One of the most frequently asked questions I get as an Elder Law attorney is “Will the Government Pay for My Nursing Home Expenses?” There are government programs that will pay or help pay for long term nursing home care but Medicare is not one of them. Medicaid does pay for nursing home care but there are very strict income and asset limits to qualify. The biggest and most costly mistake that people make is not getting information about how they can qualify for Medicaid. Watch this video to learn more. If you have a loved one in a nursing home or going to a nursing home, let us help you. Give us a call at 256 251-2137.
Hearing a doctor say that your loved one needs skilled nursing care, 24/7, can be a real shock. Chances are, you have not given much thought to planning for long-term care. If you have just learned that your dad or mom needs 24/7 care – or think this may happen in the future – continue reading to learn more about what you can do to help.
The Realities of 24/7 Care
If your mom needs 24/7 care, you are not alone. In fact, the following statistics tell an interesting story about long-term care:
52% of people age 65 right now will need long-term care at some point.
47% of men and 58% of women age 65 or older face long-term care.
Some people will need skilled nursing care for years. The cost of 24/7 care can be staggering. In Alabama, the monthly costs for long-term care in 2018 were:
$3,241 for homemaker services or a home health aide
$3,271 for an assisted living facility
$6,279 for a semi-private room in a nursing facility
$6,661 for a private room in a nursing facility
What can you do to help someone who needs 24/7 care?
Applying for Medicaid
Once you find a good nursing home, you need to figure out how to pay for it. This can be tricky. There are basically three ways to pay for long-term care: self-pay, long-term care insurance, and Medicaid.
You may need the Medicaid money now but don’t know how to get it or even if you will be eligible.
Medicaid offers a number of programs to provide medical care for people with limited assets and resources. To qualify, the application will need to meet certain asset and resource tests. For example, someone who needs 24/7 care must not earn more than $2,250 per month or have more than $2,000 in resources.
Applying for Medicaid can be frustrating and time consuming, in part because of the amount of supporting documentation. In addition, Medicaid case workers will review the applicant’s finances for a 60-month period prior to the application date. Certain transactions made during that time may disqualify the applicant from or delay benefits.
Medicaid Is Complicated. We Can Help.
It’s possible – and highly recommended – to plan ahead for incapacity and long-term care. Estate
planning can help, especially if Medicaid planning is included.
For a free consultation with an experienced Alabama estate planning attorney, contact Bill Miller
at 256-472-1900. Miller Estate and Elder Law is now located at 818 Leighton Avenue in
Anniston, but we serve clients in Gadsden, Hoover, Talladega, Vestavia Hills, and surrounding
areas.
The new year is more than a time of partying, recovering from Christmas, and figuring out how to pay our credit card bills. For many of us, it’s a time of reflection. We can use the new year as motivation to review our lives and make some necessary changes. For many of us, Medicaid planning for the new year should be top priority.
Why is Medicaid planning necessary?
For one thing, long-term care is expensive. According to Genworth statistics, the 2018 costs for long-term care in Alabama are: $3,241 per month for Home Health Care $3,271 per month for an assisted living facility $6,279 per month for a semi-private room in a nursing home $6,661 per month for a private room in a nursing home
You have three basic ways to pay for long-term care:
Self-pay,
Long-term care insurance, or
Medicaid and other government benefit programs.
Without proper planning or insurance, the nest egg you spent years building could evaporate quickly.
What does Medicaid planning involve?
When you engage in Medicaid planning, you are making it more likely that you will qualify for Medicaid. To qualify for Medicaid:
Your income must be below Medicaid’s income limit. In 2018, an applicant could make no more than $2,025 per month.
You must have resources worth less than $2,000 on the first day of the month. Not all of your property will be considered resources.
Medicaid or Medicaid must medically approve you.
Finally, you must be a United States citizen and live in Alabama.
Medicaid planning primarily concerns meeting the income and resource limits. To do so, you can reduce your countable assets. However, Medicaid does not just look at your current financial situation. They actually employ a “look back period” which means they look at your finances for the 60 months prior to your application date. Any gifts or transfers made during that 60-month period may delay or minimize your Medicaid benefits.
How should I start Medicaid planning?
Immediately, of course! It is the New Year after all. Seriously, though, it is impossible to know when might need Medicaid. If it happens less than 60 months from right now, your ability to qualify could be jeopardized.
The attorneys at Miller Estate and Elder Law have the experience and skill to get your Medicaid planning in shape for the new year. To make an appointment to learn more about Medicaid planning, give us a call at 256-472-1900. Miller Estate and Elder Law is now located at 818 Leighton Avenue in Anniston, but we serve clients in Leeds, Gadsden, Hoover, Talladega, Vestavia Hills, and surrounding areas.
Did you know a Baby Boomer is a person who was born between 1946 and 1964?
This means the Boomer is now between the ages of 55 and 73. Unfortunately, the reality of the aging process is he or she could possibly be facing a greater potential need of skilled nursing home assistance in the future. While this is a future none of us want to contemplate at any time, it is important for Boomers to understand the possible need to pay for long-term care early on.
Perhaps the most concerning issue surrounds how Baby Boomers use their personal funds.
A well intended gift could both deprive them of the money they need to pay for care in the nursing home and penalize them in their attempt to access public benefits such as Medicaid. For example, did you know a Boomer’s choice to give money to help a child with unplanned family expenses or to help a grandchild with the high cost of college tuition could result in him or her being penalized for making a gift? This can be the exact situation the Boomer is facing if he or she makes gifts like these within five years of needing nursing home assistance, as there is a penalty for uncompensated transfers when applying for public benefits.
Gifts, or uncompensated transfers, are just one of the potential threats to the success of the application for public benefits. In these situations, the child or grandchild who received money from the Baby Boomer would likely need to be able to immediately repay the gift to avoid the application for public benefits being denied. Likewise, it is important that the Boomer who received a gift from an aging parent have ready access to cash to immediately repay the loan or gift.
How can Baby Boomers plan to provide for their loved ones and still maintain access to long-term care benefits?
One of the ways to do this successfully is to work with the Boomer’s elder law attorney to create a contract for services with a child or grandchild who is caring for the Baby Boomer at home or in a long-term care facility. Another way to effectively spend down excess resources is by purchasing non-countable assets.
Non-countable assets can include, but not be limited to, any of the following:
A homestead having an equity interest less than state allowed amount after deducting the mortgage,
A vehicle regardless of its age or value,
The cash value of a whole life insurance policy having a face value of $2,500 or less,
The full value of an irrevocable burial contract regardless of the amount contributed to the policy, and
A $2,500 exclusion for the Boomer’s bank account that has been designated for burial expenses.
It is important for Baby Boomers to know that there are ways to successfully spend down their assets and still be eligible for nursing home expenses. While gifts, or uncompensated transfers, are just one of the potential threats to the success of the application for public benefits these are murky waters that need the guidance of an elder law attorney who understands the challenges Baby Boomers and their loved ones’ face. We encourage you not to wait to get the answers you need and to reach out to our office to schedule a meeting.
There is never a “right” time to enter a skilled nursing home. For most of us, we wish to live our lives in the comfort of our own homes and never have to contemplate a time when we would leave them because we need long-term care. Unfortunately, as we age, our needs, especially when it comes to our health, may not match what we want.
There may come a time when you or a loved one will need care outside the home. This could be due to a health care crisis, a cognitive decline, or for many other reasons. The question then changes to a more immediate issue: how will you be able to afford this care for your spouse in addition to your monthly bills?
Medicaid has a fixed amount of countable assets you are allowed to own and also receive Medicaid assistance.
What happens, then, should you have more than this amount? Did you know that in our state a Medicaid “spend down” of countable assets can be done to make sure the spouse entering into the skilled nursing facility is immediately eligible for Medicaid nursing home assistance? This is done because the spouse in a nursing home, often referred to as the “institutionalized spouse”, cannot own more than $2,000 in countable assets and the healthy or “community” spouse can only own countable assets that do not exceed $126,420.
A “spend down” scenario exists when the community spouse purchases assets that result in there being less cash or available assets that would otherwise disqualify the institutionalized spouse from Medicaid nursing home assistance. The “spend down” is accomplished by the community spouse paying for things that are allowed. For example, he or she could pay cash to improve his or her residence, pay off a credit card balance, or purchase a new automobile. There is no limitation on the ways in which a spend down can be accomplished. However, the spend down cannot result in a gift being made. This would constitute a penalty that would make the nursing home spouse ineligible for assistance.
The risk of a spend down is that the nursing home spouse may suddenly die. In such an event, the cash that could have available for the community spouse’s needs over the ensuing years of comfort may no longer be available for the community spouse’s medical or other emergency needs. There are alternatives to spending down. Rather than spending down the assets and subsequently not having the cash for emergencies, the community spouse should consider using the proceeds received through an allowed Medicaid strategy. For example, he or she could utilize a reverse mortgage on the residence to pay the nursing home costs rather than leaving the community spouse without sufficient funds for future expenses.
Another strategy could be creating a non-countable asset such as a Medicaid Qualifying Annuity.
This annuity can be owned by the community spouse, regardless of its value. This annuity must meet strict rules including being irrevocable, non-assignable, have no cash value, and payable over no more than the owner’s life expectancy. Since the community spouse may also eventually need long-term care, the community spouse’s purchasing a Medicaid Qualifying Annuity may be the best solution for protecting assets since the investment in the annuity, if not used for care, could be paid back to the community spouse and then be available for his or her subsequent long-term care.
We know this article may raise more questions than it answers. There is never a wrong time to plan for the potential need for long-term care in a skilled nursing facility and, often, pre-planning can help you achieve the strategies you need early on. Whether you are in a crisis or pre-planning today, know that we have solutions available for you. Do not wait to contact our firm and schedule a meeting to discuss your needs.
Everything seemed to happen in a split second. One minute, 88-year old Mary Elizabeth was living at home and appeared able to care for herself. Then her son, Jason, received a call from the emergency room. Mary Elizabeth had suffered a devastating stroke and needed the kind of 24/7 nursing care best offered in a nursing home. She moved immediately from the hospital to a nursing facility, but financing her stay was a problem. Jason quickly learned how fast he could get Medicaid for a nursing home resident.
The Basics of Medicaid for a Nursing Home Resident
We’ve all heard of Medicaid, but may not understand the finer points of applying, qualifying, and finding the services we need.
Medicaid is federally funded, but state managed. Programs and eligibility requirements may vary from state to state. Alabama Medicaid offers a program for Institutional Medicaid – or Medicaid for nursing home residents.
Qualifying as a Nursing Home Resident
For Jason to get Medicaid for Mary Elizabeth, she has to meet the following criteria:
Mary Elizabeth must be a U.S. citizen residing in Alabama.
She must prove that her nursing care is needed for a medical condition.
Mary Elizabeth must live in the nursing facility for at least 30 continuous days.
She must have a monthly income below the current limit of $2,205 per month, although this amount may be adjusted in January of each year.
Mary Elizabeth’s resources must be worth less than the limit Medicaid sets. At this time, the limit for an individual is $2,000. However, there are exceptions to this, particularly if the applicant is married.
But applying for government benefits can take months. Mary Elizabeth and Jason urgently need Medicaid coverage now.
Emergency Medicaid
It make take 45 to 90 days for a Medicaid application to be approved. However, Medicaid coverage may be granted to cover up to three months before the month in which the application was submitted. This applies if the applicant received medical case and if the applicant meets all other eligibility requirements.
One of the best ways to quickly receive Medicaid is to submit an incomplete or inaccurate application. We can help.
Get a Decision on Medicaid as soon as Possible.
The attorneys at Miller Estate and Elder Law understand the estate planning needs of their clients. Contact Bill Miller at 256-472-1900 to schedule an appointment. Though our office is now located at 818 Leighton Avenue in Anniston, we serve clients in Gadsden, Hoover, Talladega, Vestavia Hills, and surrounding areas.
