What is a Medicaid Compliant Annuity?

A Medicaid-compliant annuity is a tool which converts excess resources, which would make a person unqualified for Medicaid, into a monthly income stream. Here’s where a Medicaid-compliant annuity could save your retirement.

You buy an immediate annuity — owned and payable to you — that satisfies several special criteria, transforming cash that otherwise would prevent your ill spouse from qualifying for Medicaid into a stream of income that will help you maintain your standard of living.

Once approved, Medicaid may begin covering the stay in the nursing home, and your monthly bills become manageable.

Clients are primarily in their 70s or 80s, with no long-term care insurance, and savings of around $200,000 to $300,000.

Who Do They Benefit?

Medicaid is simply an immediate annuity purchased by a client to enable his or her spouse to qualify for Medicaid assistance.

They serve to ensure that:

  • The healthy spouse – known as the “community” spouse – has satisfactory income

  • The second, less healthy, spouse qualifies for Medicaid assistance in having to pay for long-term care costs, generally in a nursing home

Properly structured, this annuity functions as an expenditure-down tool that removes excess countable assets, allowing nursing home residents to qualify for Medicaid benefits.

Meeting Medicaid’s Eligibility Requirements

Instead of treating the purchase of the annuity as an impermissible transfer of assets to meet Medicaid’s means-tested eligibility requirements, the Federal Deficit Reduction Act (DRA) treats the purchase as a permissible investment, and the annuity payout stream as a shielded community spouse’s “income” (rather than as an asset that would be counted in determining eligibility).

This technique allows the community spouse to use funds over the resource allowance allowed by Medicaid to buy an annuity that provides additional income. This is important because it states that the resources that the community spouse can keep are strictly limited, and still allow Medicaid for his or her spouse.

Despite this, some states (including Ohio and Pennsylvania) have in recent years challenged these annuities, potentially making it much harder for a client to qualify for Medicaid using an annuity.

When is an Annuity Considered to be a Medicaid-Compliant Annuity?

The terms of the annuity contract must meet certain criteria required by federal law to qualify as a Medicaid-compliant annuity.

1. Income From The Annuity Contract Must Only Be Payable to the Community Spouse

2. The Contract Must Be Irrevocable and Non-Assignable

3. The Payment Period Must Be Based on the Life Expectancy of the Community Spouse

Payments must be made in equal installments, and the annuity cannot be a deferred annuity.

The stakes are high with Medicaid Planning using the annuities. If an annuity is “similar” to a Medicaid Compliant Annuity but does not meet all of an MCA’s requirements, it will not achieve its intended goal, and your family might lose tens of thousands of dollars or more in assets. That’s why working with professionals who are experienced with MCAs is so critical, and not being persuaded to buy a different annuity product.

To Comply With Medicaid an Annuity Must Be:

1. Irrevocable and Un-Attributable

It cannot be revoked or transferred to a person other than a spouse of the community.

2. Actuarially Sound

The annuity owner (the community spouse) should receive their investment back within their life expectancy, or a shorter amount of time.

3. Equal Amount For Regular Payments

Payment deferment or “balloon” payments are not allowed.

MCAs can offer great peace of mind to families with one spouse in need of home-care nursing and the other in the community.

Getting Your Annuity Contract

Read it up carefully when you collect your annuity contract. Be sure that this fits in with your understanding:

  • Read the Insurance Company’s disclosure or prospectus and other information provided. Inquire your salesperson on an annuity to clarify anything you do not understand

  • In many states, a law provides you to set amount of days to change your opinion about buying an annuity after you obtain it (typically 10 to 30 days). This is often referred to as a free look, or right to return. Your contract and disclosure or prospectus should set out your free look time prominently.

  • If you decide that you do not want an annuity during that time, you can notify the insurance company and give back the contract. You can either get all of your money back or your current account value, depending on which state you live in.

As with all annuity types, the pros and cons exist for each type. Concentrate on finding the best for your situations, and find help from a trusted adviser.

How To Get Started

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