Statistics don't lie; Americans are living longer to advances in health care, disease prevention and detection and overall advances in medicine. It is very likely that a family member will require nursing home care or significant and costly assistance in their home. Unfortunately, payment for nursing home care is not part of Medicare's basic entitlement package. If one needs nursing home care, one either has to pay for this cost oneself (privately or with long term care insurance), or qualify for Medicaid.
Medicare's nursing home benefit is limited and covers only skilled care but only after hospitalization. Medicare does not cover custodial or residential care. Medicaid, on the other hand, is a welfare program for health care expenses that does cover nursing home custodial and/or residential care. To be eligible for Medicaid benefits a patient must satisfy three discrete conditions: 1) wealth or resources; 2) income, and 3) need for assistance. The value of the patient’s countable assets cannot exceed $2,000. If the patient and their spouse need Medicaid benefits, the value of their combined or total countable assets cannot exceed $3,000. However, if the spouse does not require Medicaid assistance (the community spouse) may own countable assets worth $109,560. The patient’s monthly income must not exceed $1,750 to be eligible for at-home help. The income of the community spouse, however, is not a limiting factor and is not taken into account in the patient’s eligibility determination.
Until a crisis strikes, many people are unaware that Medicare and most private health insurance policies do not cover much of the costs of care defined as "custodial." This comes as a major shock to people who then realize that they can only qualify for Medicaid benefits after they have "spent down" most of their estate. If you, your spouse, or your aging parents are considering the need for assisted living or nursing home care, you should consult an elder law attorney to help formulate a financial plan to ensure that long-term care expenses can be paid, while still preserving the assets that you or your parents worked so long to accrue. Our firm provides highly competent and experienced elderly estate planning, estate tax planning, and disability planning services; as well as probate and guardianship services to clients throughout southeastern Michigan. If you or someone you care about is facing probate or estate planning issues, an Elder Law attorney at our firm will take the time to get to know you before determining your needs. We have experience in assisting your family with decisions regarding the following:
