Elder law is another aspect of estate planning, focusing primarily on the needs of families and individuals as they age. Issues of aging include disability planning, senior housing, home care, long-term care at home, in an assisted living or nursing home, guardianships, health care documents, durable power of attorney documents, conservatorships, and benefit planning for 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. In 2017 in Massachusetts the current cost of a nursing home is $11,000 to $14,000 a month depending on where you live. The average stay is slightly more than three 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. Not everyone can qualify for Medicaid (MassHealth). Our firm will also discuss with you various insurance options, such as purchasing hybrid insurance options which can leave a death benefit to your family to the extent that you do not use the insurance to pay for long term care costs. In this way, you may avoid the “use it or lose it” scenario of traditional long term care insurance. Planning ahead is key, while you are healthy enough to qualify for an insurance product or to make sure you’ll qualify to 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, some 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 9 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 called MassHealth in Massachusetts. For those who qualify, MassHealth may pay for skilled nursing home care as well as certain types of home care services. Medicaid is not an entitlement program like Medicare, but rather a person has to apply and meet certain income and asset limits in order to receive benefits. Medicaid eligibility is determined after the proper application is submitted to the state. There are many Medicaid insurance programs available in Massachusetts. Very low income seniors may qualify to have MassHealth be their supplemental health insurance or even assisted living care. People over age 62 who otherwise require skilled nursing home care may receive enhanced home care services in order to avoid having to enter a nursing home and of course MassHealth pays for skilled nursing home care for seniors who meet the strict eligibility rules.
The Massachusetts Department of Elder Affairs provides a wealth of information for seniors and care givers.
We assist seniors and their families in making the tough decisions regarding long-term care planning, including whether Medicaid eligibility or another option may be best.
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 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:
Surprenant & Beneski, P.C. can help explain the various considerations and options, and to implement a plan to meet your goals.