​Long-term care, whether provided in a private home, a nursing home, an assisted living facility or a continuing care retirement community, is expensive. According to the 2020 Genworth Cost of Care Survey, the median national rate for a private room in a nursing home is over $100,000 a year.
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Many family caregivers and seniors assume these costs will be taken care of by Medicaid, the jointly funded federal and state program that provides health insurance for people with low income and limited assets. When it comes to long-term care, this public assistance program does pay for the largest share of these services, but only if a senior meets strict financial and functional requirements. Medicaid is administered by each state, so keep in mind that criteria can vary considerably from one state to another.

Every day I hear stories or talk to folks who were doing just fine, thinking they had a firm plan in place for their future, until someone (typically a spouse or a parent) gets sick. As the illness continues, now faced with long-term care expenses, they realize their ‘plan’ did not include nearly enough to keep up with the ever-increasing health care costs.
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“How will we pay for this?” Is the number one question I hear regarding long-term care. Long-term care costs have two components, the nursing home, assisted living, or living situation, and the indirect component, the unpaid caregiving. The people who come in to help you, your family members, or the things that long-term care insurance doesn't cover. Did you know over $500 billion a year is spent in ‘unpaid’ caregiving in this country? And these costs get higher every year.

What if you want to set up a trust for Medicaid planning purposes but want to protect income from going to the nursing facility if you need long term care?
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Usually the purpose of an income-only trust in Medicaid planning is to protect the property in the trust either from having to be spent down to qualify for Medicaid in the first place or from the state’s estate recovery claim after the death of the Medicaid beneficiary. The trust can also be drafted so that the income is not distributed at all or distributed to people other than the grantor, such as the grantor’s children. While that would prevent the income from having to be paid to a nursing home, it would also mean that the grantor would not receive the income before moving into a nursing home. Do you want to forego the income while you’re healthy in order to protect it in case you need Medicaid coverage in the future, or do you want to receive it while you’re healthy with the chance of having to contribute it to your cost of care should you require Medicaid coverage in the future? 

Impact of COVID-19 Stimulus Check on Property Tax and Rent Rebates for Older Adults and Residents With Disabilities on Medicaid.

For most of us, the prospect of money appearing in our bank account is a welcome gift. However, if our loved one is on Medicaid could be cause for concern. How can this money be used? Will it result in our parent losing benefits? Should I you give the money to the nursing home? With the first stimulus, there were many questions regarding how this money could be used, but we now have a clearer picture. First, facilities have no right to this money. It is not considered income for public benefit purposes and will not be treated as a resource if it is spent within one year of receipt. So here are five ideas for how to use the stimulus check received by your loved one on Medicaid.

Bob Michaels is extremely passionate about providing the best possible legal experience for his clients, and focuses his practice on elder law, estate planning, business, and real estate matters. Bob has been able to provide piece of mind and a solid foundation to many folks in the Puget Sound area over the years and wants to provide resources and relevant information whenever he can. For more information on how Bob can help your loved ones through these troubling times, contact Bob to schedule a FREE consultation.
 
Since the Covid-19 crisis began, nursing home residents have been separated from their families. Some families have gotten creative – visiting through windows, via Zoom, Facetime, and from parking lots. Although many have had no way to reach their loved one, and must rely on staff to give them updates.

Unfortunately, this isolation has increased depression and confusion in many residents, leading to heartbreaking scenes of seniors dying alone and families not finding out until after the fact, or families unable to enter their loved ones’ room during their final days.
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Nursing Home Recommendations

(According to article in Kaiser Health News, posted February 21, 2020, by By Phil Galewitz)

The Trump administration’s top Medicaid official, Seema Verma, has been increasingly critical of the entitlement program she has overseen for three years.

Seema Verma, administrator of the Centers for Medicare & Medicaid Services (CMS), has warned that the federal government and states need to better control spending and improve care to the 70 million people on Medicaid, the state-federal health insurance program for the low-income population. She supports changes to Medicaid that would give states the option to receive capped annual federal funding for some enrollees instead of open-ended payouts based on enrollment and health costs. This would be a departure from how the program has operated since it began in 1965.

In an early February speech to the American Medical Association, Verma noted how changes are needed because Medicaid is one of the top two biggest expenses for states, and its costs are expected to increase 500% by 2050.
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“Yet, for all that spending, health outcomes today on Medicaid are mediocre and many patients have difficulty accessing care,” she said.