- Created: Tuesday, 25 November 2014 17:44
Bob and Carol are in their mid-seventies and were enjoying a comfortable, if modest retirement when Bob suffered a stroke which left him with limited mobility on one side of his body. After eight weeks of physical therapy he is told that he no longer needs “skilled nursing” care and will be discharged from the rehabilitation center. Although he has made some improvement in learning to function with his disability, he still requires the help of two people to rise from the bed or a chair, shower, or visit the bathroom. Help of this nature is defined as “custodial” care and is not covered by Medicare.
If, like Bob and Carol, you are stunned to learn that Medicare will not cover a nursing home stay for yourself or a loved one, you are not alone! Although most of us will spend time in a nursing home at some point in our lives, few of us actually prepare for this eventuality. Perhaps this is due to the assumption that Medicare or supplemental insurance will cover these costs. The fact is that Medicare was not designed for long term care for a chronic or irreversible condition such as Alzheimer’s, but for short term skilled care and rehabilitation for a limited time following an acute illness or injury, for example, recovery from a broken hip.
After a few days of frantic research, Bob and Carol come to understand that their options are limited. Carol is physically unable to manage Bob’s care at home, and their children live too far away to be of help on a daily basis. The cost of 24/7 home health care, as well as nursing home care at the private pay rate is far beyond their means.
Paying for Long Term Nursing Home Care
With the average monthly cost of a nursing home care in Florida close to $8,000.00, an extended stay can wipe out the savings of all but the most affluent families. Many seniors with sufficient income and benefits to support a comfortable retirement suddenly find themselves wondering how they will finance the care needed during their final years, and this is where Medicaid enters the picture. While originally conceived to provide health care for the poor, it has become the largest single payer for nursing home care in the United States, and can fill a critical vacuum in helping a family to stretch its health care dollars. This is especially true when resources are needed to support a healthy spouse at home as well as subsidizing the care of a spouse in the nursing home.
It is crucial to understand that Medicaid is a means-tested program, with strict income and asset limits required for qualification. Ironically, many middle-class Americans are in position of having too many assets or income to qualify for Medicaid, yet lack the means to pay out-of- pocket for nursing home care. While legitimate qualifying strategies exist, application can be a complex process, and improper transfers of assets or insufficient documentation can result in lengthy periods of disqualification for benefits. Another factor to consider is that Medicaid rules differ from state to state, adding to the confusion and complexity of the program.
LeavenLaw can help. We have the experience and resources to guide you through the Medicaid application process. We also provide a comprehensive suite of Elder Law services, including wills, trusts, durable powers of attorney, and probate administration. Feel free to contact LeavenLaw to schedule a free consultation. www.LeavenLaw.com 1-855-Leaven-Law (855-532-8365).
Anne Webb Ricke, Esq.