Medicaid Planning refers to the steps you can take now, so that you will be able to obtain Medicaid in the future to help pay for your care. When you look at the statistics, most people will need to be admitted to a nursing home at some point during their lifetime. With the ever-increasing cost of such care, currently standing at almost $10,000 per month, per person for skilled care, the question quickly becomes, “How do you pay for that?”
The short answer is that most people have to pay for nursing home care out of pocket. How do you do this? By draining retirement plans and selling off assets. Once you spend down your assets to pay for your care, you may qualify for Medicaid to pick up the rest of the cost. However, with some planning in advance, there are options available to ensure that your assets will be protected.
The best time to prepare for the possibility going into a nursing home is before you need it. The Medicaid rules are very strict regarding what is an “available resource” which can be required to be spent before the state will help pay for your care. If you take action far enough in advance it is possible to protect most, if not all of your assets from such exposure.
Medicaid is a state program which distributes federal dollars to those individuals in need. With the cost of nursing homes on the rise, Medicaid has become the primary means by which many people pay for their care. The difficulty comes when you try to apply and qualify for Medicaid. There are strict income and asset limits imposed and Medicaid will not help pay for your care if you are over these limits.
If you go into a nursing home, the Medicaid rules state that you must spend down your available resources to their asset threshold before they will step in and pay for your care. If you are a single individual, you can be required to sell your home, cash in your retirement accounts, remove the cash value of life insurance policies and sell or spend most of the other things you own until you get down to the asset limit. As an unmarried individual in 2020, Medicaid’s asset limit is $2,000. In short, that means that you can only own a total of $2,000 in assets before Medicaid pays for your care. Everything else has to be sold and spent for your care.
Married couples are treated somewhat differently under the current rules. Medicaid allows the healthy spouse to stay in the marital residence, keep one vehicle, a prepaid funeral, and a limited amount of “other assets.”
However, one point that often gets missed is what happens to the house. If Medicaid is paying for care for one spouse, Medicaid will attach a lien against the marital residence, which accrues based on what is being paid for care. They will not evict the healthy spouse, but if the spouse was to move, or when the healthy spouse eventually dies, you or your family may be required to sell the residence to satisfy the lien and pay back Medicaid for the care it paid for.
There are ways to avoid these results, but they must be taken in advance. Medicaid planning is complex and implicates many distinct legal principles. Make sure you discuss Medicaid Planning with a qualified elder law attorney who can walk you through the process.
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