Must Everything Go to the Nursing Home?

An Ohio nursing home resident does not necessarily have to spend all they own towards their care. With sound planning, they may be able to give some of their assets to family members.

In 2011, the monthly cost of most nursing homes in Ohio is roughly $7000. In just a short time, these expenses can wipe out the savings of a lifetime.

Medicare will not pay for more than 100 days in a nursing home. Oftentimes it pays fewer days than this.

Long term health care insurance, which is widely available, will pay for these services. It can protect against this costly event and, with wise budgeting, permit gifts. However, many persons are not aware of this coverage, do not wish to incur the cost, or delay until it is too late to get it.

Medicaid will pay for nursing home services if they are medically necessary and the resident meets the financial, citizenship, and residency guidelines.

In most cases, nursing home services are medically necessary if a person has advanced dementia or cannot perform at least two of the following activities: Transferring, toileting, continence, dressing, bathing, and eating. If the resident meets these criteria, and is a US citizen and a resident of the county in which they apply for Medicaid, then they should be eligible if they meet the financial guidelines.

The financial requirements fall into two categories: Destitution and no significant, recent gifts.

To be destitute, a person may not have more than $1500 in countable assets. Assets that are not countable are pre-paid funerals, burial plots, most household goods and furnishings, some life insurance, a car in limited circumstances, and a home if occupied by an eligible family member.

One must have a limited income. If the resident does not receive enough each month to pay for their care, then they should meet this test.

If a person made significant gifts within five years before they entered the nursing home and applied for Medicaid, then they can be ineligible. If five years passes after the gifts, then there is no ineligibility.

If one must enter a nursing home within five years after the gifts, then with the help of a knowledgeable practitioner, making gifts and securing Medicaid coverage may be possible. It is never too late to engage in this planning, but as a general rule, the sooner one does it, the more that can be given away.

The risks of “Medicaid Planning” include the inability to retrieve the gifts, a long ineligibility through inadvisable gifting, and a tightening of the rules by the government. But, if one can tolerate these risks and wishes to leave something for their family, they may be able to do so and still have Medicaid pay for their nursing home care.

If one is interested in Medicaid Planning, then I urge you to call us as soon as possible. Delay, or improper planning, can needlessly cost a family legacy.

Call us now at 937-667-8805 or 937-429-7730 to make your appointment.