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Long-term Care and Medicaid planning

Long-term care and Medicaid planning is not something we necessarily want to think about; however, it is important not to stick our heads in the sand. Unfortunately, many people do not address it until they are faced with serious health problems or need nursing home placement immediately.

Long-term care requires significant funds – not to mention finding the right locations / companies / aids – all of which may come with wait times and regulations. So, once you near retirement age, it is critical that you plan for these outcomes as soon as possible. Doing so will not only save money and time but also will greatly reduce stress on yourself and your family – who may have to make decisions on your behalf. There is a 70% chance that a person 65 or older will need long term care! Those are extremely high odds.

Paying for long-term care

Qualified in-home, assisted living, and/or nursing home care is expensive. Without proper planning, you can still find yourself blowing through your entire life’s savings.

Just look at these numbers:

  • $9,000 per month – the median cost for a room in a nursing home in Georgia
  • $3,335 per month – median cost for assisted living (not including the initial down payment required by most facilities)
  • $20 per hour – the average hourly rate for in-home care in Georgia

Do some quick math, and you’ll see just how quickly those rates can pile up, especially considering the average stay is two to three years. If you should need Alzheimer’s care, monthly rates climb approximately 20-30 percent (an additional $575-$1,500/month) for assisted living memory care units.

Most people do not realize that Medicare does not pay for long term care. The good news is that Medicaid does help to cover these costs. In fact, approximately 72 percent of nursing home residents in Georgia use Medicaid to pay for their care, allowing you or your loved one to get the care they need. 

However, you should also know that people are commonly denied for Medicaid coverage because they have too much money or income. In fact, Medicaid does a five-year look back on your finances to determine eligibility, so do not gift money without consulting an Elder Law Attorney.  Waiting until the last minute to plan your long-term care needs could mean paying for expensive costs out of pocket – an outcome that would devour many of the assets you want to leave your loved ones.

How do I meet Medicaid standards?

You must meet the following Eligibility Criteria:

  • Single Individuals: Income less than $2,523 and assets less than $2,000
  • Married Individual: Income less than $2,523 and couple’s assets less than $139,400

If you do not meet these criteria, a qualified Elder Law Attorney can help you qualify without having to spend down. However, pre-planning is important. If you plan five years ahead of time, we can help you preserve 100% of your assets. If you wait until you need the care, we will work with you to preserve as many of your assets as possible. 

NOTE: It is very important that you do not transfer assets to someone in an effort to spend down on your own. This is because Medicaid looks back five years to spot this very transaction. The result is a self-pay penalty for a set period of time or penalty months. The penalty months are determined by dividing your gift amount by their penalty divisor, which is currently $9,034. For example, if you gifted $90,340 you would have to self-pay for 10 months.  

Who should I contact?

At Elder Law of Georgia, Attorney Eric Owens will help you craft a plan that lets you access long-term care while protecting your assets. Meanwhile, team member and nurse practitioner Tammy Owens can also evaluate you or your loved one’s options for receiving the best possible health care.

And when circumstances change, we will help you re-examine your plan and help you find health care that better meets your needs.

Our team is ready to provide you with the guidance you need for peace of mind throughout north Georgia. To get started, call Elder Law of Georgia, P.C., at 678-971-4971 or contact us to schedule your initial consultation with an experienced lawyer. Know that we often make home visits to those who cannot make it to our office in Gainesville.

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