Medicaid & Long-Term Care Planning
Long-term care includes care needed at home to assist with your activities of daily living, as well as care in an assisted living facility, adult day care center, or nursing home. The attorneys of DeBellis Law, P.A. are experienced in assisting seniors and their families plan for the cost of long-term care and work closely with clients to preserve their hard-earned assets. We advise clients regarding how to obtain public benefits, including Medicaid for long-term care. Our firm is best known for our extraordinary and personalized service. At DeBellis Law, we will develop a tailor-made plan for clients and their families as loved ones age, including the best use and management of personal and financial resources to meet their long-term objectives, exploring all home-based care options, and easing transitions in the event a facility placement is required.
Medicaid planning varies greatly from state to state because each state implements the Medicaid program differently. At DeBellis Law, we have significant experience obtaining Medicaid benefits for clients in Florida and New York, but cannot advise regarding Medicaid in other states.
Get to know why long-term care planning is so important:
Will Medicare Cover My Long-Term Care Needs?
Long-Term Care is the care needed above and beyond doctor’s visits and hospital stays. Long-term care includes additional care needed in the home, at an assisted living facility, or at a skilled nursing facility (nursing home). Although Medicare covers doctor’s visits, hospital stays, medications, and surgeries, it only covers a very small portion of the cost of long-term care.
Medicare generally covers the first 20 days of care at a rehabilitation facility. Starting day 21, Medicare only covers a portion of the cost of care and the patient generates a hefty daily copay. Depending upon your Medicare supplemental insurance or Medicare advantage plan, that copay may be covered in full, in part, or not at all. After 100 days of rehabilitation, or if you are cut from Medicare for failing to benefit from continuing therapies, you will have to pay out of pocket for all costs. Additionally, if discharged home after completing rehab, Medicare will cover only a limited number of hours for services in the home. This typically includes wound care, physical or occupational therapy, and some skilled care, but does not include coverage for a home health aide.
Many people do not realize that Medicare coverage for these services is so limited and results in extremely high out-of-pocket costs. As a result, many people need to look to government benefits, such as Medicaid, to pay for their additional care. Although the average person does not automatically qualify for government benefits, there are planning tools we can use to protect your assets for you and your family while still securing government benefits to pay for your care.
What Does Medicaid Cover?
Medicaid has two main programs to cover your long-term care costs, depending upon your needs. The Institutional Care Program (ICP) (referred to as “Chronic Care” Medicaid in New York) covers costs incurred while living in a nursing home, while the Home and Community Based Services Waiver (HCBS) (referred to as “Community” Medicaid in New York) can help pay for a home health aide, adult day care, or care received in an assisted living facility.
Medicaid is a “means-tested” program, which means that there are strict income and asset limits in order to qualify for Medicaid coverage. As of January 1, 2020, an individual who is applying for Medicaid in Florida must have an income of less than $2,350 per month and assets of less than $2,000. In New York, an individual applying for Medicaid must have an income of less than $875 per month and assets of less than $15,750. We know those figures may seem impossible, but DeBellis Law can develop a realistic plan for you to become financially eligible for these services.
5 Year Lookback and Planning for Future Needs
Most people have heard about the dreaded 5 year lookback period, but do not really know what it entails. When applying for Medicaid, the Florida Department of Children and Families (or the Department of Social Services if in New York) has the authority to look back into 5 years of your full financial history. During this tedious and intensive process, if they discover that an applicant has gifted away any assets during that time period, they will penalize the applicant and impose a penalty period during which he or she will be ineligible for benefits.
Due to this lookback period, it is wise to begin thinking about future care needs while you have time to plan. The attorneys of DeBellis Law will help you formulate and implement a plan so that you are in a better position to qualify for benefits after 5 years.
What happens if you need care now, but have not done any long-term care planning in place? Luckily, there are still some tools we can use to protect your assets and get you qualified for government benefits in a crisis. However, the asset protection options are much more limited when you need to qualify for benefits quickly. If you or a loved one is in need of immediate long-term care, it is vital that you work with a qualified attorney to determine the best course of action. Keep in mind, non-attorneys are not allowed to give you advice regarding protecting or transferring your assets. It is important to consult with a qualified attorney so that you can get the full picture of all options available to you.
Will the Government TAke My Home?
This is the question we are asked most often. Planning for government benefits varies drastically among states, but we at DeBellis Law will make sure that your home is protected from creditors upon your death so that your property passes to your heirs. In Florida, we are very fortunate that Homestead laws protect our primary residences from forced sale by creditors. In New York, future planning to protect your home is crucial in order to avoid any creditor liens being placed on your property.
Why Choose DeBellis Law, P.A. for Elder Law Services?
As a small firm, we are able to give personalized care to each of our clients. No client or family is the same, so no two clients will leave our office with the same exact plan. We understand that discussing these topics or caring for a loved one is a difficult and foreign process. We endeavor to provide peace of mind to your family and develop trusting relationships so that you can lean on us throughout this process. We are compassionate, committed, thorough, and will go above and beyond to make sure that you and your family are provided for.
Our office is located in Palm Beach Gardens, but we are happy to schedule a consultation closer to you or in your home, particularly if you or a loved one has difficulty travelling.