What is a Medicaid Crisis and What Are Your Options?

What is a Medicaid Crisis and What Are Your Options?

Imagine that your parent or another aging loved one suddenly finds themselves in need of nursing home care. If they haven’t already planned for the potential cost of long-term nursing care, they could find themselves in an incredibly compromised and vulnerable position. Because of the strict income and asset limitations that dictate who is eligible for Medicaid, your parents (or even you) may end up blowing through your life savings in order to pay for the cost of long-term care.

It is well known that Medicaid has a 5-year lookback period, so those who find themselves in immediate need of long-term care often assume there is nothing they can do to get qualified.

Fortunately, that is a myth. With the help of a qualified elder law attorney, Medicaid Crisis Planning could help you or your loved ones preserve some of their assets while becoming eligible for Medicaid.

What is Medicaid Crisis Planning?

About 70 percent of American seniors will need some type of long-term care planning, many of whom will find themselves in nursing homes. Because of the high nursing home costs—the median annual cost of a private room in a nursing home is over $100,000—it is important to meet with an elder law attorney to work out a detailed plan to prepare for this situation long in advance.

If, however, you find your loved one facing an unexpected health emergency that will likely require nursing home care, you do have options. For people who have assets significantly higher than the Medicaid threshold, the best of these options is Medicaid Crisis Planning. Medicaid Crisis Planning is a way to avoid spending down your entire life savings when faced with an immediate or near-immediate health situation.

How Does Medicaid Crisis Planning Work?

With Medicaid Crisis Planning, the person facing a nursing home visit gifts a large part of their assets—sometimes up to 50 percent—to a Medicaid Asset Protection Trust, or in some cases directly to a child or another loved one. The rest of the person’s assets are then converted to an income stream through a Medicaid Compliant Annuity (or in some states a promissory note) After these transfers are completed, the patient applies for Medicaid to cover the nursing home cost.

In most cases, the application will be approved subject to a penalty period.  That penalty period is based on the amount of the gift they have made to their child or other loved one (and any other transfers for less than fair market value that have been made in the past 5 years). During this period of ineligibility, (penalty period) the person will privately pay for nursing home care using their monthly income, as well as the funds produced by the annuity or payments from the promissory note or annuity. Once the ineligibility period has expired, Medicaid will start paying the monthly nursing home bill.

While the applicant will need to use some of their life savings initially, in the long-run, they will be able to salvage some of what they’ve worked a lifetime to accrue.

Long-Term Care Planning

With proper long-term care planning, you and your loved ones can be protected from having to spend down your entire life savings when faced with an unexpected nursing home admission—without the need for Medicaid Crisis Planning. An elder law attorney will help you protect your assets and guide you through which financial moves to make (or NOT make) as you age. For example, it may be advised that you set up a Medicaid Asset Protection Trust or purchase assets that are exempt from Medicaid.  This can prevent you from incurring a penalty, should you need to apply for nursing home Medicaid in the future.

The sooner you start planning for the cost of long-term nursing care, the better.  As it goes, an ounce of prevention is worth a pound of cure.

Whether you are interested in long-term care planning or find yourself in need of Medicaid Crisis Planning, it is important that you work with an experienced estate and elder law attorney. Elder law matters are as complicated as they are essential, so choosing the right professional can make all the difference.

At Miller Estate and Elder Law, we have many years of experience with long-term care planning and Medicaid Crisis Planning. Call (256) 251-2137 to speak with a member of our legal team today or contact us using the brief form below.

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Providing Care After an Alzheimer’s Diagnosis: Caring for Aging Parents

Providing Care After an Alzheimer’s Diagnosis: Caring for Aging Parents

When a parent or another loved one receives an Alzheimer’s diagnosis, the news lands like a devastating blow. Knowing that you will soon watch someone you love lose their memory and struggle with daily tasks is emotionally wrenching. In addition, your loved one will eventually need intensive dementia care, which can put heavy strains on a family—both psychologically and financially.

Although it’s unlikely that you will be able to provide all the care necessary for a parent diagnosed with dementia, many children do take on a large share of the burden of looking after their parents. For most people, caring for aging parents or loved ones who have received an Alzheimer’s diagnosis is a whole new experience, and one that is very overwhelming. Knowing a few basics about dementia care can help ease the burden.

Everyday Care for Those Diagnosed with Dementia

Because people with Alzheimer’s will start to experience changes in memory and their ability to think clearly, they will need help performing many everyday tasks. The inability to perform what used to be simple tasks can prove quite frustrating, and understandably so. Here are some ways you can help support a loved one who is struggling with dementia:

  • Establish a routine. For people with Alzheimer’s, doing the same thing at the same time every day can help them stay focused on and involved in their own lives. Furthermore, certain tasks need to be performed at a time when the patient is most alert, so it’s important to schedule these at that specific time each day.
  • Help your loved one write down tasks and reminders. Writing down the things they need to do and remember will encourage them to take responsibility for their life, and will also help keep their mind sharp.
  • Allow the person to do as much as possible by themselves. Although Alzheimer’s patients will need more and more help as their disease progresses, it’s important to allow them as much independence and autonomy as possible.
  • Provide choices. Providing the person with simple choices, like the choice between two shirts to wear, can help them feel empowered and stay focused.
  • Reduce distractions. Make sure the environment your loved one lives in is free from distractions, particularly during mealtime or conversations. Otherwise, they may get confused.

Safety Considerations for People Diagnosed with Alzheimer’s

As well as helping the person with their daily tasks, providing them with a safe environment is an important part of dementia care. Here are a few things you can do to prevent them from getting injured:

  • Lock away potentially dangerous objects, such as cleaners, medicines, matches, or knives.
  • Remove anything that the person could trip over, such as extensions cords or small rugs. Also, install handrails or grab bars to help the person maintain their balance.
  • Keep the thermostat on a lower setting so that the person won’t accidentally burn themselves.
  • Insert safety plugs into unused electrical outlets.

Legal Concerns

In addition to providing care for a loved one diagnosed with dementia, there are also important legal considerations that come with looking after their affairs. At the first word of an Alzheimer’s diagnosis, you should contact an elder law attorney to ensure the proper legal documents are in place so you can focus on providing care, and not a lengthy and costly legal process. Drafting documents while your loved one is still coherent is essential, though there are limited options for those whose loved ones have already lost significant cognitive function.

At Miller Estate and Elder Law, we have many years of experience helping people whose loved ones have received an Alzheimer’s diagnosis. Use the brief form below to download a copy of our free guide: Caring for Aging Parents or call (256) 251-2137 to speak with a member of our legal team today!

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The Pros and Cons of Long-Term Care Insurance Explained

The Pros and Cons of Long-Term Care Insurance Explained

It might be hard to think about this now, but chances are—somewhere down the road—you may need help taking care of yourself. One question that arises from this situation is: how will you pay for it? One way to prepare for the potential cost of long-term nursing care is to purchase long-term care insurance. Unlike traditional health insurance, long-term care insurance is designed to cover the cost of long-term care services and support in a variety of settings, such as your home, a nursing home, or another facility.

Long-term care insurance policies cover such costs as assistance with routine daily activities, like bathing, dressing, or getting in and out of bed. They also help cover the cost of care if you have a chronic medical condition, disability, or disorder.

Taking into consideration long-term care costs is an important part of any long range financial plan. If you wait until you need care to buy coverage, it will be too late. Most policies require medical underwriting, and if you already receive long-term care services, you may not qualify. As a result, most people purchase long term care insurance plans in their mid 50’s to mid 60’s.

As we mention in the above video, there are two different types of long-term care insurance policies: traditional long-term care insurance, and asset based (hybrid) long-term care insurance. Both of these options have their pros and cons, but—as we mention—asset based insurance is usually the preferred option.

Traditional long term care insurance is a “use it or lose it” type policy, similar to homeowner’s insurance. If you do not need it or use it during your lifetime, you do not benefit from paying the monthly premium. The monthly premium that you do pay is based on your age, and how much coverage you want. This premium payment will increase over time, and can also continue to increase…even after you take out the policy.

On the other hand, a hybrid policy creates a pool of money for long-term care that is equal to several times your premium payments. The pool of money created for long-term care can either be used for a specified minimum period of time, or for a lifetime (depending on the insurance company). If you do not need these benefits, the policy pays a death benefit to your heirs upon your passing.

Long term care insurance is something everyone should consider, and it is important to understand the differences in the types of policies that are available. If you are apprehensive about navigating the long-term care maze, please join estate planning attorney Bill Miller for an upcoming free workshop using the form below. We’ll answer 

Register for our Next FREE Estate Planning Workshop

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Four Common Misconceptions About Long-Term Care Planning

Four Common Misconceptions About Long-Term Care Planning

With the US population aging, life expectancy increasing, and events like the Covid-19 pandemic showing us that no one’s health is secure, new awareness has arrived concerning the need for a long-term care plan. This is great news and yet with increased awareness comes an increase in the circulation of misinformation. In a bid to clear the air, we address four of the most common misconceptions concerning long-term care planning below.

1. If you or your spouse enters a nursing home, the state will seize your assets.
Medicaid, the state and federal government-sponsored program that millions of US adults rely on to pay for long-term care needs, seizes nothing when you enter a nursing home. Instead, the program simply will not chip in a dime until you, yourself, have spent down your “countable” assets to a level that qualifies you for assistance. This does not mean only very low-income individuals are eligible to receive Medicaid, however; it simply means that you need to work with an experienced estate planning attorney well ahead of time to put a plan in place to protect assets so that you are able to qualify for Medicaid more quickly when the time comes.

2. If you use Medicaid to pay for care, you risk losing your home.

This misconception is similar to the above but deserves a separate address because of how often it is repeated.

As long as the person using Medicaid (the beneficiary) or their spouse continues to live in their home, it can neither be taken nor forcibly sold. This is the case even if you are single as long as you communicate your “intent to return home” in writing when you enter a nursing home.

It is true that upon your death, the state can file a claim against your estate (which includes your home) in order to repay nursing home expenses covered by Medicaid but even this can be avoided with help from an experienced attorney.

3. Making a financial gift disqualifies you from Medicaid for five years.
Medicaid employs a look-back period wherein any financial transfers or gifts made in the five years prior to applying for the program may be counted against your eligibility. This does not mean you will be barred from receiving benefits if you make a gift during this period. However, it does mean that you may have to endure a penalty period before Medicaid picks up the cost of your care.

This penalty is based on the value of the gifted assets made and how many days of long-term care they could have been used to pay for. Once more, an experienced estate planning attorney can help you work out specifics and determine the most affordable way for you to gain the coverage you need.

4. It is too late to start long-term care planning.
All too often, folks who are already receiving nursing home care or those with imminent need assume it is too late to engage in planning that preserves their assets. This is simply never true. You can always, for instance, use cash to pay down your mortgage and thereby convert a non-exempt asset into an exempt asset and thus save thousands. While it is always better to begin planning early, such last-minute strategies help you retain a large percentage of all that you have worked so hard to gain.

To learn more about long-term care planning or emergency strategies to ensure you have the coverage you need, do not hesitate to call Miller Estate and Elder Law at (256)251-2137 or reach out via the contact form on our website.