The Medicaid program is the largest single source of payment for nursing home costs in the United States. It can pay for most of the cost of nursing home care for people who qualify. And the financial assistance provided by Medicaid can even keep you out of the nursing home by paying for the care and support you need to remain at home.
Studies show that most Americans will need at least some long term care support as they age. Long term care refers to the kinds of ongoing assistance that is needed by someone who has a prolonged physical illness, disability or cognitive impairment. Long term care is expensive. Many older adults are not able to afford to pay for the care they require to meet their needs. This is where Medicaid comes in.
Medicaid is not Medicare.
If you are concerned with how to pay for long term care, it’s important that you distinguish between Medicaid and Medicare. Medicaid provides much broader coverage for long term care than Medicare.
Medicare only pays if you need skilled care. But most people with long term care needs require only custodial care not skilled care. (Custodial care helps you with usual daily activities like getting in and out of bed, eating, bathing, dressing, and using the bathroom. It may also include care that most people do themselves, like using eye drops, oxygen, and taking care of colostomy or bladder catheters.)
Unlike Medicare, Medicaid can help pay for custodial care even if you do not need also need skilled care. However, Medicaid long term care benefits do involve some confusing qualification rules.
To qualify for Medicaid long term care benefits you must be classified as needing the level of care provided by a nursing facility. But you can meet this requirement even if you continue to reside at home. An assessment is completed to confirm that you require this level of care. And you must also qualify financially.
Medicaid’s financial rules are complicated and include a requirement that neither the applicant nor his or her spouse has made a disqualifying transfer of assets within the prior five years. An elder law attorney can show you how to meet the Medicaid qualification requirements more quickly, before long term care costs wipe out your family’s financial security.
Why Plan for Medicaid?
Planning for the cost of long term care whether provided in the home, a nursing home, or another residential care facility, is a crucial element of estate and financial planning for all but the wealthiest seniors.
As life expectancy and long term care costs continue to rise, the challenge is how pay for the services we will likely need someday. Few people can afford to pay the high cost each month for long term care whether in a nursing facility or at home. Life savings are rapidly depleted.
Fortunately, the Medicaid program is there to help. Unfortunately, because Medicaid is limited to those who can demonstrate financial need, applicants must meet the program’s financial eligibility requirements.
Planning can help ensure that Medicaid benefits will be optimized and your losses minimized. The Medicaid rules are constantly changing. Expert help from an elder law attorney is needed by those seeking to preserve some financial security and dignity for themselves and their families. The sooner you plan, the more options are available.
But even after you need long term care, an elder law attorney can help you determine how to get the best care in the most appropriate setting without going broke. If you are a Pennsylvania resident who is in need of long term care, or if you want to plan in advance, you can get help from one of the experienced elder law attorneys at Marshall, Parker and Weber (www.paelderlaw.com).