Medicaid regulations

2020 Medicaid Regulations

Have you done planning to deal with the high costs of any future nursing home care? If not, you need to discover how an Elder Care lawyer can help you protect yourself and your interests by understanding current Medicaid regulations. We often hear about how important it is that we prepare for the future. Whether it is business planning, legacy planning, or retirement plans, professionals continually remind us that it is vital to be prepared for uncertainty. With more than half of us expected to one day require long-term care in a nursing home or other care facility, financial planning to assist with those care costs is more of a necessity than ever before. Fortunately, our legal team can help you to prepare for that possibility.

Recognizing the High Cost of Nursing Home Care

Though it doesn’t always receive the media coverage that it deserves, nursing home costs are something about which every American should be concerned. Almost everyone knows someone who is either receiving nursing home care or will require such care in the future. Costs have been exploding for many years, and now average more than $200 a day across the United States and more than $300 a day in Florida. And while those costs have some justification, the fact remains that few seniors have an extra $9000 to $12,000 a month in income that can be used to pay for care. Recent estimates suggest that half of the country’s adults don’t even have $10,000 in retirement savings.

Medicaid Regulations and Long-Term Care Coverage

The Medicaid program provides long-term care coverage for those who need help meeting the high cost of nursing home care. Since its creation, Medicaid regulations have expanded coverage to the point where it now serves as the single most important payment source for the country’s nursing homes. Without it, millions of American seniors would be unable to afford the cost of care and would find themselves struggling to cope with their health care and daily living needs.

Why is There a Need for Medicaid Planning?

Now, some might wonder why there would be any need for planning if Medicaid can cover those costs. After all, the program was designed to help low-income Americans get health care coverage, right? The problem is that the Medicaid program’s eligibility standards include limits on both assets and income-and many seniors often struggle to meet those limits. If a senior has “too much income” for the Florida Medicaid rules he still may be far short of having so much income that he could afford the monthly costs of a nursing home. These seniors can deal with the income limits by contacting an attorney to set up a Qualified Income Trust. The trust will apply excess monthly income to the nursing home in a way that enables an applicant to meet the eligibility standards. Both for preparing and understanding the Qualified Income Trust, the senior will need a lawyer.


Are there Alternatives to Medicaid Planning?

There is, of course, no requirement to plan for nursing home costs. We are all free to ignore the need for planning and simply wait until we know that we need that care. It is important to remember, however, that waiting for the need to manifest in that way can leave us with fewer options when it comes to securing the benefits we need. Emergency planning options do exist, but they will result in fewer assets protected and can even leave some seniors with almost no legacy to leave behind for their spouse and children.

What Happens if You Don’t have a Medicaid Plan?

For instance, seniors who have failed to plan for Medicaid eligibility are often forced to spend down assets in ways that might prevent them from following through on their inheritance planning. They may need to spend money on home upgrades or a new car just to divest themselves of wealth, rather than passing that wealth on to their heirs. Others can even make the mistake of trying to shield assets by transferring them into a loved one’s name-something that can trigger an ineligibility penalty under the program’s five-year look-back period. The exact penalty is determined by the total amount of those “shielded” assets and the average costs of nursing home care cost in the area.

The best way to avoid those consequences is to start early with your Medicaid planning. Our Elder Law attorneys can help you to prepare a strategy that will ensure that your assets are properly organized in a way that facilitates your eligibility for the program benefits you may one day need. Using effective strategies and tools like irrevocable trusts (also subject to the five-year lookback), you can safeguard assets from creditors, certain tax liabilities, and the high costs of nursing home care. More importantly, you can protect those assets and ensure that they are available to be passed on to your heirs when you die. If you are currently in need of nursing home care, some tools may not be available. But there may still be planning strategies that are appropriate for saving some assets from nursing home expenses.

As Benjamin Franklin is quoted, “If you fail to plan, you are planning to fail.”

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