What Are the Top Five Questions to Ask a Medicaid Asset Protection Attorney?
Whether rich, poor, or somewhere in between, most of us cannot afford to ignore the potentially devastating costs of nursing home care and other types of long-term care. That’s why, as a Certified Elder Law Attorney, I’d like to take this opportunity to educate you about legal options, particularly Medicaid Asset Protection, also known as Medicaid planning and Life Care planning.
Medicaid is quite complex, which is why we get so many questions about it. For example, what is Medicaid Asset Protection; how does Medicaid differ from Medicare; and is Medicaid Asset Protection only for poor people? Find out the answers to these and other common questions I hear often as an Elder Law attorney:
1. What Does “Medicaid Asset Protection” Mean?
Medicaid is the primary method of paying for nursing home care in the United States. In fact, given the absence of any other public program covering long-term care, Medicaid has become the default nursing home insurance of the middle class. Medicaid Asset Protection is vital for those who cannot afford the catastrophic costs of paying privately ($14,000 - $17,000 a month in the DC Metro area — Northern Virginia, DC, and areas of suburban Maryland).
Life Care Planning and Medicaid Asset Protection is the process of protecting assets from you having to spend them down to pay for nursing home care or in-home care, while also helping ensure that you or your loved one can get the best possible care and maintain the highest possible quality of life, whether at home, in an assisted living facility, or in a nursing home.
2. Besides paying for nursing home care, what are some of the other reasons for doing Medicaid Asset Protection?
Many people who enter nursing homes, or receive nursing home level care at home, eventually run out of money. Avoiding this fate is one of the main reasons for working with an experienced elder law attorney to do Medicaid Asset Protection. The other major reasons include:
Protecting The Spouse: With proper planning, a spouse who is able to stay at home can keep all of the couple’s assets and much or all income while Medicaid pays for the nursing home. The most important goal is typically to ensure that the spouse remaining at home is able to live the remaining years of life with utmost dignity and not have to suffer a drastic reduction in standard of living.
Protecting Quality of Life: If you are a single or widowed client, the most important reason for you to engage in Medicaid Asset Protection planning is for you to be able to enjoy the highest quality of life possible in the event you are forced to enter a nursing home. Here’s how:
Money that an elder law attorney protects for you in the process of getting you qualified for Medicaid can be used, once you are receiving Medicaid benefits, to provide you with an enhanced level of care and a better quality of life while you are receiving long-term care Medicaid, whether at home or in a nursing home.
For example, families can use the protected assets to pay for important care management services from a company such as ElderTree, to pay for a private companion: someone to keep you company, to change the channel on the TV or start playing a different movie or audiobook or music stream; someone to help you get to the bathroom every couple of hours; someone to make sure you get the best possible care because nursing homes are notoriously understaffed.
Protected assets can also be used to: replace lost, broken, or outdated hearing aids, dentures, eyeglasses, and electronic equipment.
Protected money can also be used to pay your cell phone bill; replace outdated or soiled clothing; pay for streaming media services; purchase services or items for you that are not covered by Medicaid, such as some dental work, incontinence supplies, personal clothing, toiletries, nail trims, and haircuts.
Protecting Children: Some parents have saved and sacrificed their entire lives and have a strong desire to leave a financial legacy for their children. With proper planning, this goal can be achieved while still qualifying for Medicaid.
Protecting Disabled Persons: There are asset protection strategies that will allow you to protect certain assets for the benefit of a disabled child and sometimes for other disabled family members.
3. What is the Difference Between Medicare and Medicaid?
Medicare does not pay one penny, ever, for nursing home long-term care. Medicare pays for health care and rehab for people age 65 years and older, people under age 65 with certain disabilities, and people of all ages with end-stage renal disease.
Medicare only covers medically necessary care and focuses on acute care, such as doctor visits, hospital stays, and prescription medications.
Medicare also covers short-term skilled nursing care or care for rehabilitation, such as physical therapy, occupational therapy, and speech therapy, to help you regain your function after an injury such as a fall or a stroke.
Medicare's coverage of short-term rehab care or skilled nursing care in a nursing home is quite limited. Medicare covers only up to 20 days per illness, and will partially pay for another 80 days for that same illness. To qualify, you must enter a Medicare-certified nursing home within 30 days of a hospital stay that lasted at least three midnights, and the care in the nursing home must be for the same condition as the hospital stay.
Unlike Medicare, Medicaid is a means-based program. In other words, you are only eligible for Medicaid if you have very few “countable” assets.
4. Is Medicaid Designed Solely for Poor People?
Long-term care Medicaid was NOT designed for poor people; it is a different type of Medicaid than health insurance Medicaid which was designed for people with very low incomes. Long-term care Medicaid was designed for people who can qualify for it, which includes many middle- to upper-class seniors who rely on long-term care Medicaid to cover the catastrophic costs of nursing homes so people such as you don’t have to deplete the assets it took you a lifetime to earn. With DC Metro area nursing homes costing $14,000- $17,000 per month, even wealthy people and those who spend their lives saving can quickly lose everything they worked so hard to earn.
5. Do You Get Better Care if You Pay Privately?
Many people assume that you get better care if you pay privately. That is not true. In fact, it is illegal to treat Medicaid patients differently than private pay patients. Typically, the staff does not know which patient is a Medicaid recipient. In actuality, the nursing home residents who get the best care are those who have done Medicaid Asset Protection, because a loving family member can then use those protected assets to pay for better care for the nursing home resident, as explained earlier. Elder Law, including Medicaid Planning and Medicaid Asset Protection, is all about preserving dignity and quality of life for elders.
Plan Ahead for Long-Term Care
It is extremely prudent to legally protect your assets in an effort to qualify for Medicaid nursing home benefits when needed, and to do so with the help of a highly-experienced elder law attorney. Don’t ever hide your assets, and don’t make the mistake of attempting to protect your assets on your own. Make the wise choice, and call an experienced Certified Elder Law Attorney to make an appointment.
It is important to note that Medicaid Planning can be started while you are still able to make legal and financial decisions or can be initiated by an adult child acting as agent under a properly-drafted Power of Attorney, even if you are already in a nursing home or receiving other long-term care. In general, the earlier someone plans for long-term care needs, the better. But it is never too late to begin your planning!
About the Author:
Evan Farr is a Certified Elder Law Attorney who practices in Virginia, Maryland, and DC, and a four-time best-selling author. He’s also a member of the National Academy of Elder Law Attorneys' prestigious Council of Advanced Practitioners and a Charter Member of the Academy of Special Needs Planners. To learn more about Mr. Farr and the Farr Law Firm, please visit https://www.farrlawfirm.com.
