The nursing home lawyers here at our firm are in a position to save our clients a great deal of money. But first, we have to share some inconvenient truths that some people do not fully understand. When you reach the age of 65, you will qualify for Medicare if you or your spouse have worked for at least 10 years. This health insurance program will certainly provide you with a basic underpinning.
However, you should be aware of the fact that there are out-of-pocket costs that you have to absorb yourself. Medicare Part A is the segment of the program that covers hospitalization. You do not have to pay a monthly premium for this coverage, but there is a per benefit period deductible.
There are is no coinsurance if you stay in the hospital for 60 days or less, but the situation changes dramatically if you have to remain in the hospital for a longer interim. At the time of this writing, there is a $335 per day coinsurance for days 61-90, and it goes up to $670 a day if your stay exceeds 90 days.
Part B is the portion of the program that pays for outpatient treatments and visits to doctors. There is a monthly premium that must be paid for this coverage, and in 2018, it is $134 for most people. This part of the program also has a modest deductible that stands at $183 right now.
The worst news to pass along about Part B is the fact that it only pays for 80 percent of covered expenses. You have to pay the rest out of your own pocket. Medicare Part C can be used to apply your benefit to the purchase health care insurance from a private provider. The prescription drug piece is Part D, and this coverage comes with a deductible and premiums, and there can be coinsurance.
The Huge Gap
Most senior citizens are going to eventually need long-term care. Many will be able to get by with minimal assistance provided by family members, neighbors, and friends for a while. This being stated, at some point in time, you may need the level of care that can only be provided in a nursing home.
If you doubt this statement, you should understand some facts. Your life expectancy is somewhere in the mid-80s when you are 67 years of age. The Alzheimer’s Association tells us that 40 percent of people in the oldest age group have contracted the disease. Of course, this is not the only reason why people can require nursing home care.
Nursing homes are extremely expensive, and the prices here on Long Island are higher than the national averages. You are looking at somewhere in the vicinity of $150,000 for a year in a nursing home, and costs have been rising. This is a big number, but you can double it if you are married and you and your spouse eventually spend time in nursing homes.
The Medicare program will pay for convalescent care if you have physical limitations after some type of procedure and recovery is expected. That’s the good news, but the bad news is that it will not pay for custodial care. This is the form of care that is provided by nursing homes.
Medicaid Planning
You are probably aware of the fact that Medicaid is a government health insurance program that is available to people with a significant level of financial need. Medicaid will pay for long-term care, but you cannot qualify if you have a reasonable store of assets in your own name. It is possible to give assets to your loved ones so that you can obtain Medicaid coverage. This is a process called a “spend down.”
This is where a nursing home lawyer can enter the picture to provide much-needed guidance. Any gift giving has to be completed at least five years before you apply for Medicaid. If you do not abide by this rule, your eligibility is delayed, and you have to pay out-of-pocket. Depending on the amount of the divestitures, you could be ineligible for the rest of your life.
Schedule a Consultation Today!
We are here to help if you would like to discuss Medicaid planning with a licensed nursing home lawyer. You will get personalized attention when you engage our firm, and we will answer all of your questions and help you put the ideal nursing home asset protection plan in place.
If you are ready to get started, you can send us a message to request an appointment, and we can be reached by phone at 631-265-0599.
- Special Needs Planning and Medicaid Recovery - March 21, 2019
- Have You Considered a Living Trust? - March 12, 2019
- How Do You Qualify for Medicaid? - March 7, 2019
