Elder law is another aspect of estate planning, focusing primarily on the needs of families and individuals as they age. Issues of aging include senior housing and home care, long-term (or nursing home) care, guardianships and health care documents, and Medicare, long term health care pre-planning. The Florida Department of Elder Affairs provides a wealth of information for seniors and care givers.
As our population ages, more and more of us confront elder law-related issues, whether for ourselves or our parents. One of the most pressing issues is long-term nursing home care, which typically is not covered by traditional health insurance. Depending on where you live and the level of care needed, nursing home care can cost from $35,000 to $150,000 a year. The average stay is slightly more than three years. Most people end up paying for nursing home care until their personal (or family) assets are depleted, then they may qualify for Medicaid to pick up the cost.
Careful planning, however, can help protect your assets, whether for your own additional needs, your spouse or for your children. The belt-and-suspenders approach is to purchase long-term care insurance while you are healthy enough to qualify, and to make sure you receive the benefits to which you are entitled under Medicare and Medicaid. Veterans (and their single surviving spouses) also may seek benefits from the Veterans Administration.
Clients are frequently confused over the differences between Medicare and Medicaid. Though their names are very similar, the programs are quite different. Medicare is an entitlement program, a federal health insurance program in which most people enroll when they turn 65 years old. There are no financial qualification rules. Medicare has two primary parts: Part A and Part B.
Medicare Part A covers in-hospital care, extended care after a hospital stay, some home health care services, and hospice services. The rules for nursing home coverage are very strict and, in fact, Medicare pays for less than 9 percent of nursing home care in this country.
Medicaid is a joint federal-state program. Subject to certain federal requirements, each state implements its own regulations on how the program is managed. Medicaid is not an entitlement program like Medicare, but rather a needs-based program. Medicaid eligibility is determined after the proper application is submitted to the state, in Florida, the Department of Children and Families.
Linda believes that an estate planning process that ignores the issues of Medicaid eligibility and qualification is at best, incomplete. The estate plan process at Linda Solash-Reed, P.L. includes discussion of legal techniques and strategies to protect your assets so that if and when the time comes that you require nursing home care, you will be eligible to receive Medicaid benefits if needed. Medicaid planning can also be done even if you or loved one is already in or is about to enter a skilled nursing facility. However, the earlier you begin your planning, the more options you will have to protect your assets and your loved ones and to gain the security that comes from knowing your are prepared to weather the storm of long-term care.
If you are married, and you or your spouse needs to go into a nursing home, your home is exempt and cannot be counted as a resource when applying for Medicaid. If you are single or widowed and you go into a nursing home, your house may be exempt if you follow certain procedures. But planning is the key to preserving your home.
Giving your assets away means losing control. Even if you trust the person to whom you give your assets, that person may get divorced, go bankrupt or be sued, thereby placing your assets at risk. Since major changes to the Medicaid laws in 2006, "gifting" away your assets can result in ineligibility for years. Far from protecting yourself, you will be undermining your own security and ability to finance your long-term care should you need it.
Assets in a Revocable Living Trust are not protected and must be used to pay for the costs of long-term care. There are other trusts that may permit you to keep control of your assets.
Applying for Medicaid too early can result in being disqualified longer than necessary, while applying too late can mean having to privately pay for additional months of costly skilled nursing home care. Rule of thumb: Do not apply for Medicaid without a plan to ensure you qualify.
A nursing home or hospital that offers to file a Medicaid application for you has no obligation and often can't advise you on how to protect your assets. Only a qualified Medicaid planning attorney will be looking out for your interests. Since Medicaid planning is a complex matter, be sure to retain an attorney who has experience in Medicaid planning and qualification.
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