Sudden Changes and Big Decisions
Change is life’s only constant. Sometimes these changes strike without warning. If you or a loved one has experienced a sudden illness or serious accident, you understand how abruptly everything can change. Are you or a loved one suddenly in need of nursing home care? Finding and affording quality care on short notice can be stressful and draining. We can help you determine the best options for care and how to qualify for Medicaid to help finance them.
Long-Term Care: Counting the Cost
Long-term care is expensive, and these costs only continue to increase as baby boomers age. Although the range varies depending on where you live, according to the Genworth Cost of Care Study for 2019 the national median annual cost of a private nursing home room is $102,200 with a 3% annual increase projected. With improved medical care, the average life span of adults also is increasing; this translates into more years of care at increasingly higher rates. Without some sort of financial assistance, these costs could be financially devastating. In fact, your entire life savings could be quickly depleted within a few years of needing long-term care. This is where Medicaid can help.
Medicaid is a joint federal and state program to assist those with low income and limited resources. While Medicare provides very limited long-term care coverage, Medicaid is much more extensive. However, because of its restrictions, qualifying for Medicaid can be extremely difficult. But paying for a nursing home without it could be all but impossible.
The Medicaid Maze
To qualify for Medicaid, the applicant must be both medically and financially eligible.
To financially qualify for Medicaid:
- In Massachusetts, the applicant must have no more than $2,000 in countable assets on the date of application. In Connecticut, however, the maximum amount of countable assets the applicant can retain is $1,600;
- The Community Spouse (or colloquially known as the “well spouse”) must have no more than $119,220 in countable assets;
- The applicant may retain one personal residence and one vehicle, but such assets may be subject to estate recovery.
To medically qualify for Medicaid the applicant must be unable to perform at least two of the following without assistance:
- Bathing, dressing, eating, toileting, and/or transitioning from room to room;
- A diagnosis of dementia will also render an applicant medically eligible.
This is only a brief and oversimplified review of a few Medicaid rules, of which there are myriad more. Navigating them on your own could be a nightmare at best and subject you to penalties at worst. Fortunately, though, our experienced professionals can guide you through the Medicaid maze. We can advise you throughout the application process, ensuring that you retain the maximum income and total assets allowed by law.
Seek appropriate counsel before you apply for and seek to qualify for Medicaid. We can give you – and your family – peace of mind during a difficult and uncertain time. When dealing with Medicaid, legal advice is something you cannot afford to go without.