As elder law attorneys, we pay close attention to potential legislative changes that can impact government programs for seniors. There is a key proposal on the table right now, and we will look at it in this post.
But before we focus on this particular detail, we will provide some general information about the importance of the Medicaid program for seniors that will qualify for Medicare.
About 70 percent of seniors will need some form of living assistance eventually, and just over 50 percent will need paid care that is provided by a professional. Since Medicare exists in large part to meet the health care needs of seniors, you may think that it would cover long-term care.
Some would call it a head-scratcher, but in fact, Medicare does not cover nursing home care or in-home care that is provided by a paid home health aide.
The median annual cost for in-home care was over $58,000 last year, and the figure for a private room in a nursing home was $114,245 according to Genworth Financial.
Clearly, trying to come up with this kind of money out of your pocket after you have been retired for decades is not a pleasant prospect.
Now that we have set the stage, we can start to focus on the subject at hand. Medicaid will cover long-term custodial care, and there is a Medicaid Home and Community Based Services (HCBS) waiver that will pay for in-home care.
Since it is a need-based program, you cannot qualify if you have more than $2000 in countable assets in your name. However, your home (with an equity limit of $603,000) is not a countable asset this year.
Even though you can qualify for Medicaid as a homeowner, you want to steer clear of this scenario if you can. There is a Medicaid estate recovery mandate, so the program is required to seek reimbursement from your estate after you pass away.
If you are in direct possession of your home at that time, they could place a lien on the property unless your spouse or a dependent child is living in the home.
There is also an exception if one of your children has been living with you in the home for at least two years providing a level of care that has enabled you to stay out of a nursing home.
The infrastructure has been the major topic of conversation in Washington when it comes to the current domestic agenda. President Biden initially put forth a sweeping $2.3 trillion infrastructure package, but it has met with considerable resistance from Republicans.
One provision contained within his proposal would significantly increase spending on the HCBS waiver program that covers in-home care for elders. The plan includes $400 billion for this purpose, but opponents say that it has nothing to do with infrastructure.
It would appear as though a bipartisan bill that includes this spending is not going to materialize. This being stated, the population continues to age rapidly because members of the baby boomer generation are attaining senior citizen status.
Supporters of this funding contend that in-home care is less expensive than nursing home care, so we should make care that is provided in the home more readily available.
This is a matter that we will monitor going forward, because the proposal will probably emerge again even if a slimmed down bipartisan infrastructure bill is eventually passed.
We Are Here to Help!
If you take the right steps in advance, you can position your assets wisely with future Medicaid eligibility in mind. You can live comfortably during your golden years, and you can go forward with the knowledge that your legacy will be protected if you require nursing home care.
We are here to help if you are ready to work with a Cincinnati Medicaid planning attorney to put a plan in place. You can schedule a consultation if you call us at 513-721-1513, and you can use our contact form to send us a message.