Medicaid Planning

People often have the misconception that Medicare will pay for their long-term care, whether at home or in a nursing facility. In fact, Medicare will only pay for skilled care in a nursing facility for up to 20 days. Thereafter, there is potentially an 80-day co-pay required if you become a nursing home resident. This is dependent on the type of Medicare you have and your supplemental insurance. After day 100, Medicare will not pay anything, unless you have a sixty-day break in between medical illnesses.

In general, people pay for long-term care with (1) their own resources, (2) long-term care insurance, (3) V.A. aid and attendance benefits, or (4) Medicaid (also known as Long Term Support and Services or TennCare). Unfortunately, because the cost of long-term care is so high, most people’s resources and long-term care only last so long.

Average Yearly Costs of Care

According to the Genworth Cost of Care Survey, the average yearly costs of care are:

(1) $84,588.00 for a private room in a nursing home,

(2) $78,960.00 for a semi-private room in a nursing home,

(3) $48,456.00 in an assisted living facility,

(4) $46,548.00 to have a home health aid in your home,

(5) $44,652.00 for in-home private homemaker services, and

(6) $17,952.00 to attend adult day health services.

The Medicaid program for Long Term Support and Services is widely used to pay for long-term care at home or in a nursing facility. There are three important areas you, as a potential applicant for benefits, must meet in order to qualify. 

1. Pre-Admission Evaluation:
   1. The Pre-Admission Evaluation is the most important part of the process. If you do not meet the medical requirements under the Pre-Admission Evaluation, it doesn’t matter what you do from an income or asset perspective.
2. Income:
   1. If your gross income is more than $2,742.00 per month, you may need a qualified income trust in order to qualify for benefits at home or in a nursing facility.
3. Assets:
   1. Asset requirements differ depending on your marital status. 
      1. A single individual cannot have more than $2,000.00 in countable assets in order to qualify for in-home or nursing facility care.
      1. A married applicant can have no more than $137,400.00 in countable assets and no less than $27,480.00 in countable assets in order to qualify for in-home or nursing facility care.

Our Elder Law Attorneys Can Help

The good news is we at Kane & Crowell may be able to help your family protect your resources. Contact us to consult with one of our Elder Law Attorneys. Our Attorneys will conduct a comprehensive analysis of all possible benefits (including VA aid and attendance). Our plans are developed and customized based on your needs. Most plans will include elder law and estate planning services. In addition, we service asset protection strategies that consider tax issues, trust planning, asset re-titling, or the use of corporate entities.

Contact Kane & Crowell immediately at (615) 784-4800 if you or a family member are facing long-term care and health issues. It is our goal to make sure our clients have the quality of life they want and deserve that isn’t based on cost.