Practical, affordable solutions for making the heart of the home a safer, more accessible place for older adults.
Staying socially engaged leads to better health and longevity for older adults. Read this guest post for simple ways to use connect from near or far.
This guest post was submitted by Senior-Planning Services.
Qualifying for Medicaid for long-term care can feel like contending with a labyrinth of rules, exceptions to those rules, and exceptions to the exceptions. As if that were not challenging enough, Medicaid rules can also vary drastically from state to state, and as financial or living circumstances change.
Compounding the difficulty even further, those applying for Medicaid are typically under a great deal of stress and pressure as they cope with having to admit a loved one into a nursing home or assisted living facility.
The entire conceit of Medicaid is that it is a “need-based” program. This means that the Medicaid applicant must have insufficient assets to pay for their own care.
Therein lies the kernel of the problem: Since the test for whether an applicant qualifies for Medicaid benefits becomes one of evaluating their assets to see if they pass a certain financial threshold, it naturally follows that there will be a great many seniors who may fall just outside that limit disqualifying them from Medicaid.
Without guidance, these seniors on the Medicaid borderline get caught in the unenviable position of too rich to qualify, but not rich enough to afford quality care, in essence, punishing prosperity.
Medicaid Spend Down and Asset Management
Fortunately, there are concrete strategies for dealing with this issue. In general, the idea is to make the applicant eligible for benefits by bringing the assessment of their assets under the limit. This is called Medicaid “spend down.”
In a spend-down, the applicant is required to pay bills from their own funds until their funds are depleted, at which point Medicaid kicks in on the condition that other eligibility requirements are met. Here, the single smartest decision an applicant can make is to hire a Medicaid planner to assist in the procedure, because doing so counts towards the ‘spend down’ itself.
An applicant can essentially use the free money over the limit (that must be spent anyway) to get themselves approved in advance through a Medicaid planning company, while at the same time receiving professional help with the process itself. An all around win-win.
A professional can assist with the classification and management of assets to help ensure that the applicant qualifies for Medicaid while still retaining the most wealth possible.
Many are unaware that items such as personal possessions, a car, prepaid funeral expenses, Term life policies German Reparation Payments, and financial instruments like trusts set aside for the care of a disabled child, or irrevocable trusts created over 5 prior to the Medicaid request date, are NOT counted against the applicant.
Meanwhile, checking and savings accounts, assets like CDs, stocks, bonds, IRAs and mutual funds, revocable trusts, whole life insurance policies, private business and company equities, and even more, CAN all count against the applicant in qualifying for Medicaid. Click here for more FAQs.
Quite often, a senior Medicaid applicant has shared his/her life with a cherished loved one. Under complex Medicaid laws, this can affect a spouse’s ability to qualify for Medicaid, and can lead to--for example--questions about whether a spouse can keep a primary residence if the other spouse applies for Medicaid. Generally, they can.
However, in some cases the Medicaid applicant’s name must be removed from the deed. There can also be Medicaid liens and other penalties enforced against the estate, except in certain circumstances, such as in the case of a surviving spouse. These are examples of just some of the many pitfalls.
Then there is the need for providing financial statements over the last 5 years, the so-called “look-back” period. In the past, seniors would give away their money and property to qualify for Medicaid, and so the look-back requirement was created in answer to that practice.
This has placed an enormous burden on seniors, who now have to document their financial lives even beyond the scope of an average IRS audit! It also puts renewed focus on enlisting the help of financial planners who can help seniors strategically earmark funds for care earlier in life, so their loved ones are not burdened with the cost of their care years before Medicaid takes effect.
All of this sounds like a lot to tackle without help, and it is! As you can see, the complicated financial aspects of qualifying for Medicaid are often best handled by an expert. Through a combination of sound asset management and responsible long-term planning by a professional, the transition into Medicaid-sponsored care for seniors can be as smooth as it is reassuring.
Caregiving: Making Every Minute Count
by Cameron Von St. James, Mesothelioma Cancer Alliance
You can learn more about this month's guest blogger here: http://www.mesothelioma.com/blog/authors/cameron/bio.htm
Life is full of surprises -- some good, and some that we are not prepared for. My wife, Heather, and I had just celebrated the birth of our first and only child, Lily, in the summer of 2005. We couldn't wait to celebrate the upcoming holidays with our precious new addition. However, on November 21, 2005, our joy quickly turned to despair as we were blindsided by unexpected news. Heather had been diagnosed with cancer -- malignant pleural mesothelioma. In an instant, my role changed from a husband and father to the caregiver of a cancer patient.
The doctor implied that this was not going to be easy, and Heather would need care. He explained the course that mesothelioma would most likely take, and recommended seeing a specialist. There were three treatment options that he gave us: the local university hospital, a regional hospital with an excellent reputation, but without an established mesothelioma program, or commute to Boston to see a renowned specialist, Dr. David Sugarbaker. We were waiting for an answer from my wife as to which treatment she preferred, but still in shock, she could not answer.
She stared into space with disbelief on her face. Immediately, I told the doctor to set us up for Boston. All I could do then was pray that this doctor could save my wife.
Over the next two months, our previous daily routines were nonexistent. We both had full time jobs prior to her diagnosis, but due to traveling to appointments in Boston, I had to take care of Lily and only work part-time. Heather could not work at all, instead focusing on her health. The list of things to do was endless and overwhelming. I found myself secretly crying out in frustration. I feared what fighting this disease would cost; that my wife would die from this cancer and leave me a broke, homeless widower with a young daughter to raise. However, I realized that this was not about me, and I had to focus on seeing that Heather got the best I had to offer. I had to stay strong for her and not let her see my weakness.
We were offered help by our families, friends, and people we didn't even know, from phone calls, cards, and letters to financial assistance. As a caregiver, I learned not to be too proud to accept help when offered. I was worried about imposing on someone's time -- but if they didn't really mean it, they wouldn't have asked. We could never give enough thanks for the help we received. Even small things make a big difference, and most of all, it is reassurance that you are not alone.
Being a caregiver is not easy, no matter how you look at it. Besides the added responsibilities, the stress is unreal. You never know what will happen next, and you have to be prepared for it. You cannot walk away from it no matter how you feel. Anger and fear can take over and you will have bad days -- there’s no avoiding it. However, remember why and for whom you are doing this, and never give up hope. Caregiving is one of those life challenges in which the caregiver needs every outlet possible to remain sane.
Our lives finally leveled off after a few years of upheaval, and we had a somewhat normal schedule again. We managed to get Heather safely through surgery, radiation, and chemotherapy, and despite the typically poor prognosis for mesothelioma, she was able to beat this terrible disease. Thankfully, she has been cancer free for seven years.
Being a caregiver taught me many things about life. First, pride is replaced with humility in caregiving. This is about them, not you. Asking for help is not a sign of weakness, but of strength, because your loved one needs the best care possible, whether it's from you or someone else.
Never give up hope. Challenges may arise that you never would have imagined, but you can overcome them with hope.
Being a caregiver also taught me time management skills and how to deal with stress. Two years after Heather's diagnosis, I went back to school and earned a college degree.
During this difficult journey, I learned to never stop fighting for a loved one with a serious illness. My relationship with Heather and Lily has grown deeper, and I learned a lot about myself and my strengths and capabilities through the experience. Today, I look at my wife and daughter and I can’t believe how lucky I am. If you are a caregiver to a loved one, never give up hope, and always keep fighting, and you might find that you’re capable of more than you ever thought possible.
Thank you, Cameron, for sharing your story and for reminding caregivers that they're not alone. I know your words will encourage and inspire others who are in the midst of a caregiving experience.