Managing a Medicaid and Nursing Home Crisis

As of 2022, per the U.S. Department of Health & Human Services, the average annual cost of a semi-private room in a nursing home was estimated at around $82,000 ($6,833/month)  and $92,000 ($7,666/month) for a private room. These figures represent the national average.  The actual costs are dependent on location and the level of care required.  In Greater Dayton, Ohio region, the numbers not insignificantly higher. It is estimated that someone turning 65 today has a 70% chance of requiring long-term care at some point, whether at home or in a facility.

Many families find themselves forced to spend all of their loved one’s lifetime savings, and in some cases their own funds, to cover the ever-rising costs of a nursing facility. Without private long term care insurance, the only assistance families can obtain for help paying for long term care is Medicaid.  Medicaid is a federal program (implemented at the state level) which provides many kinds of benefits to those with limited income and/or assets.  The Medicaid that provides coverage for long term care is called Aged, Blind and Disabled Medicaid (“ABD Medicaid”).  ABD Medicaid assists with healthcare costs for people with limited resources (income and assets) and provides benefits not normally covered by Medicare, including nursing home care. The program has contributed to half of all nursing home stays.

A Medicaid Crisis refers to someone who is already living in a nursing home or who needs to enter a community within a short period of time and possesses too many assets to qualify for Medicaid eligibility immediately. Without Medicaid assistance, many families will find themselves scrambling to pay hefty nursing home bills until their loved one is “broke.”

Within months, people can lose their family homes and feel as if they are headed for financial ruin. Seeking the help of a Certified Elder Law Attorney (“CELA”) is critical when trying to navigate the muddy waters of Medicaid eligibility. A CELA can assist you with eligibility planning, applications and recertifications. Prior rejection does not mean you will be unable to obtain financial assistance now or in the future. A CELA can offer guidance and clarify any misinformation you may have heard along the way.  With proper planning, we are able to preserve one-half of an individual’s assets and in the circumstances of a married couple with one spouse needing Medicaid, ALL the assets can be preserved for the healthy spouse!

For seniors or their caretakers who find themselves in a Medicaid Crisis, devising a foolproof Medicaid planning strategy is the best way to ensure an application is approved. Timing is a very important part of the planning process. A CELA will take all aspects of the applicant’s personal and financial situation into consideration when determining when they should apply and whether additional steps are needed to ensure their application is accepted.

Don’t allow your legacy to be lost to nursing home costs. Implementing preventative measures and legal strategies now can ensure security for you and your loved ones in the future. Contact our office today to schedule a conversation with a Certified Elder Law Attorney here at HM Law. It’s never too late to protect assets. Let’s Talk!

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