Nursing Home Costs (Medicaid) 

Clients often believe that Probate costs are their biggest concern yet taxes are a bigger problem and nursing home costs could be the biggest problem of all. Potentially every dollar you have except for $2,000 (which an individual is permitted to keep in 2018) may be lost to nursing home expenses.

First you should understand the difference between Medicaid and Medicare. Medicaid is a government program to fund skilled nursing care for those who do not have the funds to pay for themselves. Medicare is the government health care benefits plan for people over the age of 65 and/or in certain special situations. In the Medicaid area we work with clients who are worried about losing their life savings to the high cost of skilled nursing home care. We help potential Medicaid applicants and their families protect as many assets as the law will allow and alleviate anxiety associated with the transition from their home to a skilled nursing facility.  The cost of long-term skilled nursing care presents a significant threat to the estate preservation for many of our clients and their families.

The most common reason we hear from people about why they did not plan for Medicaid is that they simply thought nothing could be done. But this answer is not correct. We often work with clients for years planning for Medicaid eligibility and the Medicaid application itself. We will not suggest anything contrary to the law but understanding how the law operates can help you make better choices.  Before applying for Medicaid you must “spend down” to a certain level before you will be accepted on Medicaid but there are better and worse ways to do that. 

The term "spend down" does not equate to being penniless particularly for a married couple. There are asset exemptions and other planning techniques that can be used to maximize what is retained by the family. Case Workers, while often helpful, are not always concerned with how much money you can preserve for your family. Their job is not to protect your family's assets by providing you advice, but to process paperwork and get your loved one qualified. How you become qualified for Medicaid can be the difference between being penniless and preserving some portion of the institutionalized person's lifetime accumulation of assets. 

The lack of understanding in this area often leads to ill-fated results. For example, one client had spent the majority of her and her husband’s assets prior to seeing us. She only came to see us to determine how she would live once her husband was put on Medicaid when they had no money. In addition to her house with equity less than $572,000 and her car she would have been entitled to keep nearly 124,000 of assets had she come in three or four years earlier when her husband first had his stroke. Unfortunately, because of her delay in seeing us she exhausted a good deal of money unnecessarily. There is a lot of misinformation floating around regarding Medicaid and you should make an appointment to see one of our attorneys if you believe Medicaid may be on the horizon. The impulse to give everything to the children, relative or friend is usually NOT the best answer and can make things worse if that person will be going into a nursing home within a short period of time.  Even if you see no reason to anticipate the need for nursing care now you would still benefit from understanding the law in advance in case the need ever develops. What you learn may benefit not only yourself but your parents and other relatives. 

Our firm assists seniors and their families plot a course through this tricky area of law. We have the expertise and experience in this area to provide you and your family with a comprehensive evaluation of your needs, to devise a plan of action and to provide all the support necessary to execute the plan.