How do you cover nursing home bills, which can run from $7500 to $9000 a month in Michigan, and average about $8200?
If you are old enough, or younger and on disability, there is a good chance Medicare will help–but Medicare typically only covers 100 days if you require skilled nursing or rehab–and afterwards people need to find other ways to cover the bill. In addition, Medicare seldom if ever pays for what is called custodial nursing care.
Privately paying by using your monthly income and dipping into saving is a typical approach. But even some who think they have salted away enough for retirement realize they might quickly deplete their savings. And while a few folks have good long term care policies in place, most experts say the percentage of folks with such coverage is low–very low–perhaps five per cent or less of us.
This means that many middle class individuals and lower income individuals will turn to Medicaid to help pay a part of the nursing home bill. Medicaid is a program that comes together through Federal and State resources, and it can help pay for a number of medical services, including nursing home services (and nursing home type services arranged so that a person can stay in their own home). Medicaid can also pay for simpler custodial care nursing home services–a level of service that is not covered by Medicare.
Medicaid however is a means tested program, and to qualify, not only must you have medical needs, but you must qualify by way of income and assets. (Medicare really is provided regardless of our resources. But not so Medicaid.) Medicaid rules and regulations change from time to time, and some of the allowable resources or assets one may keep, and still qualify, are adjusted for inflation. As a practical matter, most of the planning to become eligible for Medicaid assistance is done for a married couple, where only one of them needs nursing home care. We work to make sure the community spouse doesn’t go broke while still providing proper care for the spouse who needs nursing home care. That said, even single persons may have some chance to qualify before becoming dead broke.
We help families review their entire situation, and working within the constraints of the program, analyze their assets and income, separate out the exempt assets (assets that won’t “count against” a person becoming eligible for assistance) and then work to speed their eligibility if they might seem to be over assets or if they may have given away assets within the 5 years before application. Another matter we look into is income–while typically a person getting nursing home type Medicaid must turn over their income first, to the nursing home, and Medicaid picks up the deficiency, there might be a chance to give some of the income to the community spouse instead. We also work to preserve their homestead as allowed by the program, if they desire, and we also see if other program regulations might work in their favor.
It can get complicated, as you might guess. particularly when there are even more wrinkles in the program that allow other opportunities to help others in the family.
But our firm, like other elder law attorneys, have developed some tools we can apply depending on the individual situation–and since thousands of dollars might be at stake, it might be worth exploring this with us. Pre-planning and Medicaid crisis planning both crop up.
These following terms may not be familiar to you, but they cover some of the asset or income limitations or easy protections allowed under Medicaid. Remember, these figures do change, but as of July 1, 2017, for Michigan’s Medicaid program, we work with the following numbers:
Monthly Divestment Penalty Divisor: $8,018.00
Individual Resource Allowance: $2,000.00
Minimum Community Spouse Resource Allowance: $24,180.00
Maximum Community Spouse Resource Allowance: $120,900.00
Minimum Monthly Income Allowance (spouse at home): $2,030.00
Maximum Monthly Income Allowance ” $3,023.00
Personal Needs Allowance per Month: $60.00