what the analogy that I sort of use to sort of explain to people is say you gave your daughter last year $20,000 and say the average cost of a nursing home is $20,000, which is a little high, but we’ll just use that for numbers. If you gave $20,000 and the nursing home average cost is $20,000, that’s a one month penalty. So what that means is at the time you would have become eligible and you were under $1,600 in assets, if you were financially eligible October 1st and said, okay, I’m under $1,600 in assets, I’m eligible for Medicaid, they could say, well, you did that transfer. We’re giving you a one-month penalty, which means now you are not

Speaker 1
eligible until November. And so what happens if you’re in the nursing home? Let’s say life is life and you and I both know. So you go to rehab, find out, unfortunately, you need long-term care. You’ve got to go the Medicaid route. You’ve done this kind of thing, which we’re cautioning not to do.

Speaker 1
Give the 20,000 to your daughter. Obviously, you didn’t know. You didn’t know, you know, two years later, you’d be in this state. What happens? Like you’ve run out of private funds to pay. What happens to you? Do you get thrown out of the nursing home? Like what happens?

Speaker 2
There’s a couple of different things. Yeah. Well, and there’s a couple of different scenarios that I’ve run into. I’m actually working with someone now where there was money that was gifted over time to different people. And the daughter actually took it upon herself to say, I’m taking out a private loan and I’m giving the money back to my mother that was given.

Speaker 2
So if the money can be given back, then that’s the right thing to do.

Speaker 1
Oh, okay, nice.

Speaker 2
And so I will encourage people that, you know, you need to give that money back because this is going to be imposed a penalty. And I’ve had some really good luck. I’ve had people say or families say, you know, hey, that’s fine. And like I said, I have one client that took out a personal loan and put the money back in her mother’s account.

Speaker 1
Nice.

Speaker 2
If you if they don’t have the money or they don’t want to pay, give the money back. That becomes a problem because then there’s a penalty.

Speaker 1
Nice, nice.

Speaker 2
But I, you know, I’m going to look at my little notes here.

Speaker 1
So do we I don’t know whether we went over this. What are the different nursing home care options covered by Medicaid? I think did we go over that?

Speaker 2
I think so. Skilled, skilled care for long term care. Yep. Short term rehab.

Speaker 2
there and for an illness or say they’ve fallen, they broke a hip or they had to have knee surgery and they’re there for short-term rehab. And it pays, as you know, as you know, for a skilled nursing facility, that is a facility that provides 24-hour care, round-the-clock nursing.

Speaker 1
Okay. We did look back here. We’re cruising along. Do all nursing homes accept Medicaid? Okay.

Speaker 2
Most of them do. There are a few that do not. And I think it’s important when you’re going to look at facilities and you’re going to go and tour a facility for your mom or dad, even if you’re just thinking down the road and you say, hey, I want to go and tour somewhere and I really like this place and I want to put my mom on a wait list.

Speaker 2
But when she needs it, that’s great. But you need to check and see if they accept Medicaid. Most of them do accept Medicaid. There are a few that do not and they’re private pay. And those facilities typically will want a lot of financial information and may, you know, want money up front to pay for X amount of time.

Speaker 1
Yeah, I worked up in the Berkshires and I know that there was one up there that I, and that’s actually maybe the first one I ever actually ran into lovely facility, by the way, but they didn’t accept Medicaid at all. And Medicaid beds are limited too, in some

Speaker 2
facilities, correct? Where there’s, they have designated beds that are, yeah, exactly.

Speaker 1
And things I know, things have heated up a little bit with nursing homes. I know for a while, there were like tons of beds, but I think now do you find that it’s tough for someone to get

Speaker 2
a Medicaid bed? It really depends. I mean, when we’re in the heat of COVID, I think it was difficult because of just everything that was going on and people were sick. And, you know, there’s so many nursing facilities and there’s so many beds out there. And it can be overwhelming for family when they’re looking at places as to like which one they really prefer.

Speaker 2
So and it changes day to day. I mean, I have people that say to me, well, I really like this facility and I would really like to go there. But, you know, they don’t have any beds.

Speaker 2
And I encourage them to be put on a wait list because things change daily in skilled facilities. And you can always apply for Medicaid and be in one facility. And then if you’re on a wait list somewhere else, you can transfer and go to that other facility as long as that other facility accepts Medicaid.

Speaker 1
And that’s what I did with my mom, actually. She was in one in the Windsor area and I wanted West Hartford and then I was able to transfer to West Hartford. And I think that’s so good that you stated that because a lot of times what happens, I don’t think because we’re in the industry, we know it’s an ever moving and you can do what you need to do.

Speaker 1
But I think people get so caught up in the fear. Oh, my gosh, if I move her, blah, blah, blah. you know, but you can, you know, exactly what you said, you know, if you’re, you have to, I think the one of the most important things I always stress is ask questions and you want to get the best quality of care for your loved one. And so don’t be afraid to, like you just said, think out of the box and put them there and then move them after. I think that’s right. Rather than waiting and having their funds running out and, and that type of thing. Absolutely. Absolutely.

Speaker 2
They always have a choice. They think that if I apply for Medicaid and I’m in a facility that I don’t have a choice as to where I want to go or they feel like, you know, I can never leave the nursing facility and go out for a day with my loved one or go to church. And that’s not true.

Speaker 1
Yeah, I think it’s important for people to realize they have choice and to call on resources like yourself. Speaking of which, tell us how to get in touch with you and say the name of your company again.

Speaker 2
Sure. So the name of my company is Connecticut Medicaid Specialists with an S at the end. You can find me online or people, I give out my cell phone and I have family members call me and they can come directly.

Speaker 1
Yep. Give that web address and your phone number, please.

Speaker 2
Sure. So my the number you can reach me at is 860-490-6772. And I’m available seven days a week. I take calls and speak with families in the evening, on Saturdays, on Sundays.

Speaker 2
A lot of times there are families that are contacting me and they work. So they need to meet with me in the evenings or on the weekends. So I try to do my best to accommodate them and work with them so that we can get things done around the schedule.

Speaker 2
I’m sorry.

Speaker 1
What’s the website?

Speaker 2
Connecticut Medicaid specialists.

Speaker 1
Nice.

Speaker 2
Dot com dot org dot com. Sorry. Connecticut Medicaid specialist dot com. If you Google Connecticut Medicaid specialists, I’ll come right up.

Speaker 1
There you go. There you go. So let’s dive back in. So different states have different names for their Medicaid programs?

Speaker 2
Yes, they do. Yes, they do. Not every state, every some states have different names that I don’t even know. But a family member will refer to me and they’ll say that Medicaid in New York or New Jersey or.

Speaker 1
OK, nice. And we’re Title 19. Is Title 19 universal or where that’s a Connecticut thing?

Speaker 2
No, it’s that’s universal. So title 19 is the same as Medicaid. Okay. So that is the same.

Speaker 2
And the way to think of it is title 18 is Medicare. Oh, 18 is Medicare and title 19 is Medicaid.

Speaker 1
That is awesome. I’m like a weird trivia person. And I was going to ask you, but I didn’t want to put you on the spot because I’m like, why is the title 19? But I’m like,

Speaker 2
Yeah, let me not put it around. That’s awesome. And some people, yeah, people will say, well, I have Title 19. And I’ll say that’s Medicaid. And they’ll say, no, no, I have Title 19. And I go, and then I explain to them and say, okay, there’s different titles. So

Speaker 1
we have that same conversation with people. So let’s talk more about the home care programs. I do think that’s important. I think a lot of people don’t realize that they can get money follows a person and they can get kind of home care as well. They don’t necessarily have to go to a skilled nursing home if they qualify. So let’s talk about the Connecticut Home Care program for the elderly. Tell me who’s eligible and tell me a little bit overview of that.

Speaker 2
So I actually used to work for the Connecticut Home Care program. So I know a lot about the program, which is very exciting. It’s a great program for people that are in a skilled nursing facility or at risk of going into a skilled nursing facility and need help at home, whether it’s just to fill in gaps where family needs help for certain periods of time during the day.

Speaker 2
I’ve even had some people that actually have a live-in caregiver because they need so much care. And so the Connecticut Home Care Program is a program for people over the age of 65, and it helps pay for care at home. So there’s different levels of the program, depending on if you’re eligible for Medicaid or not.

Speaker 2
If you’re not eligible for Medicaid, sometimes they may ask that you contribute a small percentage of the cost of your care plan for services. And it is a program that can help pay for a nurse to come out and help you, a home health aide or a personal care assistant. and those people can help with bathing and dressing and meal preparation. It can help pay for a companion, someone that might be able to come in and just spend some time with you and maybe help with a meal or things to that nature. It can pay for Lifeline or Life Alert, which is a button to help call if you’re a lot of people that are on the home care program live alone. And this is a, you know, the device such as that they can use if something happens and they have a fall and they need to get help. And also we’ll pay for adult daycare. A lot of times people are home and they’re so isolated that they could have the opportunity to go to adult daycare a few days a week and it gets them out. It gets them socializing. They have meals. They go to programs.

Speaker 1
That’s wonderful. That’s wonderful. And I love this program. I think it’s been, how long has it been around now? It’s not like from the beginning of Title I.

Speaker 2
No, it’s been around for a very long time, though. It’s been around for a long time. I think it’s a great program. So many people that if that program wasn’t around, I think that there would be more and more people that would be in nursing facilities that don’t have the support.

Speaker 1
Yeah. And sometimes people are just more high functioning. You know, unfortunately, I know of a case of a gentleman that had an accident.

Speaker 1
You know, he’s in the 70s. And unfortunately, you know, he’s paralyzed. But up here, he’s great. And so sometimes being in a nursing home, he’s not mentally there yet.

Speaker 1
Maybe physically, but not mentally. This program, I think, can be very helpful for that.

Speaker 2
Absolutely. And for people that are under the age of 65, I see a lot of people that will be possibly able to qualify for the Money Follows the Person program, which is a program for people that typically they’re under the age of 65. And that program can help people to get back into a home environment and you would help navigate the care and hire and fire your own staff and you have to be able to direct your own care.

Speaker 1
Yeah, I love that. This is a great program. So tell me again about your company. Give me an overview of your services and we’ll wrap up. Thank you for this very much. We’re very great information and exactly what we needed.

Speaker 2
Oh, you’re so welcome. So again, it’s Connecticut Medicaid specialists. I assist families and I assist loved ones with the Medicaid application process.

Speaker 2
I meet with everyone on an individual basis and we’ll meet with families, whether they’re at home or even going to skilled nursing facilities to sit down and meet with them and go over the entire process. I submit the applications. I am the liaison and I will collaborate between the Department of Social Services social worker who will be assigned to the case and the nursing facility.

Speaker 2
One of the nice things with Connecticut Medicaid specialists is that we actually have a elder law attorney that is available to us and we can run by Medicaid applications that may be complicated to him. So if there’s something that’s a big red flag, such as like transfer of assets or things to that nature, or for example, if there’s a spouse that they’re still married, but they have been estranged for 20 years. And so what do you do in a case like that where you have to apply for Medicaid and the spouse is still married and they’re not together or they’re not communicating or they, you know.

Speaker 2
So that’s a really great resource that we are able to have for people that may need to get advice from an elder law attorney to kind of get some ideas of how to handle that.

Speaker 1
Nice. Nice. Well, thank you again for being here.

Speaker 1
We’re super grateful and we’ll get this out. Look forward to seeing you again for sure. Thank you.

Speaker 1
Thank you. Thank you.