The high cost of long-term care has made planning a critically important issue for most middle class seniors and their families to investigate Medicaid payment strategies, in case a nursing home is needed. In fact, most seniors will likely require some form of long-term care. Sadly, many are unprepared for the significant financial burdens it places on their family's hard earned savings. Financial devastation looms large for a family facing ongoing catastrophic costs of care.
The Pittsburgh elder law firm of Marks Elder Law has the experience and the expertise to help you avoid the financial ruin associated with the high cost of long-term care. We plan and fight to ensure:
- That you receive the health care and other services you or your loved one may need;
- That the cost of care to you and your family can be minimized; and most important
- That you and your family can keep as much of your own money as possible.
By taking care of your general estate planning needs, (such as Wills or Powers of Attorney, admission agreements or contracts, and other legal needs), we help ensure that beneficiaries recieve what you intended, and that no assets go through probate and thus become recoverable by Mediciaid after the death of the family member.
Payment Options For Long Term Care Services
We help you understand the payment options for long term levels of care and the strategies that allow you to utilize U.S. Veterans Adminsitration's "Aid & Attendance" or Medicaid benefits to pay for your needed care while sheltering your assets legally.
- U.S. Veterans Administration “Aid and Attendance” cash benefits can be available for a qualifying veteran or for the widow of a qualifying veteran, in any setting. If you are disabled and your cash costs of care exceed your monthly income, you may be eligible to receive an amount of up to just over $2,000 monthly for a veteran and up to just over $1,000 per month for the widow of a veteran.
- Medicaid is a needs-based, means-tested joint Federal and state program that pays for your nursing level care when you are unable to pay for the care from your own funds. Medicaid most often pays for nursing care in a nursing home, but can also pay for care in a patient’s private home.
Rules determining deterining eligibility are quite complex:
- You must do substantial planning and financial rearrangement of your assets to qualify, and
- You will endure bureaucracy, paperwork and annoyance to apply and be approved, and
- You must plan ahead to protect assets from Medicaid’s “Estate Recovery” program after your death.
At Marks Elder Law, we help organize your finances and assist through the application process, if needed.
The most basic strategy to protect resources at the time of the Medicaid application is to convert “available resources” such as bank deposits or other assets into “protected assets.”
- Probably the most common example is to pay money into a prepaid funeral or irrevocable burial trust account. The funeral account must be irrevocable, so that you can’t get the money back during your lifetime (or else the money would still be an available resource).
- You can buy a new car, or upgrade an old car.
- You can do needed repairs to the home, or pay off an existing home equity loan or mortgage against the home.
- You can prepay expenses that would otherwise become due soon thereafter, such as for insurance, taxes, utilities, etc.
Beyond these basic tactics, there are many more sophisticated plans and techniques that may help you protect your assets, such as:
- Gift and Annuity Strategy: You can typically protect about one half of your assets but still be eligible to get Medicaid for nursing care by making a gift of one-half your assets then buying a Medicaid-Qualified Immediate Annuity with your remaining assets before applying to Medicaid. A Medicaid-qualified immediate annuity works by converting part of your assets into income that you can use to pay for your cost of care until you become Medicaid eligible. This strategy is often particularly helpful for a single, unmarried person.
- Asset Protection Trust: You create a trust now and put part of your assets (e.g., real estate, stocks, etc.) into the trust so that you no longer own these assets directly and individually. This strategy is helpful for single and married couples who are not currently Medicaid-eligible.
- Medicaid-Qualified Spousal Annuity: For married couples only, this strategy works by converting your excess assets seen as belonging to the ill, institutional spouse, into monthly income belonging to the community spouse instead through the purchase of a Medicaid-Qualified Immediate Annuity.
- Personal Care Agreements: A personal services agreement is a contract between the Medicaid applicant and a designated caregiver for services that are not provided by the skilled nursing home or assisted living facility. As payment for services is made to the caregiver in a lump sum payment up front, and Medicaid would not treat that transfer as a gift nor include the transfer in calculating total assets.
- Exempt Transfers: Transferring assets to certain recipients will not trigger a period of Medicaid ineligibility. These exempt recipients include: a spouse, a blind or disabled child, a trust for the benefit of a blind or disabled child, etc. There are also special rules for the transfer of a house.
- Purchase For Value or Life Estate: You deed the home to your children but reserve a “life estate” (the ability to live in and control the property during the your lifetime ) for yourself. Upon your death the property will pass to the children outside of probate and (in Pennsylvania) free from government Medicaid estate recovery claims.
Call today to meet with an elder law attorney in Pittsburgh, with offices in Monroeville. Contact Marks Elder Law today to start the planning process.
We will gladly review your planning for long term care
to ensure it is up-to-date.