Change is life’s only constant. Sometimes these changes strike without warning. If you or a loved one has experienced a sudden illness or serious accident, you understand how abruptly everything can change. Are you or a loved one suddenly in need of nursing home care? Finding and affording quality care on short notice can be stressful and draining. We can help you determine the best options for care and, if necessary, how to qualify for Medicaid to help finance them.
Long-term care is expensive, and these costs only continue to increase as baby boomers age. Although the range varies depending on where you live, according to the Genworth Cost of Care Study for 2017 , the national median annual cost of a private nursing home room is $97,452 with a 4% annual increase projected. With improved medical care, the average life span of adults also is increasing; this translates into more years of care at increasingly higher rates. Without some sort of financial assistance, these costs could be financially devastating. In fact, your entire life savings could be quickly depleted within a few years of needing long-term care. This is where Medicaid can help.
Medicaid is a joint federal and state program to assist those with low income and limited resources. While Medicare provides very limited long-term care coverage, Medicaid is much more extensive. However, because of its financial restrictions, qualifying for Medicaid can be extremely difficult. But paying for a nursing home without it could be all but impossible.
Although Medicaid requirements vary from state to state, they all share one common element: complexity. Each state specifies a maximum allowed income for individuals and couples in order to qualify for Medicaid. Also, the applicant’s total assets cannot exceed a specified amount called the Individual Resource Allowance, which is consistently very low, currently $2,000*. Although certain possessions, like your home and automobile, are “exempted” for purposes of determining Medicaid eligibility, this figure is still alarming. If the applicant is married, the process becomes more complicated. To qualify for Medicaid in any state, the applicant’s spouse can keep somewhere between $55,547 and $123,600 (WA) depending on placement and level of skilled care.
What can you do if the value of your “non-exempt” assets exceeds the $123,600* Maximum Community Spouse Resource Allowance? FIRST RULE – never give away or sell assets at less than fair market value before consulting and Elder Law Attorney. If you give your extra assets away, which seems like an obvious choice, you will encounter greater problems. Violating this “Transfer Penalty Rule” could disqualify you from receiving Medicaid for months or years, depending on how much you gave away. Planning strategies can be employed to preserve assets or spend down assets in a legally sanctioned manner.
This is only a brief oversimplified review of a few Medicaid rules, of which there are myriad more. Navigating them on your own could be a nightmare at best and subject you to penalties at worst. Fortunately, though, our experienced Elder Law Attorneys can guide you through the Medicaid maze. We can advise you throughout the application process, ensuring that you retain the maximum income and total assets allowed by law.
Seek appropriate legal counsel before you apply for and seek to qualify for Medicaid. We can give you and your family peace of mind during a difficult and uncertain time. When dealing with Medicaid, legal advice is something you cannot afford to go without.
* Since these amounts (e.g., the “Community Spouse Resource Allowance,” etc.) are adjusted at least annually, these numbers may vary slightly depending on when the most recent figures are released.
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