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


Platinum Benefit Services, Inc.

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Posted on

Oct 05, 2021


Florida - Southwest

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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 Platinum Benefit Services, Inc. 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 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 Platinum Benefit Services, Inc. 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 Platinum Benefit Services, Inc. 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 Platinum Benefit Services, Inc. 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.

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Platinum Benefit Services, Inc.

Medicaid Processing , , ,

Platinum Benefit Services, Inc. is committed to helping families gain maximum government benefits for Long Term Care and providing both compassion and application expertise.  Since 1996, we have helped more than 10,000 families qualify for Medicaid while strategically protecting an estimated $1,000,000,000 in assets in conjunction with appropriate legal counsel.Platinum works diligently to process all types of long-term care applications with a specialization in complex nursing home applications for families who employ high end asset protection strategies. Platinum Benefit Services, Inc. are experts in the field of nursing home Medicaid application processing.