What is long-term care insurance and is it really necessary?
Long-term care insurance covers the risk that you may at some point in your life be placed into
a nursing home by paying for some or all the expenses associated with nursing home care. It
also frequently covers assisted living care or care in your home. Long-term care insurance can
be a very valuable tool that can help you avoid depleting your estate in order to pay for nursing
home care. Nursing homes greatly vary in cost depending on the quality of the home and the
geographic area of the country in which the care facility is located. At a minimum, you can
expect to pay several thousand dollars a month for decent nursing home care, which can
rapidly deplete an individual’s savings.
What is Medicaid Planning and what does it involve?
Medicaid is a federal program that will pay for nursing home care. Medicaid is not to be
confused with Medicare, which in most cases will not pay for extended nursing home care.
Medicare is a program which people pay into during their working years, while Medicaid is a
needs-based program intended to help impoverished Americans with medical expenses.
Doesn’t Medicare provide coverage for long term care?
Medicare does not provide coverage for long-term care, such as nursing home care. Medicare
will pay for up to 100 days of skilled nursing care per illness. A patient must be hospitalized for
the illness, and the patient must receive a high level of care in a nursing home that couldn’t be
provided at home or on an outpatient basis. After 20 days of nursing home care, there is a large
copayment required of the patient for the remainder of the stay.
Medicare will also pay for home health benefits if you are housebound and if a doctor has
ordered home health services for you, at least some of which are skilled. Medicare will pay for
up to 35 hours of services per week, and patients only have to pay for 20 percent of the cost of
medical supplies and equipment.
Is Medicaid Planning legal?
Medicaid planning is legal. Elder law attorneys work to protect clients’ assets within the bounds
of the law. Congress allows citizens to qualify for Medicaid after meeting certain requirements,
and those requirements could be changed if Congress felt they were being abused. Medicaid
planning is not any more illegal than planning to avoid taxes.
How long will it take to become eligible for Medicaid?
There’s no simple answer as to how long it might take an individual to qualify for Medicaid.
There are many variables in every situation that must be taken into consideration and ultimately
affect the eligibility timeline, including the state in which you live, whether your application is
complete, your assets, income and expenses, any asset transfers you’ve made to individuals or
trusts, and more. Before applying for Medicaid, you should consult an elder law attorney in your
area. The attorney can help you understand both eligibility and the application process, and
should be able to give you an estimate of the time frame you can expect.
Can my children take money out of our joint account without affecting my eligibility?
If a child removes money from your joint account, that could be considered a transfer to him.
Currently, Medicaid has a “look back” period on transfers of assets within the past 60 months.
This means that any gifts or other transfers of assets you made in the 60 months before you
applied for Medicaid will be assessed in order to determine your eligibility. If you did transfer
assets in the five year period before applying for Medicaid, you could be subjected to a penalty.
Therefore, if you made a transfer of assets in the past five years, you should not apply for
Medicaid without consulting an elder law attorney because the penalties could be severe.
What are some criteria to look for when selecting a nursing home?
First, how is the nursing home ranked by accreditation agencies or state regulators? Have there
been violations or complaints against the nursing home? How does the nursing home rank
when compared with other homes in the area? You should also visit the facility in person and
request a tour.
Another important factor to consider is location. Is the nursing home located in an area that is
convenient for family and friends to visit? Would family members be more likely to visit a
nursing home located in another area?
Before choosing a nursing home, take a tour and ask for references of family members of
current residents. If possible, take the tour at an unscheduled time, so that you know that what
you are seeing isn’t staged for your benefit. During the tour, look carefully at the interactions
between staff and patients. Does the staff seem caring and concerned? Do the residents seem
content? What is the quality of the food served?
Choosing a nursing home can seem overwhelming at first, but often after visiting a few and
evaluating their quality of care, the decision becomes easier.
Should I wait until I need Medicaid benefits before I see an elder law attorney?
No, if you anticipate needing Medicaid at any point in the foreseeable future, it’s prudent to seek
the advice of a qualified elder law attorney. There are steps you can take to protect your assets
which may not be available when you actually need Medicaid. Some of those steps may include
transferring your assets or establishing trusts. An elder law attorney with expertise in Medicaid
planning can evaluate your situation and advise you on the most prudent steps to take in order
to preserve your rights and maximize benefits.