Take the Stress out of Long Term Care Planning

Many people are unaware that Medicare will only pay for a nursing home for up to 100 days.  Medicare will pay the total cost of care for the first 20 days, and then requires the family to pay a hefty co-pay of almost $200 a day for the remaining days.  Unfortunately, Medicare often stops paying on day 20, claiming that the patient’s condition is not improving.  Therefore those in need of long term care will likely have to depend on Medicaid at some point.

The confusing Medicaid process can lead people to submit their loved one’s application with unknown errors, which risks delay. And because of strict deadlines, this delay can cause the denial of an application.  In addition, Medicaid reviews 5 years of all financial statements, and many people underestimate the amount of time it takes to gather and review these documents.  Most people don’t have the experience to know what Medicaid looks for and what transactions will cause problems or require additional documentation.  We catch potential problems and “cure” them up front, which saves time when working against a deadline, and prevents a denial when we are able to correct something before Medicaid can sanction it.

Medicaid is need based, so the elder can only have $2,000 in “countable” assets in order to qualify.  Often when you talk to a Medicaid office or the nursing home where your loved one is placed, they will tell you that you have to spend down all of your loved one’s assets, except for their home.  But that is just not the case.  Senior Life Planning works hand in hand with our legal colleagues to take advantage of various exemptions to help you purchase, retain or re-characterize certain assets, while still qualifying for Medicaid.

Assisted Living and Skilled Care Medicaid programs have a 3 and 5 year “look back period.” Assets gifted (transferred) to any third party will either make you ineligible for Medicaid or cause a transfer penalty where you must private-pay a facility for a period of time. There are complicated formulas and processes to “cure” the gifts, and there are loopholes and exemptions that the average person, and often the Medicaid caseworkers themselves, do not know about.  Some clients consult with the Medicaid office before coming to us, and we caution you to not accept Medicaid’s determination of potential gift transfers, as the case workers often DO get it wrong.

We have the knowledge and experience to efficiently and compassionately handle every part of the Medicaid application process.  We tackle the critical task of reviewing 5 years of financial statements and know how to “cure” gifts and recommend the best options for “spending down.” We advocate for you with the case worker, keep track of deadlines and provide policy and case law if the caseworker is unsure of the laws themselves. We stay by your side from our initial consultation until the day you receive your benefits decision from Medicaid.