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Stewart + Gordon
Purpose and Peace of Mind

Medicaid and Elder Law Issues

Special Planning for Seniors and Those Who Serve Them


Long term care generally

While we’ve figured out many ways to prolong life, we are still working on prolonging its quality. Many of us are all too familiar with the aches and pains of our aging bodies and have taken time away from work or our other family needs to attend to an aging or infirm loved ones. It’s a real struggle, and it’s one with which we are intimately familiar.

As part of our planning, we regularly counsel clients regarding financing long term care solutions of their choice and navigating care decisions that need are much simpler when thought out ahead of time.

The right legal tools combined with the right financial strategy can go a long way towards ensuring peace of mind and allowing seniors and their loved ones to focus on the physical and emotional decisions that need to be made. We’ve long made it a practice to be well-connected in the senior care community and are in a position to help be a guide.

medicaid and veterans’ aid and attendance

Going broke in a nursing home is something that many retirees fear. The state-run Medicaid program is there to assist financially with nursing home costs, but when? What involvement does Medicare have? It can all be quite a bit to sort through.

Medicare is the primary insurer of most retirees in the country. It provides insurance for routine medical care and functions much as traditional insurance. It does NOT, however, cover long term care in the home, in assisted living, or in nursing facilities, except perhaps for a temporary period of rehabilitation such as after a taxing surgery. We are expected to pay those costs out of pocket, and those costs can routinely exceed $7000 per month.

Medicaid, then, will provide assistance, once we have depleted our savings to a qualifying amount (currently approximately $120,000 for a married couple when one spouse is healthy and remaining at home, $3000 when both spouses are in need of nursing home care, and $2000 for singles). Some assets don’t count against that amount, such as one car, personal belongings, and even a home up to just shy of $600,000 in value. Here, we ask that you beware that we are generalizing, and that you not make any plans based solely on this information. Give us a chance talk things through with you, as there are nuances that need to be understood.

Another catch to Medicaid is that, though you can own your home while receiving assistance, this can be complicated. Nearly all of your monthly income will need to be channeled towards your nursing home, leaving no budget for upkeep or payments on the home. Further, the State is permitted to essentially run a tab against the dollars spent on your care. After death, the State can present that tab to your heirs, even to the point of putting a lien on the home, depriving your heirs of receiving it as inheritance in its fulness.

Yet another pitfall is that the Medicaid application can require a disclosure of the financial history five years leading up to the application (known as the look-back). Gifts to family members, churches, purchases made on the behalf of others, all of these types of transactions are basically disqualifying for Medicaid.

There is also a wonderful program for veterans, their living spouse, or their widow(er), called Aid and Attendance. It is not generally advertised prominently by our overworked VA, but is a program to assist these military families with long term care type expenses. It is not limited to veterans who have VA disabilities, service related injuries, or even those who have seen combat time overseas. The veteran need only have served active duty during one of the major conflicts (in any capacity) and been discharged as something better than dishonorable. There are financial requirements that are in flux, so please contact us to discuss your specifics.

senior abuse and prevention

The statistics are not good for seniors experiencing financial abuse, neglect, or exploitation, and one of the saddest realities is that the perpetrator of the abuse is often a family member or someone who was named in a legal document as having authority to make financial or medical decisions for the senior. While we do not prosecute instances of abuse as this is a criminal matter, we work with our senior clients and their children to prevent abuse, take reasonable safeguards, and provide accountability for those charged with caring for seniors.

Contact us to discuss the specifics of your family.