When preparing for a loved one to enter a skilled nursing facility, there are likely many concerns you and your family have. One of the most stressful is the cost. Many facilities cost upwards of $10,000 a month, leaving you to wonder: will Medicare and/or Medicaid cover that? You need Medicare and Medicaid planning to find out.
Long-term care planning can be stressful, which is why you and your family must meet with a skilled elder law attorney who focuses on Medicare and Medicaid planning. The Scranton elder law attorneys of Mazzoni Valvano Szewczyk & Karam understand how confusing and simply time-consuming this process can be. We will work with you to ensure the needs of your loved one are met and protect their assets into the future so they’re always provided for.
Many of us aren’t sure what the difference is between Medicare and Medicaid until we have to use them. But understanding what each does, and does not do, is critical to your long-term care planning.
Medicare is the federal health insurance program for:
What you need Medicare for will determine the plans you select. For example:
However, the misconception is that Medicare covers it all. In reality, Medicare only covers a portion of many elder care expenses, leaving many Pennsylvania residents dependent on Medicaid for extensive stays in nursing facilities or services.
Medicaid is a federal and state funding health insurance program that covers:
Often, when Medicare doesn’t cover a cost, elderly adults will look to their Medicaid coverage to see what options exist for them. However, this is complicated, as there are numerous deadlines, eligibility requirements, and hoops you must be aware of.
Though many older Americans depend on Medicare coverage for their healthcare needs, it doesn’t cover everything. The reality is, Medicare only covers a very minimal amount of coverage for patients in nursing homes.
In addition, very few elderly Pennsylvanias have long-term care insurance to cover the costs Medicare won’t. In these cases, you or your family are left paying for the care yourself until your assets have been used and you can apply for Medicaid.
To be eligible for Medicaid, you cannot have financial resources of more than $2,400. This includes cash, stocks and bonds, bank accounts, IRA, and real estate.
Also, you may impact your eligibility if you transfer any assets to family or friends within five years of applying for Medicaid. But dwindling your assets can be risky. What do you have?
Just because the eligibility requirements may make it seem that you have to have no assets and zero income, it doesn’t mean there are no ways to protect yourself from financial ruin.
One way to protect your estate from the financial ruin of Medicaid eligibility is through an asset protection trust. Trusts can also be part of that five-year lookback period for Medicaid eligibility. When done correctly, an asset protection trust in the form of a Medicaid Trust (Income Only Trust) can avoid it.
A Medicaid trust is an irrevocable trust that holds assets in place in case the individual needs skilled nursing care in the future. The restrictions built into a Medicaid trust work to prevent assets from disqualifying the individual from medical assistance.
Be mindful, not every attorney is knowledgeable in elder law and the intricacies of Medicaid asset protection. This is why you need a skilled elder law attorney to guide you through the Medicare and Medicaid process.
When a loved one needs skilled nursing care, your first concern is likely how it will get paid for. If you are in need of an elder law attorney, don’t delay. Call (570) 348-0776 and schedule an appointment with Mazzoni Valvano Szewczyk & Karam. We can walk you through the Medicare and Medicaid process, help you create asset protection plans, and get your loved ones the care they need.
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