03- May2017
Posted By: Tony Fischer

Five Long Term Care Options That Aren’t The Nursing Home

Many people think of long-term care as the nursing home.  However, the fact is there are many levels to the senior healthcare continuum, several of which are considered long-term care.  As people age and make their way through the senior healthcare continuum it is inevitable that they will use a service classified as long term care.

That probably changes your view of long term care. So let me give you a simple definition to determine whether a service is or isn’t a long term care service.

Simply put, any health problem that can’t be “fixed” with a doctor’s visit, hospital, or rehab stay is considered long term care.  This includes chronic illnesses or conditions such as Alzheimer’s, Dementia, Arthritis, and COPD, decreased mobility or memory care.  What more is that insurance coverage for these conditions are short term, once the patient is stabilized insurance coverage often stops.  For this reason almost all of long term care services are paid for out-of-pocket.

A common question asked by seniors is about insurance coverage of long term care services.  The majority of the time our Senior Care Sherpas have to tell them services aren’t covered under Medicare or traditional health insurance.

READ RELATED: How to pay for long term care

The post referenced above explains some different payment options for long term care services, so we won’t go into those here. Instead, now that we know how long term care is defined, let’s look at five options that don’t include going to the nursing home.

Private Duty Home Care

This service features non-medical personal who are hired to come into the home and help the senior with day-to-day tasks.  Healthcare professionals call these tasks “Activities of Daily Living” and they include things like bathing, grooming, housekeeping, laundry, and meal preparation.  Private Duty Home Care companies can also provide companion services for patients suffering from a Dementia based diagnosis.

Home Chore Services

Need work done outside the house? Home Chore services can help.  Many communities offer these services through Area Agencies on Aging or community groups funded by private and government grants. Home Chore service workers will mow lawns, remove snow, clean gutters, clean-up debris and anything else an elderly home owner may need to maintain their property.

Transition Services

With the passing of the Affordable Care Act, many traditional services have evolved to include services for seniors who are at risk for returning to the hospital. Consequently, one of these evolutions is the transitions care manager.  They are nurses who visit the senior’s home and set-up services to help them maintain their independence.  Insurance companies sometimes offer these services as well.  They are often limited in scope but can provide the insight and resources a senior needs to remain at home.

SeniorCareSherpa.com also offers transition services that include a senior care plan.  CLICK HERE for more information.

Independent Senior Living

These are communities of seniors who can live independently with minimal services.  These communities often feature services such as outdoor maintenance and housekeeping.  They also work in conjunction with home care companies to provide additional services as needed.

Assisted Living

With more service offerings than Independent Living, Assisted Living offers services that can almost mirror that of a nursing home.  Assisted Living communities offer a variety of services that enable the seniors to age in place without leaving the community. A senior care get 24-hour care in an assisted living environment if they have the resources and medical conditions warrant.

Senior Care Planning

Want more information? Our Senior Care Sherpas can help guide you through the process of understanding services and identifying needs.  Use the form below and we will be happy to guide you through the list of long term care options.

03- Apr2017
Posted By: Tony Fischer

Medicaid Planning: What You Should Consider Before Starting

Planning for long-term care cost is a harsh reality for those planning for retirement.  As Americans live to be older, using of the long-term care system is inevitable. When seniors are forced to use the long-term care system is determined by variable such as health and the availability of family support.

The way many seniors and their families choose to plan for this unknown aspect of aging is through Medicaid Planning.  It is the process of using legal or financial tools to make themselves Medicaid eligible before they would have been otherwise.

Here are a few things you should consider before beginning the Medicaid Planning process.

Medicaid In A Nutshell

Medicaid is funded through the state with eligibility based solely on financial criteria.  It is different than Medicare which is automatically granted to US Citizens at the age of 65. A senior must apply for Medicaid and meet criteria before receiving coverage.

Medicaid has become the default payor for nursing home care. It covers the cost of nursing home care which is averages about $81,000 a year. That considered, it is easy to see why seniors are looking for ways to get Medicaid to pick up the nursing home bill.

Becoming Medicaid Eligible

Most seniors spend down their assets to the eligibility level, typically around $2,000 in assets, in order to qualify for Medicaid coverage.  Others use legal mechanisms like irrevocable trusts in order to protect their money from long-term care cost and preserve assets for the next generation.  This often involves transferring ownership of assets to a trust making them unavailable to the senior.  It is a strategy almost exclusively used by the rich but has recently been used by middle class seniors in order to become Medicaid eligible.

However it happens, for a senior to become eligible they must have less than $2000 in total assets. Check with your local department of human services in order to find out the exact state requirements.

The Look-Back Period

Any Medicaid Planning strategy usually involves navigating around the five-year look-back period. Each Medicaid application asks whether or not the applicant has transferred assets to someone else in the last five years.  If the answer is yes, the government will likely want the applicant to contribute a portion of the amount transferred to long-term care expenses before becoming eligible.

Assets transferred over five years ago will not counted as assets.

Avoid Giving Cash Gifts

Seniors often try to transfer assets to their family for friends through gifting.  Seniors will give the maximum amount allowable by the IRS, pay college tuition, buy cars, anything to control the distribution of assets.

A cash gift can be anything but if given within the look-back period.  The state can require that assets be returned and applied toward long-term care expense. They can even go after the person or organization who received the assets.

Considering gifting a portion of your assets to someone in your family? Make sure to consult your local Medicaid guidelines before making the gift.

Consult the Correct Expert

The population of those age 65 years of age and older is the fastest growing demographic in America.  As a result, everyone has a product designed the serve the senior population. There any number of professionals that offer Medicaid planning services but not all have the ability to actually do it. Even for those with a modest assets, Medicaid Planning involves complex legal and estate planning tools best accomplished by an Elder Law Attorney.

Going to an “expert” without the proper skills or authority to engage in Medicaid Planning could result in lost money and additional regulatory entanglements.

Stay In Control

If you can avoid it, it is always best to avoid government subsidies when paying for long-term care. Spending your own assets allows you to choose the care you receive and the place you receive it in. Using government subsidies restricts choice to the care funded by that subsidy.

Senior Care Plan

SeniorCareSherpa.com offers plans to help seniors and their families plan for long-term care. Senior care plan’s are elder-centered. The plan addresses the unique healthcare, financial and environmental needs of the senior. Whether it be brief or ongoing, we help seniors and their families navigate the senior care system.

Next Post: Four Reasons To Get A Senior Care Plan

Editor’s Note: The author, Tony Fischer, is not an attorney. The content in this post is intended to provide general information and not intended as legal advice. Contact an Elder Law Attorney before making any decisions on Medicaid Planning or any other Elder Law matters.