Most of us know that nursing homes can be very expensive, even if we don’t have a loved one already residing in one. The unfortunate reality is that most private health insurance coverage does not include nursing home services. Even those with Medicare coverage may not receive sufficient coverage to make Kentucky nursing homes affordable. So, when it comes to the need for nursing homes, our nursing home lawyers can help you be prepared.
Understanding the basics about Medicaid
Medicaid is a government health care assistance program that is made available to low-income individuals, regardless of age or disability. Patients with Medicaid are typically responsible for a small co-pay if anything at all. Medicaid benefits cover health care expenses and are paid with federal, state and local tax funds. Because Medicaid is administered on the state level, the eligibility requirements and types of benefits available may are likely from one state to the next.
Medicaid coverage for nursing home services
Medicaid coverage is typically limited to “medically necessary” services at Kentucky nursing homes. That means Medicaid will only pay when it has been determined that the services are reasonable and necessary to: protect life, prevent significant illness, prevent significant disability, or alleviate severe pain.
Typical services included in skilled nursing care
Not every form of nursing care is categorized as “skilled” nursing care. Usually, skilled care includes treating bed sores, dressing wounds, maintaining feedings through a gastric tube, giving injections, and inserting or replacing catheters.
Skilled nursing care can also include what is referred to as “intermediate care,” which involves providing a protective and supportive environment and ongoing observation in order to reduce deterioration of health. Basically, to be eligible for skilled nursing care, your physician must determine that your health would be at risk if you do not have access to such care. If you have questions, speak to our nursing home lawyers.
Medicaid planning is important for everyone
If you aren’t familiar with Medicaid, it is a health care assistance program, run by both the state and federal government, that pays for medical services deemed medically necessary by a physician. Medicaid is considered a “need-based” program because there are limitations on the amount of financial resources a recipient is allowed to have in order to qualify for benefits.
For example, to be eligible for Medicaid, an individual can only have assets valuing $2,000 or less. Your residence is generally excluded in determining the value of your property or resources. Nevertheless, it is still relatively easy to spend all your savings before Medicaid will start paying for necessary long-term care expenses. Medicaid planning is a useful strategy for preventing that from happening.
How do I keep the nursing home from taking my house?
A common misconception with regard to Medicaid is that will need to give away all of your property before you can qualify for Medicaid benefits. As a result, they mistakenly believe that they can transfer their property to their family members in order to reduce their estate. The problem is, you cannot simply give away your property when you decide to apply for Medicaid.
In fact, there was a law passed in 2005 which created a period of ineligibility for anyone who transferred their property to someone else at any time within five years of submitting their application for Medicaid benefits. Because the period of ineligibility begins when you actually apply for Medicaid, timing is very important and creating a Medicaid plan early is crucial. Let our nursing home lawyers get you started as soon as possible.
The option of “spending down” your assets
In some cases, people are allowed to “spend down” their assets in order to qualify for Medicaid. This is something that you should first discuss with your estate planning attorney. Spending down basically refers to using your countable assets to pay off certain debts or expenses. However, this must be accomplished in a certain way in order to avoid the potential penalty period for fraudulent transfers.
Medicaid trusts are a wise strategy for Medicaid Planning
A Medicaid Trust is a specific type of trust used to protect a Medicaid applicant’s property so that you can maintain your eligibility for Medicaid benefits. A Medicaid Trust is an irrevocable trust that allows you to be the income beneficiary while identifying residual beneficiaries who will receive the trust property after your death.
If you have questions regarding nursing homes or any other Medicaid planning matters, please contact the experienced nursing home lawyers at the Gersh Law Offices, P.S.C. for a consultation. You can contact us either online or by calling us at (502) 423-7023. We are here to help!