Medicaid can help individuals with special needs get access to essential healthcare services and financial assistance. In Wisconsin, navigating Medicaid eligibility and special needs planning will help you ensure your loved one will receive the necessary support without jeopardizing their benefits. Let’s look at the key aspects of these plans.
Medicaid Eligibility in Wisconsin
In Wisconsin, the Medicaid program is known as BadgerCare Plus. Also, there is the Medicaid for the Elderly, Blind, or Disabled (EBD Medicaid). Both of these programs provide healthcare coverage for low-income residents, including long-term care and home-based services.
Depending on the classification of the person, there are different income limits outlined by the State of Wisconsin’s Department of Health Services. If an applicant has a higher income than the threshold, they could use the spend-down programs, which deduct medical expenses from income.
Also, Medicaid has strict asset limits. For example, there are exclusions for certain pieces of property, such as a primary residence and a single vehicle.
To qualify for these programs, applicants must meet the Social Security Administration’s (SSA) definition of a disability. With that, there must be a physical or mental impairment that limits their ability to work. This impairment is also expected to last at least 12 months or result in death.
What About Special Needs Planning?
Sometimes, individuals with disabilities can receive financial support without disqualifying them from Medicaid. Special Needs Trusts, ABLE accounts, and life insurance are a few ways to protect their future financial needs.
Special Needs Trusts (SNTs)
These trusts will hold the assets of those persons with disabilities without affecting other Medicaid or Supplemental Security Income (SSI) eligibility.
There are First-Party SNTs, which are funded by the person’s own assets, such as settlement. After the person passes away, then the remaining assets are reimbursed to Medicaid.
On the other hand, a Third-Party SNT is funded by family members or third-party individuals. However, there is no requirement for Medicaid payback upon the person’s death.
ABLE Accounts
Another option is the Achieving a Better Life Experience (ABLE) Act. Under this, individuals with disabilities can save money in a tax-advantaged account without losing eligibility for Medicaid or SSI. Wisconsin is part of the national ABLE for ALL program. These funds can be used for disability-related expenses like housing, education, and transportation.
Life Insurance
Finally, don’t forget about life insurance for special needs planning. With a life insurance policy, you can name a Special Needs Trust as the beneficiary. In these cases, family members and other loved ones can offer financial support without affecting the person’s eligibility for these needs-based programs.
Special Needs Planning Is Often Needed in These Situations
If you have a loved one, you will want to think about planning for their needs. It is important to make sure they have the financial resources even after you have passed away.
Without proper planning, receiving assets through an inheritance or settlement could disqualify a person with special needs from Medicaid. You can use tools, such as special needs trusts and ABLE accounts, to make sure that their eligibility is maintained.
With planning, you can enhance their quality of life. While Medicaid covers many necessary services, additional resources are often needed for supplemental expenses that improve quality of life. Proper planning makes sure that your loved one has funds available for these needs.
Finally, you can have some peace of mind. Once you have a special needs plan in place, you can have some confidence that your loved one will receive ongoing support.
Get the Special Needs Planning You Need
When it comes to your loved one, Medicaid eligibility and special needs planning in Wisconsin involve many financial and legal considerations. These tools will ensure your loved one with disabilities will get the care they need without losing access to government benefits like Medicaid.
If you are looking for help with your planning, reach out to the legal team at Collins Law Firm. We offer estate planning, estate administration, business law, and elder law services. We proudly serve Southeastern Wisconsin and the Milwaukee area. Contact us or call (414) 207-6292. Schedule your free and confidential consultation today!