Refuel #31

🔥 Refuel | Issue #31
A Newsletter from Faith + Gasoline
📅 Subject: “Medicaid: What People Don’t Get”

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🛠️ Welcome to Refuel

Hey fam,

Let’s talk about Medicaid.
I can’t tell you how many families misunderstand it—and that confusion costs real money, real homes, and real peace of mind.

Most people think Medicaid is just “government healthcare.” But the truth? Medicaid is the only program that covers long-term nursing home care. And getting it is not simple.

If you’re caring for a parent, spouse, or sibling, you need to know this: Medicaid is not Medicare. And if you don’t understand the difference, you could spend down every dollar your loved one has before help ever arrives. And then they come after you once they transition. so consider these things BEFORE signing up.

Failing to plan is planning to fail.

🚗 Story from the Road: “We Thought We Were Covered”

A friend of mine called in a panic. Her dad had been admitted to rehab after a fall. She thought Medicare would handle it. After all, he had paid into the system his whole life.

But here’s what she didn’t know: Medicare covers short-term rehab, not long-term care. And once he couldn’t safely return home, the facility started billing thousands per month. Medicaid wouldn’t step in until he had spent nearly all of his savings. It’s called the spend down. Check your state - in MO, you don’t automatically qualify if you make over $750 a month. What?

She cried when she realized the retirement her dad had worked for was gone in less than a year.

This happens every day. Families don’t plan. They don’t ask the right questions. They don’t know the rules until it’s too late. It’s not your fault. Most people don’t have any idea about this stuff.

📊 What People Don’t Get About Medicaid

⚖️ Medicare ≠ Medicaid
Medicare is federal health insurance for those 65+. Medicaid is a joint federal–state safety net program for people with low income and limited assets. Only Medicaid covers long-term custodial care.

💸 The Asset Test
In most states, if your loved one has more than $2,000 in countable assets, they don’t qualify. Savings, retirement accounts, and extra property often count against them.

⏳ The 5-Year Lookback
You can’t just give money away to family to “protect” it. Medicaid reviews all asset transfers for the past 5 years. If they find gifts, they impose penalties that delay care coverage.

🗝️ Trust Myths
A revocable trust (where the person still controls the money) doesn’t protect assets from Medicaid. Only particular irrevocable trusts, set up years in advance, can help—and you need an elder law attorney to do it right.

🏚️ Estate Recovery
Even if Medicaid pays for care, the state can recover costs from your loved one’s estate after they die—often by placing a lien on their house. Families don’t see it coming.

This is a topic I wanted to revisit because I am trying to help a sibling protect his money. He needs long-term care, but it’s so expensive that you can quickly drain 100K and then need Medicaid. Yes, you could have $350,000 in the bank and still be on Medicaid within two years.

⛽ Quick Refuel: ✅ 5 Steps to Understand Medicaid

✅ 1. Don’t confuse Medicare with Medicaid. Medicare doesn’t cover long-term nursing home care.

✅ 2. If your loved one has savings, know they will likely need to “spend down” before Medicaid kicks in.

✅ 3. Get professional advice. Elder law attorneys are worth every penny for Medicaid planning.

✅ 4. Don’t wait until crisis hits. Medicaid planning takes time—sometimes years. Start the conversation early.

✅ 5. Protect yourself, too. If you’re a spouse, remember that your retirement and stability are tied to these decisions.

📌 Takeaway: Medicaid isn’t a rescue plan you can count on at the last minute. It’s a system full of rules and traps. Learn them now, so you can keep more of what your loved one worked for.

📘 Recommended Read:
Refuel: The Caregiver’s Handbook – This digital download is the perfect introduction to long-term caregiving. Buy it for yourself or as a gift for a friend. Many of you are caregivers, even if you don’t know it yet!

Know someone who needs this newsletter? Forward this link:
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📢 Share this with a friend or family member who thinks Medicare will cover it all. They need to know the truth before it’s too late.

💙💙 Community is the new currency 💙💙

Caregiving is already hard. Don’t let misunderstanding Medicaid add to the burden. Protect your family. Protect your legacy.

Go be great. 🚀💙
Love you.

With faith & fuel,
Judith A. Culp