MEDICAID COMPLIANT ANNUITY
Accelerate Your Client's Eligibility for Medicaid
A Medicaid Compliant Annuity is a powerful tool that helps elder law attorneys achieve a better solution for clients facing a costly nursing home stay. This innovative product helps achieve:
A Medicaid Compliant Annuity is a single premium immediate annuity (SPIA) that contains zero cash value and provides income to the owner. Properly structured, this annuity functions as a spend-down tool that eliminates excess countable assets, allowing the nursing home resident to become eligible for Medicaid benefits.
a Medicaid Compliant Annuity must:
The annuity contract payment amount and term cannot be altered, and the parties to the contract cannot be changed.
The annuity contract cannot be assigned to another party and cannot be sold on the secondary market.
The term of the annuity must be fixed and must be equal to or shorter than the owner’s Medicaid life expectancy. This figure is determined by the life expectancy table published by the Chief Actuary of the Social Security Administration, or by a state’s specific life expectancy table, as outlined in each state’s Medicaid manual.
The annuity contract must provide equal, monthly payments, with no deferral or balloon payments.
In most cases, the state Medicaid agency must be named primary death beneficiary to the extent of benefits paid on behalf of the institutionalized individual. Exceptions to this rule vary from state to state but may apply in certain cases involving a married couple, or a minor or disabled child. If a particular case qualifies for an exception, the state Medicaid agency likely must be named contingent beneficiary.
The Medicaid Compliant Annuity is available in 48 states and the District of Columbia. It is irrevocable, non-assignable, and typically must name the state Medicaid agency as beneficiary. The product has zero cash value and is considered income only. It can be funded with either non-qualified or tax-qualified funds. The minimum investment amount is $5,000, and the minimum term length available is two months, in most states.
We’ve offered Medicaid Compliant Annuities since the early 1990’s. Several federal laws and regulations have altered the structure and strategy over the years, but the basic planning concept remains the same: Utilize a properly structured immediate annuity to convert excess assets into an income stream, thereby accelerating Medicaid eligibility. Most recently, however, it’s the Deficit Reduction Act of 2005 (DRA) provides the framework for an annuity’s “Medicaid compliance.” For more information on the DRA and other Medicaid legislation, go to our Intake Forms & Planning Tools page.
Strategies using an MCA vary depending on marital status. When dealing with a married couple, an MCA is purchased by the community spouse to spend down excess countable assets. They are the owner and payee of the contract. The institutionalized spouse can then gain immediate Medicaid eligibility. In the case of a single person, they may consider using the “Gift/MCA Plan” to accelerate eligibility while still creating a wealth transfer to heirs. To learn more about our most popular strategies, view the case studies on this page or go to our Case Studies page for even more examples.
To qualify for Medicaid, an applicant must be 65 years of age or disabled and must be a U.S. citizen or qualified alien. Because the Medicaid program is administered at the state level, most states have their own residency requirements. Most importantly, the applicant must be residing in a Medicaid-approved facility – typically a skilled nursing home. Some states may have waiver programs which extend to assisted living facilities or at-home care as well.
The income of a Medicaid applicant must be below their cost of care. In some states, a Qualified Income Trust may be required if their income exceeds the current threshold. There are no limits on the income of the community spouse. However, if they have very low monthly income, they may be entitled to some of the institutionalized spouse’s income under the Monthly Maintenance Needs Allowance rules.
The primary reason most people don’t automatically qualify for Medicaid is they have too many countable assets. For a single person, they can typically only keep $2,000 in most states. For a married couple, the amount of the Community Spouse Resource Allowance varies but is no more than $123,600 in 2018 in most states. This means most applicants must spend down thousands of dollars. One quick way to accomplish this is through the purchase of an MCA, which contains zero cash value.