New Medicaid Rules


Effective January 1, 2012 Illinois adopted new Medicaid rules; finally adopting their version of the Deficit Reduction Act of 2005.
Key Changes:

  • Look back period is now 5 years for all transfers.
  • Back dated eligibility: must meet both financial and non-financial criteria during each of 3 months prior to application.
  • Penalty period: Begins when applicant becomes a resident AND has been otherwise approved for Medicaid. Now calculated to the day instead of rounded down to the nearest whole month.
  • Annuities must be irrevocable, non-assignable, actuarially sound and paid out in equal installments and with the state of Illinois named as a remainder beneficiary.
  • Personal Care Contracts: Must be in writing, predating care, and a record of services rendered or other documentation must be kept. Fees paid for care at or below community rate for similar services.
  • Hardship waivers: State will provide a hardship panel for disallowed transfers made prior to 11/01/11.
  • Home equity limit: $750,000 adjustable for inflation. ($786,000 in 2012)
  • Prepaid Funerals: Exemption increased to $10,000 if directly with funeral home or financed by insurance or trust account.

There are still planning techniques that can save a family tens of thousands of dollars even if your loved one is already in a nursing home. The area of Medicaid planning is not a do-it-yourself proposition. Get good legal advice and guidance.





Community Spouse Resource Allowance
Maximum Monthly Maintenance
Needs Allowance (MMMNA)
Personal Needs Allowance
- if receiving Aid & Attendance
Penalty Period Divisor  
Individual Resource Allowance
Home Equity


$2,841 $
Private Pay Rate

$21,912 - $113,640

$1,849 -  $2,841

Why you need to be concerned

  • For a couple age 65 or higher there is better than a 50/50 chance one of them will spend time in a nursing home.
  • The average stay in a nursing home is 2.44 years. Many are much longer.
  • The average daily rate of a semi-private room in metropolitan St. Louis is $170/day.
  • If you do not have long term care insurance an average stay will cost a family over $150,000.
  • Depending on the return on your investments you may need as much as $2,000,000 to pay for an average stay in a nursing home without cashing in your savings.

 Tools on the Website
1)Net Worth Required To Avoid Need for Medicaid
2)How Much Can You Save Today With Medicaid Planning

How we can help:
We help families preserve and extend their assets to the extent possible when faced with long term care costs. If necessary we will help families apply for Medicaid benefits for their loved ones. We can shorten the application time and work with the Department of Human Services to get all questions answered so a positive decision can be made. We also help war time veterans or their widows qualify for and apply for Aid & Attendance Benefits. Any questions call us at (618) 251-3300.

Rick Gibson
James E. Gau, II


200 North Wood River Avenue Wood River, IL 62095 | v (618) 251-3300 f (618) 251-3358
(800) 525-0513 Toll Free
Contact Us

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Disclaimer: This web site has been designed to provide educational information only and is not intended to offer legal advice. Please do not make any decisions about any legal matter without first consulting with an Elder Care Attorney. No Attorney Client Relationship is formed by any use of the information provided herein.




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