If you are fortunate enough to have sufficient monthly income to privately pay for nursing home care, you do not need Medicaid. Everyone else must find an insurance product that will give them the extra money to pay for their care or must plan for Medicaid eligibility. If you can afford the right Annuity or Long Term Care Insurance or some combination product, your problem might be solved. Otherwise you must make some tough choices.
Nursing Homes are licensed as skilled care facilities or intermediate care facilities or both. Assisted Living Homes are licensed for domiciliary (custodial) care.
Your Medical doctor initially determines the level of care you need. Your doctors opinion is then reviewed by EDS who determines the level of care required. One must remember that your level of care can change upon reevaluation.
If you need Skilled Care or Intermediate Care, you can plan for Adult Medicaid. That program allows many to plan with a knowledgeable attorney to provide for your needs and protect your loved ones. If you need Custodial Care, Adult Medicaid is NOT available. The program that provides for assisted living is called Special Assistance. This program gives you very limited options for planning. If your gross monthly income exceeds $1157, you are NOT eligible for special assistance.
When you are well and healthy and planning for the future or when you need longterm care now, you must make a difficult planning decision.
Option 1 is to give all your assets away knowing that you are creating a period of ineligibility. During that penalty period, it will not matter if you are out of money and destitute, there is no long term care assistance available for you. Also giving all your property away creates it own set of legal issues and problems. In our planning we try very hard to create no period of ineligibility, but that takes time.
Option 2 uses the rules under Adult Medicaid to plan for eligibility. Most clients choose to plan for Adult Medicaid, but they do so knowing that it is unlikely that they will ever be eligible for benefits under the Special Assistance Program. In other words, they must privately pay for care as long as they are in an assisted living facility. If they are elevated to Intermediate Care or Skilled Care Nursing later, they are eligible then for Adult Medicaid.
© 2005, Legacy Lawyers.
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bill.alexander@legacylawyersnc.com
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