Advances in medicine allow people to live longer, but they are not necessarily healthier. As people age, nursing home care often becomes the only reasonable choice. Nursing home care is expensive, and extended care is beyond the means of most families. Medicare nursing home benefits are limited, but Medicaid benefits are available for nursing home patients in many cases.
Medicaid income and asset restrictions are severe, but qualifying for the program is possible even when you have the means to private pay. When you are wondering how to pay for a nursing home, consult an elder law attorney about qualifying for Medicaid.
The best time to plan for eventual nursing home care is when you are in good health. You could employ various strategies to prepare for the cost of nursing home care if it ever becomes necessary.
Long-term care insurance is available and worth considering. People with pre-existing conditions may find the cost prohibitive, and it is also expensive for people nearing retirement age. However, compared to the cost of a month in a skilled nursing facility, it may be worthwhile for some people.
Another strategy is to direct assets strategically. Medicaid has strict income and asset limits to qualify, but some assets are exempt. In addition, when an applicant is married and only one spouse needs nursing home care, the program allows the non-patient spouse to retain certain assets for their own support. An experienced Medicaid planning attorney can help an individual or family develop a strategy that will work for them.
Unfortunately, some medical conditions progress rapidly, and catastrophic events can happen at any time. Sometimes, people need nursing home care immediately, and there is no time to plan for Medicaid eligibility.
Although the patient or their family will likely have to use their own assets to pay for care initially, there are ways to speed up eligibility for Medicaid. These include spending down excess assets, purchasing an annuity, establishing trusts, and strategic gifting, among other options.
An experienced elder law attorney can help a family develop a strategy to become eligible for Medicaid as quickly as possible. They may also be able to identify other sources of funding, such as veteran’s benefits.
The Medicaid look-back period is five years, meaning that reviewers will scrutinize any below-market transfers the applicant made in the 60 months prior to their application. Any below-market transactions will delay Medicaid eligibility.
The length of the delay is determined by dividing the total amount of the below-market transactions by the average monthly nursing home costs determined by the state. For example, if the reviewer determines there were $100,000 in below-market transfers over the preceding five years and the average cost of a nursing home in the area is $7,023 per month (the penalty divisor for 2024 in Virginia), Medicaid eligibility will be delayed for a little over fourteen months although there are strategies to speed up the penalty period.
Nobody likes to think about having to move to a nursing home, but many of us will have to do so. Planning ahead is helpful, but when the need is urgent, there are still ways to get the care you need without impoverishing your loved ones.
A skilled elder law attorney at Parks Zeigler can help you figure out how to pay for a nursing home. Reach out today to get started.
With an office near Town Center, Virginia Beach and a second location beside the Chesapeake courthouse, our team provides quality legal representation across the entire Hampton Roads Area.
Parks Zeigler, PLLC – Attorneys At Law
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