Long-Term Care Planning Q&A

By: Marcus Kroll, Esq.

Q– My loved one is in a nursing home. I was told it's too late to plan for their long-term care needs.

A – It's never too late to plan, but time is of the essence. For every month which you delay, the average cost of care in our community is $13,000.

Q – I was told by the nursing home that we needed to "spend down" to less than $14,000 before my loved one could qualify for Medicaid.

A – With proper legal planning, it is possible to qualify an individual with significant assets for Medicaid. There are many options available, including additional planning tools available for those with spouses in the community.

Q – What's the 5-year look back I keep hearing about?

A – For every $10,073 an individual transfers out of their name, the Department of Social Services presumes that the transfer was made for the purpose of qualifying for Medicaid, and penalizes an individual for one month of eligibility. There are planning options to work around this penalty.

Q – We're applying for Medicaid. What kind of information will I need?

A – You will need vital records and information for the applicant, as well as 5 years of bank records. It is important for older adults to keep up to 5 years of records, even if they're healthy, in case something happens and they need to engage in long-term care planning. Year-end statements are not enough.When applying for Medicaid, every page of every monthly statement (including pages intentionally left blank) for 5 years needs to be produced.This can be especially problematical for seniors whose statements come to them online, unless they make a habit of printing and saving those statements, which we understand runs contrary to the reason for using online access services, but is necessary for Medicaid eligibility.

Q – I was told that only people showing significant resources get their choice of nursing home beds.

A – This has some truth to it. If possible, your loved one should consider planning ahead of time to protect some resources, but should also leave some resources in their own name so that if they require medical care in a nursing home they have the luxury of choosing the best one – in terms of both care and location.

Q – My loved one is in assisted living. Will Medicaid pay for this?

A – No, Medicaid is not an option for someone in assisted living. However, there are other programs, such as Veterans Aid and Attendance, which may help pay for some of the costs.