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MEDICAID AND AFFORDING LONG-TERM CARE
Topics in this overview include:
INTRODUCTION
 | Long-term care planning for an older person or couple
raises a tangle of legal and emotional issues. When adult children or other
younger family members are also involved, conflicts of interest between the
generations may also arise. |
| Over and above intra-family concerns, there is also the
growing conflict between the family's planning goals and emerging public policy
on allocating primary responsibility for the costs of long-term care. The
family's goal usually is to have long-term care paid for by public funds to the maximum
extent allowable. Government policy, on the other hand, is to increasingly
restrict access to the publicly funded program -- Medicaid -- that pays for such
care but which is consuming a larger and larger portion of federal and state
budgets. |
| Recent amendments to federal and state Medicaid laws
make clear that current public policy is to have public funds be used as the
last resort in paying for long-term care, only after the individual's own assets
have been exhausted, and only to the extent that his or her monthly income cannot fully
pay for such care. |
| Long-term care planning thus involves trying to achieve
the older person’s goals within an arena of ever-changing rules. Medicaid
statutes and regulations tend to be extremely complex, prone to inconsistent
interpretations between the federal and state systems, and subject to continuous
change. Planning based on Medicaid rules thus needs to be periodically
reviewed and updated as necessary to keep current with changes in the law. Rules governing the transfer of assets have grown particularly
restrictive, and current federal and state budgetary problems suggest that
current planning opportunities in this area will be subject to further
curtailment. |
OVERVIEW OF OPTIONS FOR AFFORDING LONG-TERM CARE
| Medicaid
eligibility has
been the focus of most long-term care planning, but Medicaid is not the only
potential source of payment. Other possible sources include: |
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Medicare,
but it is of limited
benefit to an older person concerned with paying for long-term care in a nursing
facility, because it requires prior hospitalization and will only cover a
maximum of 100 days of skilled nursing care, which many older persons do not
need. (Even with those 100 days, only the first 20 will be fully covered by
Medicare; after day 20, there is a daily co-pay.) |
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Private Financing
from a practical
planning viewpoint, may be necessary for some period of time prior to applying
for Medicaid. |
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Long-Term Care (Nursing Home) Insurance
is
becoming an increasingly popular option for persons whose assets are substantial
enough to make it unlikely that they will ever become eligible for Medicaid, and
for those who fear the limited quality of care that Medicaid will
likely pay for in the future. |
Use The Following Links To
Navigate to the Topic of Your Choice
PLANNING FOR MEDICAID ELIGIBILITY
TRANSFER OF ASSETS AS AFFECTING LIABILITY
SPOUSAL
RESPONSIBILITY AND
ANTI-IMPOVERISHMENT RULES
LONG-TERM CARE PLANNING
STRATEGIES
MEDICAID ESTATE RECOVERY
PROGRAM
LONG-TERM CARE INSURANCE
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