My husband and I are over 80 years old. We own our house and a car. We also have some savings in the bank. Some people have suggested that we put that money under our daughter's name (she lives in another city), but we don't think it's legal. Both of us have health issues, especially my husband who lately suffered two strokes and was left with many limitations. My question is what will happen if we live long enough to use up all our savings. Right now we live on what we get from Social Security, but since it's not enough for to cover all our needs, including hospital and medication co payments, the savings are decreasing day by day. If that day comes, what can we do to meet our financial needs. Our daughter is not in the position of helping us. Is there a waiting period between our assets are almost used up and qualifying for Medicaid?
Glad you are planning ahead for when the time comes. Check with your State Medicaid office for their requirements and start working on those requirements to give you a head start, or at least learn what is available.
How expensive is it to keep up your house? Utilities, property taxes, maintenance, repairs? Some seniors find it is time to downsize into something more manageable. Since you own your home, use some of that equity as a safety net for any future medical issues.
There are ways to use differnt trusts to hold money and to use it for caregiving.
Consider downsizing and a possible assisted living that will accept medicare if your needs are higher in the future for your husband.
If your daughter can help with being a sounding board or a trusted family or friend who has experience is very helpful.
Second, this issue also has ethical implications. Nursing homes do not make any money on Medicaid reimbursement. This is problematic for both for profit and nonprofit facilities as both have rising operational costs and reimbursement from Medicaid is designed to not allow a profit and is retroactive in its cost adjustment (18-24 months in some states). The point here is that as more people "plan" to avoid paying the non-Medicaid or private charge for nursing home care, the fewer residents are contributing to the basic business that makes a nursing home succeed in terms of being able to offer competitive pay/benefits, more nursing staff, better activities, etc. There is a STRONG correlation between those facilities that have a majority of Medicaid residents and low star ratings on Medicare's Nursing Home Compare site. And the kicker here for me is that there are numerous responses on this website that think nursing homes are terrible places and money grabbers but the same people would scheme to hide assets and deny paying their fair share. Medicaid was established to ensure that those who truly need care are able to receive it, not to ensure that the more fortunate could have their cake and eat it too.
Third, there is an irony here as well. The fastest growing line item in almost every state budget is the Medicaid expense for long term care. This is due, in large part, to families transferring assets to avoid paying for nursing home care. Twenty years ago I was administrator in a facility that had about 60% of its residents paying privately. This facility is now averaging only 12% private pay. As the facility has had to rely on Medicaid reimbursement as its primary source of revenue, staffing has been reduced and resident satisfaction has declined, as one would expect.
I'm the POA to my parents who are now 90 & 94. If you haven't chosen a trusted family member to watch over your best interest, this is the time to do it while you are of sound mind and body. My parents selected me in their 80s. Now I handle everything for them. It's difficult to think about, but health, memory and ability to care for yourselves, your home and finances will become more and more difficult. You need someone who will be with you every step of the way. I have access to all their accounts and make all the transactions for them as they are no longer able to. Even though I live in the West coast and they live in the East coast.
It sounds like you may be needing more help sooner than later with you husbands limitations. Downsizing might be the logical next step. There is a 5 year look back with Medicare. So the question is where do you see you self in 5 years? In our situation, my parents lived in their own home, had their own car and other assets. My mother started to fall and injure herself often. It was clear that they could not keep up the house, the bills and my dad was taxed from caring for mom. So together we made the decision to sell all their assets and move to an independent living. It was a good first step. They were able to use the funds from the house and car to pay for it, while having transportation provided, maid service and meal prepared for them while dad cared for mom. As time went by mom needed more help and we got ancillary help to come in. Of course this can get expensive and when it was clear that dad was slowing down, I moved them into assisted living. We are now getting to the point where all their assets are spending down and Medicare is the next option. My point is, don't hold on to your assets if you think you are going to need the funds from them. Putting them in your daughter's name is not illegal but Medicare will know with their 5 yr look back. The funds might serve you better in finding a place that can give you the assistance you need now. Many expenses that come along with owning a home/car will be gone, your life will be simplified to allow you both to focus on your health and well being. Get your daughter involved and together you can make the best choices for you.
Best of luck.
Surprise no one suggested more life or long term care insurance.
In a spend down you can buy whatever you want so long as it is for the person who owns the money. Cannt give away or donate but the little bit.
Suggest you do all of above.
Surprized that plz dnr did not suggest a policy To "PAY" for LongTerm Care! ! Make sure your policy allows greatest flexability of longterm care.at home.
Paying into cost for healthcare is allowed spend down and is deductable from assets.
Heck If you can afford it pay out a longterm policy all but to cash value if any. Guidelines can be found online best place to obtain them from, dcf medicaid medicare soc sec.
Elder Affairs
Some policies will cover only three years worth of care, then what? Some age related illnesses, such as Alzheimer's/Dementia can last for over a decade.
plzdnr has summed it up. medicare is there as a safety net not to be used by those who could pay their own way.
Medicaid and Medicare are TWO DIFFERENT PROGRAMS. Medicare will not pay one red cent for nursing home or assisted living. It will pay for hospitalization for certain amount of time, and other things.
When you spend down, and have nothing, Medicaid will pay for some of your nursing home. (Doubtful about assisted living). They will take your social security check and pension, if any, and your house.
Two different things.
Medicare pays Dr bills and medicaid usually comes in with longterm care and medication supplies.
Medicare will have a nursinghome or hospital days cap.
If you know you are going to need help you dont have to wait till broke to apply. Fill out the financial eligibility form on line to see if eligible
Organize a spend down if this is needed.
Most long term care funded state programs have a date deadline Nov. and only review once a year for eligibility for longterm care.
So if it looks like ylu are going to need it apply for nursing home and homebased health longterm care for those at risk for repeated hospitalization and nursing home placement; And keep your paperwork.
Educate yourselves by visiting continuing care, assisted living, nursing homes, etc. Don't buy ANYthing.
Talk to your doctor as well. A hospital social worker will also know a lot.
Keep a notebook of what you learn and who told you and their phone number. Some church-related continuing care facilities will not kick you out when you run out of private pay funds. Some assisted living facilities WILL kick you out when you run out of money. Make sure you know which is which. Medicaid will be there for you when you run out of money, but they don't pay much. Nobody wants Medicaid patients.
MediCARE however, is better-paying and is available to pay for a nursing home for about 3 months after a qualifying hospital stay (usually has to be in-patient care for 3+ days and NOT just observation).
You have to go learn a lot right now and pretty quick. You can do it. Read through the legal/financial sections of this website to start with. Good luck.
Kind of you to plan ahead.