Medicaid Planning & Asset Protection
One of the greatest fears of older Americans is that they may end up in a nursing home. Many do: In fact, nearly one in two women and one in four men find themselves in nursing homes at some point in their lives. This not only means a great loss of personal autonomy, but also a tremendous financial burden. Depending on location and level of care, nursing homes cost in excess of $170,000 a year.
Most people end up paying for nursing home care out of their savings until they run out of money. Then they can qualify for Medicaid benefits to pick up the cost going forward. The advantages of paying privately are that you are more likely to gain entrance to a better quality facility and doing so eliminates or postpones dealing with the bureaucracy of the New York government—an often demeaning and time-consuming process. The disadvantage is that it’s very expensive.
Despite what you may have heard, Federal and state law allow you to plan and protect assets.
At Dutcher and Zatkowsky – RochesterElderLaw.com, we can help you prepare for the possibility of eventual nursing home care in advance, or in response to an unanticipated “crisis” situation—and protect your assets for your spouse and children. This can be done by purchasing long-term care insurance (if you qualify) or by making sure you receive the benefits to which you are entitled under the government’s Medicare and Medicaid programs. In addition, if you or your spouse is a Veteran, we may also be able to help you receive benefits from the Veterans Administration. Increased benefits, from whatever the source, allow you to apply your life savings to other priorities than covering the high cost of nursing home care.
How does Medicare differ from Medicaid?
Medicare Part A covers up to 100 days of “skilled nursing” care per illness. However, the definition of “skilled nursing” and the other conditions for obtaining this coverage are quite stringent, meaning that few nursing home residents receive the full 100 days of coverage. As a result, Medicare pays for only about 9 percent of nursing home care in the United States.
What is Medicaid?
For all practical purposes, in the United States the only “insurance” plan for long-term institutional care is Medicaid. Lacking access to alternatives such as paying privately or being covered by a long-term care insurance policy, most people pay out of their own pockets for long-term care until they become eligible for Medicaid. Although their names are confusingly alike, Medicaid and Medicare are quite different programs. For one thing, all Americans are entitled to health insurance coverage upon turning age 65. That is called Medicare. Medicare is an “entitlement” program which became Federal law on July 30, 1965 when President Lyndon B. Johnson signed the new program into law.
Medicaid, on the other hand, is a form of public assistance — or at least that’s how it began. So to be eligible for Medicaid, you must become “impoverished” under the program’s guidelines.
Also, unlike Medicare, which is totally federal, Medicaid is a joint federal-state program. Each state operates its own Medicaid system, but this system must conform to federal guidelines in order for the state to receive federal money. The federal government pays states for a specified percentage of program expenditures, called the Federal Medical Assistance Percentage (FMAP). FMAP varies by state based on criteria such as per capita income.
This complicates matters, since the Medicaid eligibility rules are somewhat different from state to state, and they keep changing. (The states also sometimes have their own names for the program, such as “MediCal” in California and “MassHealth” in Massachusetts.) Both the federal government and most state governments seem to be continually tinkering with the eligibility requirements and restrictions. The rules for eligibility to the program in New York are comlex but can be explained in simple terms by our experienced attorneys. The only way to be certain of your rights, you must consult an expert. Be careful of listening to those with a self -interest or others without the expertise. Contact Dutcher & Zatkowsky for a consultation. It could mean the difference between protecting your life savings or not.
Planning ahead is always better than being forced to make a significant decision in a short period of time. Planning ahead means broader options while waiting for a crisis means limiting your alternatives.
Those who are not in immediate need of long-term care may have the luxury of distributing or protecting their assets in advance. This way, when they do need long-term care, they will quickly qualify for Medicaid benefits. Giving general rules for so-called “Medicaid Planning” or “Asset Protection” is difficult because every client’s case is different. Some have more savings or income than others. Some are married, others are single. Some have family support, others do not. Some own their own homes, some rent. We can help no matter your particular situation.
Please contact us for a private consultation as soon as possible to find how you can personally benefit from Medicaid planning.