Most senior citizens will need living assistance at some point in time, and just over one third of elders will require nursing home care. These facilities are expensive, so it is not easy to pay out-of-pocket.
When we say “expensive,” we are talking about somewhere in the vicinity of $85,000 a year for a private room in an Ohio nursing home.
The majority of seniors will qualify for Medicare coverage when they reach the age of 65. It will certainly help, but Medicare will not pay for the custodial care that you would receive in a nursing home or assisted living community.
Some people can get the help they need in their own homes from home health aides, and Medicare does not cover in-home care either.
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Medicaid is another government health insurance program, and it does cover long-term custodial care. Since it is intended for people with limited resources, there is a low asset limit of just $2000.
These are the limits for countable assets, but your home is not included. There is however a $595,000 equity limit.
Other non-countable assets include one vehicle, wedding rings, engagement rings and heirloom jewelry, household items, and your personal belongings.
A prepaid burial plot is permissible, along with $1500 set aside for final expenses. You can have the same amount of whole life insurance, and there is no limit to the amount of term life insurance you can carry.
Provisions for the Healthy Spouse
If you were to apply for Medicaid to pay for long-term care, and your spouse was still capable of living independently, your spouse would get some allowances.
First, as we have stated above, your home is not a countable asset, but there is an equity limit. When a healthy spouse is remaining in the home, there is no limit at all.
There is a Community Spouse Resource Allowance gives the healthy spouse the ability to keep half of the shared countable assets. The maximum limit is $128,640, and the minimum allowance in Ohio is $25,728.
A healthy spouse can also be eligible for a Monthly Maintenance Needs Allowance. Ordinarily, a Medicaid recipient must contribute most of their income to defray the cost of the care that is being received. When a healthy spouse is relying on the income, this requirement is waived.
The Monthly Maintenance Allowance is $3216 on the high end, and the minimum allowance it $2113.75.
Medicaid Five-Year Look Back Period
You could give away countable assets in an effort to qualify for Medicaid to pay for living assistance. However, you have to complete all gift giving at least five years before you apply for coverage. Your eligibility is delayed if you violate this rule.
Simply put, if you give away enough to pay for one year of nursing home care within this five-year window, you would be ineligible for a period of one year.
Medicaid Estate Recovery
Though you can potentially gain eligibility if you are in direct personal possession of a home, you have to be aware of Medicaid estate recovery efforts. Medicaid is required to seek reimbursement from your estate if you are enrolled in the program.
If you had a home in your name when you gained eligibility, they would be able to attach the property.
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