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MEDICAID PLANNING FOR LONG-TERM CARE COSTS

Let’s face it, long-term care is extremely expensive. If you are facing financial stress or are being faced with the prospect of liquidating assets to pay for long-term care for yourself or a loved one, you need assistance from a Medicaid planning expert or an elder law attorney.

 

The Medicaid planning experts and elder law attorneys with our firm have been very successful in protecting assets and obtaining financial assistance from government programs, such as Medicaid, to pay for long-term care.  You and your family have been paying into these programs for years.  With our proven strategies, we can help you obtain the benefits you or your loved one qualifies for and deserves. 

Before things get out of control and before you and your family are stressed out financially, call the Medicaid Planning and Elder Law attorneys with The Law Offices of Benjamin T. Vader, PLLC, at 586-268-4463 and start planning today.

TYPICAL OPTIONS TO PAY FOR LONG-TERM CARE COSTS

Out of Pocket

You can use your own resources to pay for long-term care costs.  Assisted living facilities costs typically range from $2,500-$10,000 per month.  Skilled nursing facilities can cost anywhere from $8,000-14,000 per month.

Medicare

Medicare MAY pay for up to 20-100 days of nursing home care after a qualifying 3-day hospital stay.  Typically, Medicare does not cover any assisted living care and does not cover skilled nursing care for more than 100 consecutive days.

Long Term Care Insurance

This is private insurance which can pay for long-term care costs.  The types of insurance and coverages provided vary greatly based on the terms of the policy.  Some policies may not cover in-home care or assisted living, premiums can be very expensive, and this type of insurance must be purchased before long-term care is required.     

Medicaid

Medicaid is a joint State and Federal program which can help pay for certain health services for qualifying individuals.  If you qualify, you may be able to get financial assistance to pay for medical expenses such as nursing home care and, in limited situations, assisted living costs.

Veteran’s Benefits

The Department of Veteran’s Affairs has an Improved Pension Benefit available to qualifying veterans who served during a time of war and are now housebound or need the aid and attendance of another with activities of daily living.  This Benefit is also available to the surviving spouse of qualifying deceased veterans.  Our elder law attorneys are VA accredited and can assist with planning and applying for this Benefit.

MEDICAID ELIGIBILITY – WELCOME TO THE MEDICAID MAZE

Medicaid is a program is designed for “needy” individuals.  Eligibility is determined by the Michigan Department of Health and Human Resources.  The eligibility criteria are numerous and complex and even simple errors can result in ineligibility.  Some of these eligibility requirements can include:

  • Applicant must be over 65 or disabled.

 

  • Countable assets must be below threshold.  The countable asset threshold varies based on if applicant is single or married and cannot be exceeded.  Assets of spouse are included in determining eligibility.

 

  • Countable income must be below threshold.  Monthly income of applicant must not exceed eligible monthly medical expenses.

 

  • Medical eligibility requirements.  The Michigan Medicaid Nursing Facility Level of Care Determination is Michigan’s assessment test used to determine if the applicant meets the nursing home level of care and qualifies for Medicaid.   

WHAT IS MEDICAID PLANNING?

A general definition of Medicaid planning is any assistance provided to a potential Medicaid applicant in advance of, and in preparation for their Medicaid application.  Medicaid planning can be as simple as assistance with the collection and preparation of documents or as complicated as a complete restructuring of financial assets or seeking asset or income protection through the probate court.

WHY ENGAGE IN MEDICAID PLANNING?

  • Long term care is very expensive and families want to ensure their loved one receives the care they require which they could not otherwise afford.

  • To ensure that the healthy spouse, who lives at home, will have the financial resources to continue doing so.

  • To preserve a family’s limited assets to ensure the next generation can live in a home or afford an education.

  • Medicaid eligibility is extremely complicated, and even simple errors can result in a denial which can be devastating emotionally and financially to those impacted.

  • The application process is time-consuming.  Working with a Medicaid planning attorney can accelerate the process and substantially increase the likelihood of a favorable outcome.

ADVANCE PLANNING STRATEGIES

There are numerous ways an elder law attorney can assist to plan to protect assets for a situation where Medicaid benefits are not needed now, but may be needed in the future to help cover the costs of long-term care.  Examples of some strategies an elder law attorney may recommend in advance are:

  • Create an Estate Plan – Durable Power of Attorney (Single or Married).  If you become incapacitated, the person in charge of your affairs will need comprehensive legal authority to act on your behalf to protect assets and apply for benefits.

  • Avoid Probate on Death (Single or Married).  In 2007, Michigan passed the Estate Recovery Act which allows the State of Michigan to recoup long term care benefits paid from the recipient’s probate estate on death.  Avoiding probate can avoid recovery.

  • Ladybird Deed – Primary Residence (Single or Married).  A ladybird deed allows the property owner to retain ownership of their primary residence for life and designate a beneficiary on death thereby avoiding probate.  This excludes the property as a countable asset when applying for Medicaid, and avoids probate and Estate Recovery upon death.

  • Transfer Primary Residence into Trust (Married Only).  This strategy can be beneficial for married couples with less than $250,000 in non-primary residence assets because it can increase the amount of assets they can keep when applying. 

  • Testamentary Trust for Spouse (Married Only).  A married couple can create a trust under their will for the benefit of their surviving spouse known as a Testamentary Trust for Spouse.  If properly drafted, the assets in this type of trust are not counted against the surviving spouse when applying for Medicaid.

  • Irrevocable Income Only Trust – Dynasty Trust (Single or Married).  This type of trust is typically used to transfer assets to beneficiaries upon death while reserving the right to receive income during life.  If properly designed, the trust principal will not be counted as an asset, but there will likely be a transfer penalty if the transfer occurs during the five-year lookback period before applying for Medicaid.

CRISIS PLANNING STRATEGIES

There are many strategies an elder law attorney may recommend to obtain Medicaid eligibility even if the applicant is already in the nursing home.  Examples of the strategies an elder law attorney may recommend in a crisis situation are:

  • Spend Down Excess Assets (Married or Single).  This may include paying for qualifying items or services which the applicant will benefit from later such as paying off credit card or mortgage debt, making funeral arrangements, repairing the home or paying for legal services to assist in the Medicaid application process.

  • Convert Countable Assets to Exempt Assets (Married or Single).  This strategy may include using excess countable assets to purchase an exempt asset such as purchasing an exempt qualifying annuity or promissory note.

  • Petition the Probate Court (Married or Single).  This type of strategy can involve petitioning the Probate Court to enter an order for the protection of the applicant or the applicant’s dependents.  This strategy can be used to protect income and assets.

  • Half-a-loaf (Single Only).   This involves making a gift of approximately half of the applicant’s assets and converting the other half to an income stream to pay for care during the resulting penalty period.  This typically allows the applicant’s family to protect half or more of the applicant’s assets.

  • Ladybird Deed (Single or Married).  A ladybird deed allows the property owner to retain ownership of their primary residence for life and designate a beneficiary on death thereby avoiding probate.  This exempts the property when applying and avoids Estate Recovery.

COMMON MISTAKES

Many people make mistakes which can have financially devastating consequences.  Common mistakes we see as elder law attorneys are:

  • NOT HAVING A PLAN - NOT TAKING ACTION.  It is never too soon to take action and have a plan in place if nursing level care is required.  As long as the person is alive, it is not too late to engage in Medicaid planning. 

  • HAVING AN INSUFFICIENT POWER OF ATTORNEY.  If the applicant needs assistance in managing their financial affairs, it is important that they have a power of attorney which expressly allows their Agent to engage in Medicaid planning and apply for benefits.

  • GIVING AWAY ASSETS - DIVESTMENTS.  Even if the applicant meets the eligibility criteria, he/she may be penalized for any activity the Medicaid program determines is a “divestment.”  This typically involves any transfer of the applicant’s assets within 60 months of application but can include things such as adding another owner, such as a child, to an account or parcel of real estate.

  • RELYING ON THE NURSING HOME OR GOVERNMENT TO TELL YOU WHAT TO DO. The nursing home and government cannot and will not give you Medicaid planning advice.  It is not in the government’s interest to tell you how to qualify.

  • NOT CONSULTING AN ELDER LAW ATTORNEY.  This is a complex area of the law.  Most people have no idea that there are strategies that can be used to protect assets and obtain eligibility sooner rather than later.  Consulting with an elder law attorney who specializes in this type of planning can save time and money and reduce stress.

CONTACT US TODAY TO ATTEND ONE OF OUR FREE SEMINARS TO LEARN MORE!