How to Plan for Your Senior Loved Ones After a Crisis Event

By Allyson Fion | September 2, 2021

As our loved ones age at home, there’s one call we all dread getting: our loved one has had an accident and needs to go to the hospital. Very often, this accident is a fall, and that fall often requires surgery. So what happens next? How do you plan for senior loved ones after a crisis event?

Typically, after a hospital stay for an accident, your loved one will need continued care at a rehabilitation center upon being discharged from the hospital. If your loved one requires more intensive, in-patient care, this will most likely occur at a skilled nursing facility. 

What does this mean for you and your loved one in-terms of cost? In some situations, your loved one’s rehab may be paid for by Medicare. Some approved skilled nursing facilities will be covered by Medicare, as long as your loved one has entered the facility within thirty days of their hospital stay. However, that hospital stay will need to have lasted three days and have been considered an “admitted” stay versus “observation.” 

If your loved one’s rehabilitation care is covered by Medicare, Medicare Part A will cover the first twenty days of your loved one’s stay. After that, if Medicare approves continued rehabilitation services, you will have to pay the coinsurance of $185.50 per day for days twenty-one through one-hundred. After one-hundred days, Medicare does not cover the stay, and your loved one would have to pay out of pocket. 

If your loved one needs care beyond one-hundred days, and if their accident has caused them to need long term care sooner than expected, you are now faced with the unexpected challenge of how to afford this extended rehabilitation care and long term care beyond that. 

This is why many people must utilize federal programs, such as Medicaid. However, in order to take advantage of Medicaid, you have to meet strict eligibility requirements. If you haven’t done any advanced planning, this can be tricky, but not impossible. This is where crisis planning comes in handy. 

Often, if you have not done any advanced planning, your loved ones will have too many assets to qualify for Medicaid. Your family is now in a crisis and needs to protect what assets you can, and spend down other assets quickly and legally. You may also be looking at potential Medicaid gift transfer penalties if your loved one has gifted money to friends or family in the last five years. 

Upon submission of your Medicaid application, the last five years of your bank statements will be scrutinized for these transfer penalties and for other transactions that are a red flag for Medicaid qualification. This review by Medicaid is one of the most complex and rigorous steps of the application process and causes many families to have their applications rejected. You will also want a plan for how to protect the assets you are able to keep, once your loved one is on Medicaid. 

When your family is already in crisis, and worrying about your loved one’s care, the nitty-gritty ins and outs of Medicaid eligibility is the last thing you will want to be dealing with. Luckily, there are elder care experts who can assist you with this crisis planning. At Parker Eldercare, we have a swift and thorough process for our clients in crisis to ensure that your loved one is able to get the care that they need. And if you are reading this ahead of a crisis event, now is the time to begin advanced planning, so that you and your loved ones can rest as easy as possible when the time comes for long term care.