Elder law is another aspect of estate planning focusing primarily on the needs of families and individuals as they age. Issues of aging include senior housing and home care, long-term (or nursing home) care, guardianships and health care documents, Medicare and Medicaid.
As our population ages, more and more of us confront elder law-related issues, whether for ourselves or our parents. One of the most pressing issues is long-term nursing home care, which usually is not covered by traditional health insurance. Depending on where you live and the level of care needed, nursing home care costs can vary greatly. In 2020, the national median cost for a private room in a skilled nursing facility was $105,850. The average stay is slightly more than two years. Most people end up paying for nursing home care until their personal (or family) assets are depleted, then they may qualify for Medicaid to pick up the cost.
Careful planning, however, can help protect your assets, whether for your spouse or for your children. The belt-and-suspenders approach is to purchase long-term care insurance while you are healthy enough to qualify, and to make sure you receive the benefits to which you are entitled under Medicare and Medicaid.
Clients are frequently confused over the differences between Medicare and Medicaid. Though their names are very similar, the programs are quite different. Medicare is an “entitlement” program, a federal health insurance program in which most people enroll when they turn 65 years old. There are no financial qualification rules. Medicare has two primary parts: Part A and Part B.
Medicare Part A covers in-hospital care, extended care after a hospital stay, some home health care services, and hospice services. The rules for nursing home coverage are very strict and, in fact, Medicare pays for less than nine percent of nursing home care in this country.
Medicaid, is a joint federal-state program, subject to certain federal requirements, each state implements its own regulations on how the program is managed. Medicaid is not an entitlement program like Medicare, but rather a form of welfare. Medicaid eligibility is determined after the proper application is submitted to the commonwealth. There are many Medicaid insurance programs available in Wisconsin, from basic medical coverage to nursing home programs. Information about Medicaid for long-term care in a nursing home or community setting can be found on the Wisconsin Department of Health Services website.
We assist seniors and their families in making the tough decisions regarding long-term care planning, including whether Medicaid eligibility may be an option. Navigating the Medicaid rules on your own can be a nightmare at best, and subject you to penalties at worst. We work closely with clients to assist with understanding the challenging Medicaid rules, and provide sound legal advice regarding plans for securing eligibility for Medicaid.
Helping a parent move to senior housing can seem more intimidating than orchestrating a rocket launch. The death of a spouse, declining health or safety concerns can trigger the need to move. The first phase comes with the realization that what has been home is no longer suitable. Emotional ties to a place are hard to overcome. Finding a new home that is both appealing and appropriate is no easy task, and neither is culling through a lifetime’s accumulation of “stuff.”
Here are some tips to help make the transition easier:
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