Avoiding Spend Down Requirements to Pay for Skilled Nursing / Nursing Homes

Author

Long Term Care Solutions

Posted on

Oct 05, 2021

Book/Edition

Florida - Southwest

Share This
For More Information on the Author, Hilary Hayes of Long Term Care Solutions, CLICK HERE!

DONT LOSE YOUR LIFE SAVINGS to the High Cost of Nursing Home Care
If you're looking for long-term care in a skilled nursing facility for a loved one, its important that you familiarize yourself with the rules of Medicaid .It is a government-funded health insurance program and perhaps one of the largest sources for nursing facility long-term care payment.
Understanding Medicaid eligibility can be mind-boggling. Adding to that, so much misinformation and wrong advice can be given by many different professionals - not intentionally but because the rules change so frequently. Medicaid eligibility is very specific depending on the state in which your'e applying for benefits. Additionally, the eligibility is different if the applicant is a single person (widow or widower) or has a spouse living in the community. There is much to consider with Medicaid qualification such as, which assets are considered countable and which assets are considered exempt. Gifting and transfer rules, income diversion to the community spouse, how IRAs are treated in the eyes of Medicaid, allowable asset limits, life insurance cash values, the Homesteaded property, additional properties, and much more all factor into the equation. This article will focus on spend down strategies and help guide and answer many of your questions.
You can employ a strategy known as Medicaid spend-down to manage expenses. This typically involves giving away or spending your assets to meet the financial requirements of Medicaid. Medicaid has strict rules for asset transfer. But keep in mind...this is NOT the only option!
If your loved one, spouse, or parent is currently in need of a nursing home or requires a skilled nursing facility for their healthcare, and you don't want them to spend down their hard-earned assets to qualify for Medicaid, is there any solution or alternative? Yes there is!
The Department of children and family services (DCF) have their own legal team reviewing all documents, whether it be trusts, contracts, employment agreements, promissory notes, power of attorney etc. Their main goal is to look for any way possible to deny the Medicaid application. This is where working with a seasoned experienced company like Long Term Care Solutions, LLC can assist with all aspects of coordination with elder law attorneys to prepare the appropriate legal documents and submit income and asset information to DCF for Medicaid approval. The guidelines and rules change frequently with Medicaid eligibility so you will want to work with a company who focuses on Medicaid application/audits every day.
Why Understanding Medicaid Qualification is Important
Did you know that more than 70 percent of elderly people over 65 require some type of assisted or long-term care (LTC)?
The recent surveys from the US Department of Health & Human Services show that 7 out of 10 people will need extended care before they die. Currently, the risk is increasing with an average span of three years with spiking care cost that ranges from $8,000 - $15,000+ MONTHLY!
For example, if a fall at home results in a trip to the hospital and then to a rehab or skilled nursing facility, it's often MediCARE (NOT mediCAID) that pays that bill. Medicare is a national health insurance program and primarily provides health insurance for Americans aged 65 and older, but also for some younger people with disability status. It is worth mentioning that MediCARE does NOT pay for long-term care. Medicare does cover up to 100 days of skilled nursing benefit, but beware this is not a guarantee and often is cancelled with little notice in as few as 20 days! Once that happens, "private pay" is the means of payment for the $10K-$12K/month in a skilled nursing facility.
MediCAID, however, is one of the primary payers for rehab or nursing homes with limited coverage for assisted living. That said, it is difficult to qualify for this benefit. That is why many families use the following means to pay for skilled nursing facilities or assisted living costs.

Long-Term Care Insurance-Care insurance is a financial product that protects people against care costs associated with a nursing facility.
Personal Residence-It is based on selling or renting a personal residence or requesting equity loans and reverse mortgages.
Savings and Income -It includes retirement accounts, savings, gifts from friends or family, pensions, or social security.


Life Insurance -Some hybrid Life Insurance policies allow a pre death benefit to pay for long-term care.
Senior Care Bridge Loans -The program offers short-term cost care. You can benefit from it until you get the qualified funds.
Veterans Pension -Aid and Attendance and Housebound Benefits-Veterans who served on active duty for at least 90 consecutive days, including at least one full day during a time of war, may be eligible for additional income through Aid and Attendance if they also qualify for the basic Veterans Pension and meet the clinical and financial requirements.


Note that there is a large percentage of elderly people who look for help to pay for their Long Term Care (LTC). Most of them think that they are ineligible to qualify for Medicaid assistance programs as they have sufficient income sources or assets; they feel they cant get financial assistance for any long-term care program.
The misunderstanding surrounding eligibility requirements for long term care stems from false information available on the internet or myths that have been established over the years. This is where working with a Medicaid Professional can help you to gain access to the programs that don;t require you to spend down your valuable assets to pay for skilled nursing.
DIY - Do it Yourself Approach
You can file for Medicaid yourself or for a family member, if you are under thein come AND asset limits set by Medicaid for each state. If you are based in Florida, for the counties Charlotte, Collier, DeSoto, Glades, Hendry, Lee, or Sarasota, it's recommended to reach out to Area Agency on Ageing for Southwest Florida. AAASWFL is also the states designated Aging and Disability Resource Center for Southwest Florida. They will direct you to apply for the waitlist for Medicaid benefits that can be used in community or in facilities. The current waitlist can be 2-3 years and depends on need.
That said, if your income or your assets are over the limit (even by $1),the best approach ist o seek the assistance of a professional Certified Medicaid Professional(CMP) such as Long Term Care Solution LLC, out of Clearwater, FL. There are many allowable Medicaid planning strategies that protect all kinds of assets. Once assets are reviewed and properly dealt with, many individuals may qualify for Medicaid without selling or losing any of their assets! This is where a seasoned Medicaid filing company such as Long Term Care Solutions LLC can review income and asset values to properly assess their treatment before moving forward to apply for Medicaid benefits.
Keep reading to find out how working with a Medicaid filer can help you avoid spend-down requirements to pay for skilled nursing. Generally they are the cost of an elder care attorney, charge a flat fee, and specialize in Medicaid approvals.
Save Your Valuable Assets from Financial Spend Down Requirements!
It is misleading or false information that prevents many elderly people from getting access to programs that can assist them in long-term care costs. That means you need to have accurate information to qualify for Medicaid programs without losing a lifetime of hard earned earnings. The team at Long Term Care Solutions, LLC can provide this valuable service.
Keep in mind that when you have access to Medicaid programs that help you pay for your nursing facility or care costs, you will be able to secure your financial assets, such as family property. There is no need to sell or spend down your precious assets with the right assistance. As a result, you can avoid liquidation of the valuables you have worked hard to obtain.
Role of a Medicaid Professional to Save Your Valuable Asset
The complexity attributed to gaining access to the Medicaid programs for long term care occurs when your assets or income are above the allowable Medicaid limits. The use of contracts and trusts are a common practice with Medicaid qualifications.
There is no denying that your Medicaid eligibility is complicated, and you need to keep the process impeccable to prevent even the small mistakes that may deny your healthcare benefits. And denial of medical benefit is probably the last thing you want your spouse, family, or loved one to face.
This is when the role of knowledgeable Medicaid filing specialists comes into play to ensure your qualification for the right Medicaid program. A professional, in this regard, specializes in providing LTC solutions to assist filing a comprehensive application that ensures qualification for the program that suits your financial needs the best.
Why Leveraging Professional Assistance is Highly Recommended
A professional has current knowledge of Medicaid programs and the acceptable exemptions. They are well aware of the fact that long-term rehab or skilled nursing may have uncertain costs. Therefore, they ensure that you consider all your options to get the desired outcomes.
Consulting a qualified Medicaid professional enables you to explore legitimate means that can preserve your income, valuables, and assets. The application process, without a doubt, is time-consuming and daunting. However, if you dont want your loved one to go through unnecessary hassle and stress, working with a certified Medicaid professional is essential to obtaining the desired Medicaid benefits.
However, if you think your loved one will not get quality care in the nursing home due to payor source, you're mistaken. Regardless of the nursing home you choose for your loved one; it is against the law to discriminate care based on payer source. That means if your elderly family member receives assisted living or nursing home care under Medicare, or Medicaid, he or she will get the same assistance as others paying privately.
Summing Up
All in all, if you have countable income that exceeds the limit of$2,382 monthly (for the state of Florida and at the time the article was written), OR if your countable assets are over the allowable limit, Medicaid can deny your eligibility application, if you have not taken action before applying.
Working with a Medicaid Professional, can help you file a thorough, impeccable, and successful application to qualify for a Medicaid program that excludes the need to sell or spend down your valuables.
Thus, if you want to ensure that your spouse or loved one lives a happy and healthy life, and does not deplete their entire savings, you will need to seek along-term care cost solution through a Professional Medicaid Specialist and secure their financial resources.
Next Steps

Schedule FREE Consultation with Long Term Care Solutions LLC, by calling 727-240-0750anbe sure to ask for Hilary Hayes or Click Here(http://longtermcaresolutionsllc.com/consultation/)
Update Advanced Directives by downloading here:http://longtermcaresolutionsllc.com/advancedirectives/
Read up on Q&A on Medicaid Filing by downloading here:http://longtermcaresolutionsllc.com/wp-content/uploads/booklet.pdf



Article written by
Hilary Hayes,
Regional Director Southwest Florida
Long Term Care Solutions, LLC
HQ: 1421 Court Street Unit F Clearwater, FL 33756
HILARY@LTCSLLC.COM

To schedule a FREE Consultation
727-240-0750 or 1-844-252-1336

Hilary Hayes is Regional Director Southwest Florida of Long Term Care Solutions, LLC, (LTCS LLC) covering Venice, FL to Marco, FL and beyond. Her role keeps her connected to Senior Care Workers in Skilled Nursing Facilities, Assisted Living Facilities, Hospice, Hospitals, Senior groups, & Adult Protective Services to best educate those that serve our seniors to advocate for their financial options.

LTCS, LLC is a Medicaid Filing company assisting families throughout the state of Florida to qualify their loved one to receive nursing home or assisted living facility Medicaid benefits. The company has filed over 10,000 applications and works closely with the families and nursing facilities for complete service and communication until the Medicaid application is approved. We have been assisting families with asset preservation and Medicaid qualifications for over 25 years. The company founder Charlotte Yensen, and the Elder Law Attorneys she works with, provide a free consultation with families to discuss the asset preservation strategies needed for the Medicaid approval.

Charlotte Kay Yensen is an industry leader on Medicaid qualifications and speaks regularly at nursing facilities, assisted living facilities, hospice, senior groups, Adult Protective Services, managed care companies, the Ombudsman Program and the Department of Children and Family Services. She would be glad to speak to you or your group to discuss the many guidelines of Medicaid qualifications. Charlotte has written a 22 page, very handy Medicaid qualification booklet to answer and address many questions and concerns pertaining to Medicaid benefits. Please visithttp://www.longtermcaresolutionsllc.comto view and print this informative booklet.

Other Articles You May Like

Estate Planning within Blended Families

Blended families are when people get remarried, but have children from a previous marriage. This can be a little trickier for estate planning, but nonetheless, very possible! This has become an increasingly common arrangement.The biggest concern is ensuring assets are divided accordingly. In the event a Will is left solely to your new spouse, will your children be a factor in the surviving spouses own estate planning documents or beneficiaries of accounts you left for your surviving spouse? Do not worry, there are systems in place for this occurrence.One way to ensure your children will still receive an inheritance from you is a trust. A Trust is established to hold your assets and will state how you want the assets to be distributed. An example, your spouse can receive some assets outright, and an income from other assets. Then when your spouse passes away, your children will receive the assets that your spouse was just receiving income. Just be sure to voice your concerns to your attorney to ensure that your wishes are honored even after your death.Another example: if you have your new spouse as a beneficiary on your retirement accounts, such as an IRA or 401K. You may have your children listed as your contingent beneficiaries. If you are survived by your spouse, the spouse will now own that retirement account. The contingent beneficiaries are no longer a part of the plan. Your spouse needs to update the beneficiaries, and may not include your children as the primary beneficiaries to the account. Again, these are issues to discuss with your attorney and prepare a plan that will give your spouse the income from the retirement account, but the remainder to your children upon the death of your spouse.While blended families can seem more complex, it is very important to plan ahead. Even if families are all getting along now, unfortunately, relationships can change after someone passes away. Your new spouse also will have similar concerns to make sure his or her children, or other family members are not forgotten. Just be sure to sit down with your new spouse and any family members you wish to involve and discuss your wishes in the event of your passing. At the end of the day these decisions are yours to make, whether that coincides with the wishes of all parties involved, or not. Contact us to get started with your estate plan.

Will Long-Term Care Insurance Cover Assisted Living?

Will Long-Term Care Insurance Cover Assisted Living?March 24, 2023Will long-term care insurance cover assisted living? Yes. A good long-term care policy will help pay for assisted living and include coverages in other settings. But the real question is whether or not you currently have a long-term care policy.Most seniors do not. And by the time you need one, you might not qualify due to age or pre-existing conditions.More than 70% of American seniors over 65 will likely need long-term care at some point. But only 10% of Americans have any long-term care coverage.Without long-term care insurance, you or your family will most likely pay for your long-term care costs from savings, retirement accounts, equity loans against your house, or other private sources.And depending on if you decide to age in place at home or choose an assisted living community, these costs are challenging for most families. Using Sarasota, Florida as an example, according to Genworth Financial, the 2023 monthly costs average about $6,700 for Home Health services, $4,570 for assisted living, and $10,500 for a semi-private room at a nursing home.What is Long-Term Care Insurance?Long-term care insurance provides many services not covered by regular health insurance. Every policy is different and has specific coverage. But most long-term care policies include assistance with routine daily activities, like dressing, bathing, or getting in and out of bed.Where Does Long-Term Care Apply?Long-term care insurance helps seniors pay for the services and support they need as they age. And long-term care is for more than just assisted living communities. These policies often cover long-term care provided at:Your homeAn assisted living residenceA nursing homeAn adult day care centerWhat Is Covered Under Long-Term Care Insurance?Long-term care policies help with areas often ignored by other health insurance policies. A long-term care policy can help cover the costs of chronic medical conditions, a disability, or a condition like Alzheimer's. This includes:Assistance with your activities of daily living (ADLs)Certain homemaker services that are in conjunction with personal careSkilled nursing carePhysical, speech, and rehabilitation therapyRespite CareWhat Is Not Covered Under Long-Term Care Insurance?Like most insurance policies, long-term care policies have limitations and exclusions. It is essential to read and understand the policy to know what is covered and what is not.Many long-term care policies do not cover:Pre-existing conditions for a certain period of time. Understanding this clause is crucial. A pre-existing condition is typically defined as receiving medical advice or treatment or having symptoms within a certain period before applying for the policy. Some companies look further back than others, and some do not have restrictions for pre-existing conditions at all.Self-Inflicted InjuriesCertain nervous disorders or mental conditionsDrug and alcohol abuseWhy buy long-term care insurance?The reason to buy long-term care insurance is the same reason you purchase other insurance, like car, home, and health insurance: peace of mind. You pay a little each year or month, so you don't have to worry about paying a large amount of money should the unexpected happen.But long-term care is different, because needing it is expected and a normal part of aging in the US. More than 70% of the population will need long-term care help not covered by regular health insurance.Suppose you are fortunate enough to be wealthy and can easily cover all long-term care expenses out of pocket. In that case, long-term care insurance may not be for you. But for most Americans, long-term care insurance can be a valuable part of their financial planning.Do Medicare and Medicaid Cover Long-Term Care?Long-term care insurance policies are specifically designed to help with most long-term care costs.  Medicare does not pay for long-term care. Medicaid is a state-run program designed for those whose assets and income are under the states low threshold. Even then, the program is complex, the benefits are limited and minimal, and the waitlist can take years. Medicare Does Not Pay for Long-Term CareMedicare is of little help with long-term care costs. The Medicare website is pretty blunt about this subject, stating, "Medicare and most health insurance, including Medicare Supplement Insurance (Medigap), don't pay for long-term care." The site goes on to explain it is important to plan for long-term care to maintain your independence and get the care you need in the future.Medicare does pay for limited stays in rehabilitation facilities, like in-patient physical therapy for a hip replacement. But, the limit is 100 days. And suppose after that you must move to assisted living or a nursing home. In that case, Medicare does not cover your custodial costs.Medicaid Is Very Limited and Can Take YearsFor seniors over 65, Florida Medicaid is a minimal program. You must require nursing-facility-level care, and your assets must be below Florida's low threshold. The program was designed to help the frail and neediest first, and you can be on the waitlist for years. Medicaid recipients typically have a low income and have exhausted most of their savings. Because of the complexity, uncertainty, and length of time required to access any benefits, expecting Medicaid to help with long-term care needs may not be the best option.When Should You Buy Long-Term Care Insurance?The time to buy long-term insurance is before you need it. And the premiums are less when you are younger. Typically, most long-term care insurance buyers are between 50 and 65. It is becoming challenging to buy long-term care coverage over 70 due to health conditions, insurance company policies, expensive premiums, and pre-existing conditions.And even if you are age-qualified, the insurance company might reject your application if any of the following are true:You currently need help with daily activities (ADLs).You are already receiving long-term care.You have been diagnosed with dementia or another cognitive impairment.You have a progressing neurological condition like Parkinson's or ALS.You have had a stroke.You have specific cancer diagnoses. However, a diagnosis of cancer does not automatically get you declined. It depends on the type of cancer, how long ago you were diagnosed, and the individual insurance companies' underwriting guidelines.The best advice is to buy long-term care insurance before you need it and while you are younger and healthy.Summary: Should You Get Long-Term Care Insurance?Everyone ages and almost everyone will need help with senior care expenses, whether they age in place at home or choose an assisted living community.But paying for that care can be overwhelming and severely impact a family's budget and savings. Many families are forced into difficult financial challenges with an additional and unexpected $5,000 to $10,000 monthly expense for care.Long-term care insurance can help you plan for the future and give you and your family peace of mind.Whether your senior loved one is deciding to age at home or considering an assisted living community, Florida Senior Consulting can help.And if they don't have long-term care insurance, we can help you navigate all the other options.We are a Florida-based company with expert knowledge of the Florida senior market. While senior options can seem confusing, this is all we do. Florida Senior Consulting helps seniors decide their next best steps and the easiest way to afford the transition.We have certified staff, licensed nurse advocates, and decades of experience in the field.Senior living should be on your terms, and the choice should always be yours.Call us, and we will answer all your questions and help you decide what is best for you or your senior loved one.For peace of mind, call us at (800) 969-7176 or visit FloridaSeniorConsulting.com.

Five Tips for Starting Retirement Planning in Your 50s

When it comes to retirement planning, many Americans find themselves underprepared. A majority of baby boomers (born between 1946 and 1964) and Generation Xers (born between 1965 and 1978) often end up without retirement savings or dont have realistic expectations about post-retirement costs. According to the Insured Retirement Institute, only 25 percent of boomers are confident of having sufficient savings in retirement. If you're in your 50s and nearing retirement without substantial savings or a plan, dont despair -- it's never too late to start planning.Although every working professional should contribute towards retirement from their early days, for various reasons they often delay the process. If you're nearing your 50s without a post-retirement plan and see yourself working for another 10 to 15 years, this is an opportunity to plan judiciously and save for your retirement right away.Here are five strategic steps for achieving the best retirement plan:1. Set Specific and Practical GoalsProper retirement planning begins with setting specific goals. Calculate your current income, total savings, and ongoing investments to understand how much you could save, and be sure to set realistic goals.While providing for emergency expenses and paying off a mortgage can be your short-term and intermediate goals, saving up for retirement should be your long-term goal. An annual financial review is helpful in evaluating your past goals and understanding your earnings as well as liabilities.2. Plan a Realistic Budget Focusing on RetirementReview your monthly and yearly expenses and list the factors that are likely to remain constant for the next few years. Now allocate funds to each category in a way that will allow you to save more for your retirement.According to financial experts, if you're saving for retirement after 50, it's best to contribute 30 percent of your salary towards this end. If you find that goal difficult to meet, look at your budget list and reduce optional expenses.3. Pay Off DebtsPaying off debts early will help you meet your retirement budgets and ease the financial burden. According to an AARP report, 44 percent of Americans continue to pay for their home after they retire.Clearing off outstanding debts, credit card bills, loans, and mortgages will make it much easier to prioritize retirement funds.4. Invest in Retirement Plans401(k)s, 403(b)s and IRAs are some of the retirement plans available in the U.S.  While 401(k)s are one of the most popular plans, not all companies offer them and those that do have their own, often restrictive, investment rules. Then there are two types of IRAs: traditional and Roth IRAs.To make the best choice among the many retirement plan options, it's essential to have a thorough understanding of IRA vs. 401 (k), Roth IRA vs 401(k) and other investment alternatives, as well as  contribution limits.5. Diversify Your InvestmentsInvestment diversification will help keep you on a firm financial footing. Don't stash all your money in banks; instead, create an investment portfolio and explore your options.It's important to diversify and distribute your money among multiple sectors. Considering the volatility of markets, diversification of your investment portfolio safeguards your capital and helps it grow.Its Time to Step Up a GearA concrete retirement plan with emphasis on savings is essential to ensure a comfortable and healthy post-retirement life. Saving for your retirement is the first priority and the sooner you start, the better your chances of achieving your retirement goals.