Ensuring that your aging loved one feels comfortable in their assisted living environment is critical to their happiness and ability to live out the rest of their life in peace. The good news is that there are many home and community-based services available to provide such care, and this is music to the ears of those families that wish to prevent placement in a nursing facility.
Nursing facilities provide a high level of care and compassion when it is needed most, and they are the perfect fit in a variety of situations. But like anything else, there is no one-size-fits-all solution.
As estate planning and elder law attorneys, we pride ourselves on being a valuable resource for individuals and their families who are trying to make sense of the journey that lies ahead and crave options for elderly care. So with that said, we wanted to use today’s article to highlight two programs that can help prevent placement in a nursing facility:
- The Medicaid Aging Waiver Program
- PACE (Program for All-Inclusive Care for the Elderly)
Medicaid Aging Waiver Program
If your elderly loved one qualifies for a nursing facility level of care and is financially eligible, Medicaid benefits that would otherwise be used to pay for a nursing facility can be used to pay for home and community-based care instead.
What is Medicaid? Medicaid helps cover medical costs for people with limited income and resources, many times offering benefits such as long-term nursing home care and personal care services that are not covered by Medicare. This is likely music to your ears, as these services can cost more than $120,000 a year out-of-pocket. The problem is that Medicaid has specific eligibility requirements, and understanding that process feels like it requires a degree in rocket science.
Federal law imposes restrictions on whether you will qualify for benefits to cover long-term care expenses. For example, if you transfer assets, it may make you and/or your loved one ineligible for Medicaid for a period during what is known as the “look back period.” The larger the sum of the assets given away, the larger the potential ineligibility period.
The good news is that despite the numerous restrictions the law has placed on Medicaid eligibility, it is often possible to develop a plan to put you and your family in the best possible position to qualify and protect most of your assets at the same time.
This is true even if your loved one is already in a nursing facility.
With the Program for All-Inclusive Care for the Elderly, comprehensive medical and social services are provided for certain frail, community-dwelling elderly individuals, most of whom are eligible for both Medicare and Medicaid benefits. An interdisciplinary team of health professionals provides PACE participants with coordinated care, and for most participants, the service package allows them to remain in the community or home rather than receive care in a nursing facility.
PACE services provided can include:
- Primary and specialty physician car
- Adult day care
- Emergency services
- Home care
- Hospital care
- Rehabilitative services
- Prescription drugs
- Social services
Keep in mind that individuals who need end-of-life care and ultimately choose hospice care for the remainder of their journey will need to voluntarily disenroll from the PACE program.
Call Leigh Hilton PLLC today!!
At Leigh Hilton PLLC, our goal is to protect and preserve your most valuable assets while also educating you and your family every step of the way. We want you to feel empowered so that you can confidently embrace your estate planning strategy — even in the face of a devastating disease such as Alzheimer’s.
Leigh Hilton PLLC wants to be your first call every time for any estate planning need. We look forward to serving you.