Like most of your peers, you have likely gone your entire life without ever giving the need to qualify for Medicaid a second thought. After all, you probably had employer sponsored health insurance coverage throughout your working years and may now be depending primarily on Medicare to cover healthcare costs. Why then would you be concerned with qualifying for Medicaid? Moreover, why would you need a Medicaid attorney? The answers to those questions can be found in the likelihood that you, or a spouse, will be faced with the need to pay for the high cost of long-term care at some point in the future. Unless you can afford to cover long-term care costs out of pocket you will likely find yourself turning to Medicaid. That is why you need a Medicaid attorney — because qualifying for Medicaid can be a complex and confusing process.
The Need for Long-Term Care
You may not wish to dwell on the possibility; however, the reality is that the longer you live the better the odds are that you will eventually need long-term care. The same applies to your spouse. At age 65 you both stand about a 50-50 chance of eventually spending time in a long-term care facility. If you are still here at age 85 those odds jump to a 75 percent chance with an average length of stay of 2.5 years. Nationwide, the average cost of a year stay in a long-term care facility runs just over $80,000 as of 2016. While long-term care costs in North Carolina re slightly below the national average, you could still end up spending close to $200,000 over the course of a two and a half year stay in a nursing home.
Who Will Pay for Your Long-Term Care?
At this point you may be wondering why it matters how much long-term care costs — you have insurance after all right? It matters because most private health insurance policies do not cover long-term care costs unless you purchased a separate long-term care rider at a considerable additional cost. What about Medicare, you might be wondering. Unfortunately, Medicare only covers long-term care costs in very specific circumstances and then only for about three months. This is where Medicaid comes into the picture because Medicaid will cover the costs associated with long-term care. The “catch” is that you must first qualify for the benefits.
Medicaid Eligibility Guidelines
Medicaid is a federally funded (primarily) yet state administered healthcare program targeted at providing healthcare to low income individuals and families as well as to the disabled and elderly. Because it is administered by the individual states, both the eligibility criteria and the benefits offered by the program will vary somewhat. One universal problem for many seniors, however, is the asset, or “countable resources,” limit that can be exceeded. For an individual, most states set the limit as low as $2,000. Having work for decades, the average senior has more than $2,000 in “countable assets.” If your assets exceed the limit Medicaid will expect you to rely on those assets to cover your long-term care costs until your get your assets down below the program limit. Understandably, the thought of working hard for decades to put away a nice “nest egg” for your golden years and then losing all of it to long-term care costs probably doesn’t sit well with you. Making matters worse, you cannot transfer assets just before applying for Medicaid benefits either because the program uses a five year “look-back” period policy which allows them to review your finances for the five year period prior to applying for benefits. Any assets made during the five year period will likely be ignored and the value of the transfer added back into your estate for purposes of determining eligibility for Medicaid benefits.
How a Medicaid Attorney Can Help
Though it may not sound like it at this point, it is possible to protect your assets and qualify for Medicaid when you need it. The key is to work with a Medicaid attorney to incorporate Medicaid planning strategies into your estate plan. Medicaid planning uses legal tools and strategies aimed at reducing the value of your countable resources so that when the time comes to apply for Medicaid you will meet the eligibility criteria.
For additional information, please download your free copy of our “Set the Stage for Medicaid Eligibility” pamphlet. If you have additional questions or concerns regarding Medicaid planning, contact the experienced New Hampshire Medicaid attorneys at Debruyckere Law Offices by calling (603) 894-4141 or (978) 969-0331 to schedule an appointment.