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Medicaid Crisis and Long-term Care Planning

 

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Medicaid is a federal program administered by the State and paid for jointly by the federal government and the State. In addition to providing health insurance to low-income individuals and families, Medicaid also covers a portion of the cost of long-term care for those who require it. Long-term care refers to a range of services and support that people may need as they age or if they have a chronic illness or disability that makes it difficult for them to care for themselves.

 Long-term care services can include assistance with activities of daily living (ADLs) such as bathing, dressing, and eating, as well as instrumental activities of daily living (IADLs) such as managing medications, handling finances, and household chores. Long-term care may also include medical care, such as nursing care, physical therapy, and occupational therapy.

Medicaid covers long-term care services for eligible individuals, including nursing home care, home health care, and community-based services. To be eligible for Medicaid long-term care benefits, individuals must meet certain income and asset requirements, as well as have a medical need for long-term care services. Each state sets certain rules, including income and asset limits, for Medicaid recipients and their spouses, if applicable. For people over the asset limit, they may have to “spend down” their assets on long-term care and may also be able to spend down by making allowable purchases. Certain assets are exempt from counting toward the asset limit.

 

 

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To qualify for Medicaid long-term care benefits must have limited assets, such as cash, investments, and property. Some assets, such as a primary residence, may be exempt from consideration when determining eligibility. In calculating the total assets owned by a Medicaid applicant (and spouse, if applicable), the State will also look at any transfers made “without value” in the five years prior to applying for Medicaid, called the look-back period. While the State is not looking at reasonable purchases for gifts at holidays and birthdays, the State is interested in larger gifts of cash a property. Assets given away in the look-back period may disqualify an applicant from benefits for a period equal to the amount given away.

Once an individual is determined to be eligible for Medicaid long-term care benefits, they can receive care in a nursing home, in their own home, or in a community-based setting. Nursing home care is typically the most expensive form of long-term care, and Medicaid covers the cost of nursing home care for eligible individuals who require it.

In some cases, individuals may be able to receive long-term care services in their own homes, such as home health care or personal care services. Medicaid may cover the cost of these services if they are medically necessary and if they are provided by a Medicaid-certified home health agency or personal care provider.

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It is important to note that not all long-term care services are covered by Medicaid, and the services that are covered may vary by state. Some states may offer additional long-term care services, such as respite care or home modification services, while others may have more limited coverage.

 

In addition to income and asset requirements, Medicaid long-term care benefits are also subject to certain medical requirements. Individuals must have a medical need for long-term care services, and this need must be documented by a healthcare provider. In general, Medicaid will only cover long-term care services that are considered medically necessary.

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If you are faced with the possibility of long-term care for a spouse or loved one, engage the services of an experienced estate and elder law attorney to shepherd you through the process. Remember, though, that early planning is ideal. Implementing asset protection strategies before there is ever a need is the best route.

 

We can help you with advanced estate planning strategies including asset protection as well as Medicaid crisis planning to assist those families facing long-term care. Our consultations are always at no charge so please call on us today at (913) 592.2029.

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