Long Term Care Planning FAQ
Answers to Your Long-Term Care Planning Questions
Senior citizens have a different set of legal problems. For the public at large, elder law attorneys deal with these problems on a daily basis and can guide you through the complexities. The decisions which seniors make will impact their lives as well as the lives of their loved ones. Hiring an elder law attorney will enhance your ability to make the correct decisions allowing you or your loved one to age with security and dignity.
There are three possible ways to pay for nursing home care. These are long term care insurance, Medicaid and private pay, i.e. your own assets.
You do not have to spend all of your assets before you qualify for Medicaid. While technically as a single person you have to "spend down" to $8,000 or $2,400 (depending upon your monthly income) before you are eligible for Medicaid, advanced planning, through the aid of an attorney who is knowledgeable in this area, can help you avoid spending all of your hard earned assets on the cost of a nursing home. The law is more flexible for married couples and it is possible that with proper planning you may be able to retain the majority of your assets.
Are there any assets that I can keep in addition to the $2400 and what can I save through advanced planning with the aid of a competent elder law attorney?
There are assets that you can keep. These include your principal residence, a small amount of life insurance, items of tangible personal property such as personal effects and household furnishings and equipment, one automobile, property used in a trade or business, prepaid funeral arrangements and burial reserves.
Medicare will only pay for a maximum of 100 days in a skilled nursing facility and only the first 20 days are covered in full. Medicaid on the other hand will pay the entire cost of long-term custodial care in a nursing home if the person qualifies.
When you go into a nursing home you can give assets to your spouse and still qualify. The law permits a spouse to keep up to a current maximum of $104,400 in assets. In fact, the present state of the law will also permit even a greater amount under certain circumstances. Proper guidance from a qualified elder law attorney will help you get all you are entitled to.
If I still own my house at the time of my death and my house is sold after I die, won't the Pennsylvania Department of Welfare have a lien on it in the amount of medical assistance (Medicaid) paid for my long term nursing care?
Yes. However, there are advanced legal techniques such as the creation of life estates that will permit you to keep your home until you die and avoid the imposition of a Medicaid lien when your heirs go to sell your home. Again the advice of a competent elder law attorney is essential.
Estate planning is extremely important. Simply put, without a properly written will or trust there is no guarantee that the people who you want to receive your property after you die will in fact receive it. Wills and trusts are legal documents and should always be prepared with the advice of an attorney, preferably one who is knowledgeable in this area of the law.
In most situations your agent (the person or persons to whom you grant the power to act on your behalf) should have expansive powers to properly handle your particular financial matters. One such power may be to permit your agent to make gifts in excess of the annual exclusion amount of $12,000. This is especially important in those limited situations where gifting becomes part of an overall planning strategy to achieve eligibility for Medicaid.
By all means, you should have a durable health care power of attorney and a living will. Wills, trusts and durable property powers of attorney generally address only financial concerns. A health care power of attorney authorizes another individual to make medical/health care decisions on your behalf when you are unable to make those decisions yourself. A living will generally sets forth your choices as to end of life care and treatment.
Estate administration can be explained as follows. When individuals die it is still necessary to pay their bills and distribute their property according to their written intentions (usually a will or trust). The process of doing these things, along with paying taxes where applicable, is what is known as an estate administration. Any person authorized to handle a decedent's financial affairs (i.e., an executor/executrix or an administrator/administratrix) should obtain the services of a lawyer who routinely handles these matters.