Medicaid & Crisis Care Planning
Medicaid planning offers you the piece of mind when it comes to payment options for long-term health care. Planning protects your assets while you receive the benefits and care you need.
As life expectancies and long-term care costs continue to rise, we are challenged to devise ways to pay for these services. None other than the very wealthy can afford to pay over $80,000 annually for nursing home care. Even those who have deep resources will find their life savings wiped out when having to pay out of pocket. Fortunately, the Medicaid Program is there to help.
My family and I engaged John to assist us in a State Medicaid application issue for our mother. Our only regret is we didn’t call him sooner. John’s knowledge of the process, law and his many years of experience saved our family a significant amount of money. We highly recommend John for elder estate planning or care issues. My family and I will not hesitate to use him again.
Personal care is expensive whether at home, in assisted living or in a nursing home. We have guided seniors and their families through this process, helping them to protect their savings and to receive the benefits and care to which they are eligible. We do this through both advance planning and crises planning when necessary. John Burns Estate & Elder Care can help to protect your assets from the cost of nursing home or other long-term care expenses while providing security for your spouse and a legacy for your children.
Without question, long-term care is expensive with the average cost in Alabama and Tennessee exceeding $7,000 per month. Patients and their families are faced with the dilemma of how to pay for the care needed. Essentially, there are five ways in which to pay for long-term care in a nursing home: (i) Private Pay; (ii) Long-Term Care Insurance; (iii) Medicare, but only for a limited time; (iv) Veterans Benefits; and (v) Medicaid.
Few patients have long-term care insurance; many are uninsurable or cannot afford such insurance. Medicare pays part of the first 100 days of a nursing home stay, and unless you are a qualified veteran or spouse, VA benefits are not an option. Essentially, that leaves Private Pay and Medicaid as the only options for paying for long-term care for most patients. Practically speaking, most patients are private pay patients until they are eligible for Medicaid.
What is Medicaid?
While Medicare is an entitlement program, to be Medicaid eligible, you must become “impoverished” under the program’s guidelines. The Medicaid program is a partnership between the states and the federal government. The states administer their respective programs, but the federal government provides a portion of the funding for the state programs.
Medicaid: Assets & Penalties
Many times, clients have expressed concern that “Medicaid is going to take everything that I have” or “I don’t want to give it all to Medicaid.” The truth is that Medicaid is not particularly interested in taking anything during a person’s lifetime. Yes, there is a procedure for estate recovery after death, but what Medicaid requires is that a person spends one’s own resources for their own care until those resources have been exhausted. For this reason, it is critically important that one engage in prior planning in order to preserve as many assets as possible without having to spend them on long-term care.
Medicaid recipients are usually allowed to retain a small amount of countable assets. In the case of a married couple, the Community Spouse (the spouse not in the nursing home) is allowed to retain a greater portion of the couple’s countable assets. Fortunately, some assets are not counted, such as a home (under certain circumstances), an automobile, personal effects, burial funds, wedding and engagement rings, and medical equipment. Despite most attempts to separate assets and even prenuptial agreements, for Medicaid purposes, the assets of both the husband and wife are combined.
Medicaid is keen to investigate transfers of assets, and it can look back for up to 60 months for uncompensated transfers. This serves to prevent transfers of assets and cash prior to applying for benefits. If prohibited transfers were made during the lookback period, a penalty is imposed which is, in effect, a deferral of Medicaid benefits for a period of time. Transfers made by either the Institutionalized Spouse or the Community Spouse to third parties are penalized. Transfers between spouses and transfers to certain disabled persons are exempt from the Medicaid transfer penalty.
As with traditional estate planning, Medicaid planning raises a number of tax considerations. Creation of trusts and transfers of assets carry with them income tax, gift tax, and, possibly, federal estate tax implications. Therefore, we strive to design Medicaid plans with a tax-planning element. However, when it comes to Medicaid planning, nothing beats starting early because the failure to act may cost a significant amount of money. Starting early gives us the best possibility of protecting assets.
John Burns Estate & Elder Care Law represents clients before the Alabama Medicaid Agency and Tennessee’s Bureau of TennCare. We are familiar with the intricacies of the process, and in the event of a contested application, the firm stands ready to represent clients in an agency hearing to obtain approval for benefits. Often we are called to represent individuals after a denial of Medicaid benefits. Timing is of the essence in this situation so do not delay.