Long term care

[ROCKETMAN]

I’m sure some of you have these questions or have actually experienced these circumstances. I am talking about Medicare nursing facilities, not private. Private ones run about $9000.00 a month so for me that’s out of the equation. Been to seminars where they tell you you can protect your assets including sale of your house and just your s.security will cover cost. A lawyer quoted me $5000 to do the paperwork. My lawyer who has done my wills in a phone conversation asked me why I would I spend $5000 and have no idea if I would or my spouse would ever go in a nursing home. You can fill out the paper work the day before you would go in or even after you go in. My lawyer does not charge like the ones in fancy offices, has a small office in a tiny strip mall in Eustis. Used to be in summer field but closed that one.

[retiredguy123]

About 80 to 90 percent of fulltime nursing home residents (not rehab) are on Medicaid. When you move in, they actually have an office to calculate your "spend down" time plan to spend all of your money before applying for Medicaid. Your lawyer is probably talking about a plan to give most of your money away to make you eligible for Medicaid and avoid spending it all at the nursing home. To be eligible for Medicaid, you need to be almost broke, and they include a 3 to 5 year "look back" period to prevent people from gifting their money just prior to entering a nursing home. I don't know if you need a lawyer, but a gifting plan is a good idea to avoid spending all of your money at the nursing home. Most people cannot afford to live in any nursing home. Note that Medicare does not cover nursing homes.

[LuvtheVillages]

I’m sure some of you have these questions or have actually experienced these circumstances. I am talking about Medicare nursing facilities, not private. .

Medicare only pays if you are there for rehab. Medicare does NOT pay for long term care. Medicaid pays for long term care, but only after you have spent all your money and have nothing left.

So start giving away your money to your heirs now, to establish a pattern and so that they get something from you.

[ROCKETMAN]

Giving away your money is not the answer. They look back and if you have given to much you pay a penalty.Look back 5 years so do it now and hope you have 5 healthy years in front of you.

[Aces4]

Medicare only pays if you are there for rehab. Medicare does NOT pay for long term care. Medicaid pays for long term care, but only after you have spent all your money and have nothing left.

So start giving away your money to your heirs now, to establish a pattern and so that they get something from you.

What a joke, dump your money on your heirs so they can live the good life while the rest of the population pays for your fanny. I think to stop this practice, which has been going on for a long time, long term care should be beds in wards, shared public bathrooms and very, very basic care including the food. How about your kids take you in, provide the care and you pay them? That would be far more equitable for the American people.

I have watched so many couples dump their money to the kids to live off the public coffers. Talk about a travesty...barf

[retiredguy123]

What a joke, dump your money on your heirs so they can live the good life while the rest of the population pays for your fanny. I think to stop this practice, which has been going on for a long time, long term care should be beds in wards, shared public bathrooms and very, very basic care including the food. How about your kids take you in, provide the care and you pay them? That would be far more equitable for the American people.

I have watched so many couples dump their money to the kids to live off the public coffers. Talk about a travesty...barf
I partially agree with you. But nursing homes are basically Government Medicaid-funded facilities. The nursing homes do the bare minimum to comply with Government rules and it is the nursing home owners who are getting rich. If you move into a nursing home with $100,000 in life savings, it will be gone in about a year or so, and then the Government will be paying the nursing home through Medicaid. You will be broke and won't even be able to go out to dinner or buy a TV or a piece of furniture. But, if you can gift that money to your heirs, they can help you out by spending some of the money on you. (hopefully?)

[Pairadocs]

What a joke, dump your money on your heirs so they can live the good life while the rest of the population pays for your fanny. I think to stop this practice, which has been going on for a long time, long term care should be beds in wards, shared public bathrooms and very, very basic care including the food. How about your kids take you in, provide the care and you pay them? That would be far more equitable for the American people.

I have watched so many couples dump their money to the kids to live off the public coffers. Talk about a travesty...barf

I have always thought along your same line of thinking, thought I must be the only one who thinks it strange that people would NOT want to pay for the care they receive (from any provider actually), yet find it morally sound to try to hide, or "get rid of" assets they have worked for all their lives and saved for the 'what if's", what IF I have to have nursing home care, etc. ? When people divest themselves of assets, surely SOMEONE has to pay the people who work in nursing homes ? If the people receiving care have money but don't want to pay, who then pays ? ? Isn't that similar to going to the doctor and needing heart surgery to save your life, but after the surgery you don't want to pay the surgeon for services rendered ? I can't help but think somehow, some body, must pay to build and staff nursing facilities !

[dewilson58]

Protect 1/2 of your assets now...............Divorce your spouse.

:popcorn::popcorn:

[ThirdOfFive]

I’m sure some of you have these questions or have actually experienced these circumstances. I am talking about Medicare nursing facilities, not private. Private ones run about $9000.00 a month so for me that’s out of the equation. Been to seminars where they tell you you can protect your assets including sale of your house and just your s.security will cover cost. A lawyer quoted me $5000 to do the paperwork. My lawyer who has done my wills in a phone conversation asked me why I would I spend $5000 and have no idea if I would or my spouse would ever go in a nursing home. You can fill out the paper work the day before you would go in or even after you go in. My lawyer does not charge like the ones in fancy offices, has a small office in a tiny strip mall in Eustis. Used to be in summer field but closed that one.
Lots of good (and accurate) observations about what Medicare pays and doesn't pay. Bottom line though is that if you are in a nursing home beyond what Skilled Nursing will pay (90 day Medicare limit, back when I was in the game) anything above and beyond comes out of your pocket and, when your pockets are empty, the public nickel (i.e. Medicaid). Florida has a 60-month look-behind when Medicaid is applied for and as other posters have indicated there are penalties if they find you've hidden assets. There are ways around some of that (irrevocable trusts, some other things) but those have tightened up as well. Some folks do carry long-term care insurance but unless those policies are purchased when the purchaser was relatively young and healthy the premiums can be pretty hefty.

Suggest you might want to look at some options other than a Nursing Home. Florida isn't great when it comes to "other options" but they do exist, and are designed to keep people in the community for as long as possible. Services such as homemaker services, personal care (PCA) services, Home Health Aides, and the like may be available, with the beauty of them being that you don't have to empty your bank account to pay for them but basically pay as you need them.

Availability of services vary state by state, but it might be worth your while to contact The State of Florida Health and Family Services to see what is out there and what it takes to access services.

[Altavia]

Protect 1/2 of your assets now...............Divorce your spouse.

:popcorn::popcorn:

Sad but true.

[Aces4]

I partially agree with you. But nursing homes are basically Government Medicaid-funded facilities. The nursing homes do the bare minimum to comply with Government rules and it is the nursing home owners who are getting rich. If you move into a nursing home with $100,000 in life savings, it will be gone in about a year or so, and then the Government will be paying the nursing home through Medicaid. You will be broke and won't even be able to go out to dinner or buy a TV or a piece of furniture. But, if you can gift that money to your heirs, they can help you out by spending some of the money on you. (hopefully?)

Spend some time in a nursing home. It's some of the toughest, most difficult work out there or people would keep their parents in their home.

If you want to work, maintain, change adult diapers, dig dentures out of returned food trays and locate their owners, bath, shave, hair groom, lift and move patients, the list goes on and on for $15./hr, they will hire you immediately. Appears to be bare minimums to you because it's not a spa.

The buildings, maintenance, heating, air conditioning, insurances including liability, food, entertainment, skilled employees, managers benefits and all the incidentals not even mentioned here make the care very expensive. Look at what pro athletes are paid and so called movie/entertainment people, this world is very upside down. As mentioned early, apply to a nursing home and advise us how to run it as a nonprofit entity.:loco:

Also, if you are in a nursing home, you won't have to worry about going out for dinner.

[retiredguy123]

Spend some time in a nursing home. It's some of the toughest, most difficult work out there or people would keep their parents in their home.

If you want to work, maintain, change adult diapers, dig dentures out of returned food trays and locate their owners, bath, shave, hair groom, lift and move patients, the list goes on and on for $15./hr, they will hire you immediately. Appears to be bare minimums to you because it's not a spa.

The buildings, maintenance, heating, air conditioning, insurances including liability, food, entertainment, skilled employees, managers benefits and all the incidentals not even mentioned here make the care very expensive. Look at what pro athletes are paid and so called movie/entertainment people, this world is very upside down. As mentioned early, apply to a nursing home and advise us how to run it as a nonprofit entity.:loco:

Also, if you are in a nursing home, you won't have to worry about going out for dinner.
Not sure I understand your post. I have spent time in nursing homes, but not as an employee. They had the required number of employees, but they were not first class. In one that I remember, the call bell rang 24/7 because there were not enough staff to respond, but apparently, the Government required the bell. I think nursing homes are very profitable for the owners. But my point is that I don't blame people who want to keep some of their money.

[Plinker]

I’m sure some of you have these questions or have actually experienced these circumstances. I am talking about Medicare nursing facilities, not private. Private ones run about $9000.00 a month so for me that’s out of the equation. Been to seminars where they tell you you can protect your assets including sale of your house and just your s.security will cover cost. A lawyer quoted me $5000 to do the paperwork. My lawyer who has done my wills in a phone conversation asked me why I would I spend $5000 and have no idea if I would or my spouse would ever go in a nursing home. You can fill out the paper work the day before you would go in or even after you go in. My lawyer does not charge like the ones in fancy offices, has a small office in a tiny strip mall in Eustis. Used to be in summer field but closed that one.

There are many ways to qualify for Medicaid despite having substantial assets. It is imperative you contact an experienced elder law attorney who has extensive knowledge in this field.
For instance, you are allowed one car which is not counted as an asset. You could buy a $200,000 Bentley to reduce assets. The current limit on your primarily residence is $713,000 if single and no limit if married. If your current home is valued less than this, you could upgrade to reduce countable assets. A Qualified Income Trust (aka - Miller Trust) can allow your income to exceed the threshold and still qualify for Medicaid. These are just a few of the many strategies that can be utilized. Contact an elder law attorney as there is a five year look-back on asset transfers. Spending $10,000 for an attorney to get this right would be a bargain.

[Aces4]

Not sure I understand your post. I have spent time in nursing homes, but not as an employee. They had the required number of employees, but they were not first class. In one that I remember, the call bell rang 24/7 because there were not enough staff to respond, but apparently, the Government required the bell. I think nursing homes are very profitable for the owners. But my point is that I don't blame people who want to keep some of their money.

Keep some of their money? So others can work harder, go without and have to subsidize them when this is exactly how their money should be spent if required? When did this something for nothing mindset begin?

(If that bell keeps ringing it's because you can't get enough people to work under those conditions for so little income.)

[jimhoward]

If we could somehow get rid of Medicaid entirely, then the calculus would change. That has its own moral problems, but I think it would be better.

[retiredguy123]

Keep some of their money? So others can work harder, go without and have to subsidize them when this is exactly how their money should be spent if required? When did this something for nothing mindset begin?

(If that bell keeps ringing it's because you can't get enough people to work under those conditions for so little income.)
Are you saying that people who follow the rules shouldn't take advantage of a Government benefit, like Medicaid? Medicaid allows them to gift their money to avoid paying for nursing home care out of pocket. If done timely and correctly, they are entitled to the benefit.

[Grinchie]

It’s Medicaid, not Medicare, provided by the Federal gov. (as tweaked slightly by some states). The greater percentage of us will need Medicaid when we can’t continue to live alone/at home due to being unable to competently perform the basic functions of living independently. There is also a ‘Waiver’ program that allows a person to remain in home & receive services there.
There is a monthly income amount which one must be below (usually about 2300) to qualify & if married, the spouse (community spouse) can retain most of the joint assets (technically to a max of about $140,000, but there might be more protected from access by being in a Trust) . There is a five year look-back period during which, if any gifts were made, Medicaid would only be available five years after that date (or they charge you the full amount of the monthly rate). The biggest mistake people make is to sell their house as Medicaid, theoretically puts a claim on the house, effective after the death of the person & no gifts of money or sales of property are allowed during the 60 month ‘look back’ period.
However, many attys will do a Trust to transfer assets to a ‘Community Spouse’ or another, to essentially keep funds out of consideration.. When the monthly income is too high to qualify, a different Trust (Qualified Income Trust, also given other titles) to transfer income to that place when those funds are over the legal income limit to qualify for aid - that allowed Trust is meant to provide other additional medical care & appliances for the person. Theoretically, the Dept of Health & Human Resources has a type of lien on the person’s home upon the person’s death, although they often have not exercised that right to pay back the system - possibly changes will be coming under Doge, but I think it would be a few years before that gets changed. (This Dept has often been used to dispense money to migrants.).
If applying, the forms detailing bank accounts must be provided for the prior 60 months (5 years) & all information must be accurate. Google Medicaid & the state you would be living, and the rules are explained well. Each state can tweak the rules slightly & some states are aggressive in their Medicaid recovery through Probate.

[Grinchie]

PS: You have to find a Nursing Home which has available ‘Medicaid’ beds. Not all are geared to Medicaid, & many predominantly Medicaid NHs are in terrible condition, under-staffed, over-patiented, and frequently get violations for patient falls, poor medical care, and other failures of required care. There isn’t enough oversight by the authorities, & owners of these Medicaid homes have inadequate oversight & auditing.

[RoseyRed]

I partially agree with you. But nursing homes are basically Government Medicaid-funded facilities. The nursing homes do the bare minimum to comply with Government rules and it is the nursing home owners who are getting rich. If you move into a nursing home with $100,000 in life savings, it will be gone in about a year or so, and then the Government will be paying the nursing home through Medicaid. You will be broke and won't even be able to go out to dinner or buy a TV or a piece of furniture. But, if you can gift that money to your heirs, they can help you out by spending some of the money on you. (hopefully?)
It is tough from either point of view! I have had several family members go through the spend down Medicaid process. The taxes we have paid in all these years is being put to use.

[SoCalGal]

What a joke, dump your money on your heirs so they can live the good life while the rest of the population pays for your fanny. To stop this practice, which has been going on for a long time, long-term care should be beds in wards, shared public bathrooms and very basic care including food. How about your kids take you in, provide the care and you pay them? That would be far more equitable for the American people. I have watched so many couples dump their money to the kids to live off the public coffers. Talk about a travesty...

Thank you! That's what I wanted to say. People who have lived a moral life then deteriorate in their old age because lawyers told them this was the smart thing to do. Sickening.

[retiredguy123]

It is tough from either point of view! I have had several family members go through the spend down Medicaid process. The taxes we have paid in all these years is being put to use.
The problem is that the Government doesn't collect enough in taxes to pay for all of the wasteful spending. That is why the country is $36 trillion in debt.

[RoseyRed]

I have always thought along your same line of thinking, thought I must be the only one who thinks it strange that people would NOT want to pay for the care they receive (from any provider actually), yet find it morally sound to try to hide, or "get rid of" assets they have worked for all their lives and saved for the 'what if's", what IF I have to have nursing home care, etc. ? When people divest themselves of assets, surely SOMEONE has to pay the people who work in nursing homes ? If the people receiving care have money but don't want to pay, who then pays ? ? Isn't that similar to going to the doctor and needing heart surgery to save your life, but after the surgery you don't want to pay the surgeon for services rendered ? I can't help but think somehow, some body, must pay to build and staff nursing facilities !
Who pays for the nursing homes? Our tax dollars. We have all paid taxes for years right?

[SoCalGal]

The problem is that the Government doesn't collect enough in taxes to pay for all of the wasteful spending. That is why the country is $36 trillion in debt.

Hopefully, DOGE is on the way.

[RoseyRed]

Spend some time in a nursing home. It's some of the toughest, most difficult work out there or people would keep their parents in their home.

If you want to work, maintain, change adult diapers, dig dentures out of returned food trays and locate their owners, bath, shave, hair groom, lift and move patients, the list goes on and on for $15./hr, they will hire you immediately. Appears to be bare minimums to you because it's not a spa.

The buildings, maintenance, heating, air conditioning, insurances including liability, food, entertainment, skilled employees, managers benefits and all the incidentals not even mentioned here make the care very expensive. Look at what pro athletes are paid and so called movie/entertainment people, this world is very upside down. As mentioned early, apply to a nursing home and advise us how to run it as a nonprofit entity.:loco:

Also, if you are in a nursing home, you won't have to worry about going out for dinner.
good point for sure!

[Berwin]

Something not mentioned in this thread is what is called "Aid and Attendance" for veterans. It is a monthly amount to pay for in-home assistance for those not able to take care of daily chores by themselves. If you are a veteran, look it up.

[mraines]

I’m sure some of you have these questions or have actually experienced these circumstances. I am talking about Medicare nursing facilities, not private. Private ones run about $9000.00 a month so for me that’s out of the equation. Been to seminars where they tell you you can protect your assets including sale of your house and just your s.security will cover cost. A lawyer quoted me $5000 to do the paperwork. My lawyer who has done my wills in a phone conversation asked me why I would I spend $5000 and have no idea if I would or my spouse would ever go in a nursing home. You can fill out the paper work the day before you would go in or even after you go in. My lawyer does not charge like the ones in fancy offices, has a small office in a tiny strip mall in Eustis. Used to be in summer field but closed that one.
Be careful.

[Cliff Fr]

Are you saying that people who follow the rules shouldn't take advantage of a Government benefit, like Medicaid? Medicaid allows them to gift their money to avoid paying for nursing home care out of pocket. If done timely and correctly, they are entitled to the benefit.

Medicaid was setup for people who are very poor or destitute. By hiding or giving away money or assets you are ripping off the government and the taxpayers.

[mraines]

I partially agree with you. But nursing homes are basically Government Medicaid-funded facilities. The nursing homes do the bare minimum to comply with Government rules and it is the nursing home owners who are getting rich. If you move into a nursing home with $100,000 in life savings, it will be gone in about a year or so, and then the Government will be paying the nursing home through Medicaid. You will be broke and won't even be able to go out to dinner or buy a TV or a piece of furniture. But, if you can gift that money to your heirs, they can help you out by spending some of the money on you. (hopefully?)
If you need a nursing home, would you be going out to dinner or buying furniture? That would make you healthy enough for assisted living.

[retiredguy123]

Medicaid was setup for people who are very poor or destitute. By hiding or giving away money or assets you are ripping off the government and the taxpayers.
It is not ripping off the Government if you follow the rules that the Government established within the program. And, people have every right to give away their money to anyone they want. I would also point out that, in 2023, 91 million people were enrolled in Medicaid, not just the very poor or destitute.

[mraines]

I have always thought along your same line of thinking, thought I must be the only one who thinks it strange that people would NOT want to pay for the care they receive (from any provider actually), yet find it morally sound to try to hide, or "get rid of" assets they have worked for all their lives and saved for the 'what if's", what IF I have to have nursing home care, etc. ? When people divest themselves of assets, surely SOMEONE has to pay the people who work in nursing homes ? If the people receiving care have money but don't want to pay, who then pays ? ? Isn't that similar to going to the doctor and needing heart surgery to save your life, but after the surgery you don't want to pay the surgeon for services rendered ? I can't help but think somehow, some body, must pay to build and staff nursing facilities !
These are the same people who begrudge needy people being on welfare or help for those less fortunate.

[mraines]

It is not ripping off the Government if you follow the rules that the Government established within the program. And, people have every right to give away their money to anyone they want. I would also point out that, in 2023, 91 million people were enrolled in Medicaid, not just the very poor or destitute.

That's how the rich get richer. They know how to skirt around the rules and find the loopholes.

[retiredguy123]

If you need a nursing home, would you be going out to dinner or buying furniture? That would make you healthy enough for assisted living.
Yes, because not everyone living in a nursing home is bedridden. If you need a certain level of medical care, you may not be eligible for assisted living.

[crash]

I partially agree with you. But nursing homes are basically Government Medicaid-funded facilities. The nursing homes do the bare minimum to comply with Government rules and it is the nursing home owners who are getting rich. If you move into a nursing home with $100,000 in life savings, it will be gone in about a year or so, and then the Government will be paying the nursing home through Medicaid. You will be broke and won't even be able to go out to dinner or buy a TV or a piece of furniture. But, if you can gift that money to your heirs, they can help you out by spending some of the money on you. (hopefully?)

If you are there on Medicad they take your Social Security and give you $100 a month for personel care items. So you won’t be going out to dinner or buying a TV. Your kids can do that for you with the money you gifted them but I have seen where once they have the money you are on your own.

[retiredguy123]

If you are there on Medicad they take your Social Security and give you $100 a month for personel care items. So you won’t be going out to dinner or buying a TV. Your kids can do that for you with the money you gifted them but I have seen where once they have the money you are on your own.
I totally agree. But, you don't need to give all your money to your kids, especially if they don't deserve it.

[Barkriver]

What a joke, dump your money on your heirs so they can live the good life while the rest of the population pays for your fanny. I think to stop this practice, which has been going on for a long time, long term care should be beds in wards, shared public bathrooms and very, very basic care including the food. How about your kids take you in, provide the care and you pay them? That would be far more equitable for the American people.

I have watched so many couples dump their money to the kids to live off the public coffers. Talk about a travesty...barf

The travesty is the cost and quality of long term care, and this country's entire medical system.

[Susan1717]

We have all worked hard for our money and let’s just hope that we have children to where If we give them money they will save it and use it to take care of us when we need it! I know I trust my son explicitly! And some of the threads I’ve read have said they think it’s awful for people to live off of Medicaid later? Well, I would rather see the government take care of its own senior citizens then spending billions on illegal immigrants, that’s just my opinion.

[sdeikenberry]

Depending on the amount of wealth you have, there is an option to protect it, keep it, and still be able to go into a nursing facility. Buy long term care insurance. Yes, you pay an annual premium, but again, depending on your wealth, it could be money well spent. Basically, with LTC insurance you can keep all your money, go into a nursing home, and insurance will pay for the costs up to a certain number of years. Depending on the level of care you want you may have to supplement the monthly cost. Premiums are based on your age when you purchase the policy...the older you are the more the premium, but the younger you are the longer you pay the lower premium. I'm not generally in favor of insurances, but in this case it's worth considering for wealthy people.

[retiredguy123]

Depending on the amount of wealth you have, there is an option to protect it, keep it, and still be able to go into a nursing facility. Buy long term care insurance. Yes, you pay an annual premium, but again, depending on your wealth, it could be money well spent. Basically, with LTC insurance you can keep all your money, go into a nursing home, and insurance will pay for the costs up to a certain number of years. Depending on the level of care you want you may have to supplement the monthly cost. Premiums are based on your age when you purchase the policy...the older you are the more the premium, but the younger you are the longer you pay the lower premium. I'm not generally in favor of insurances, but in this case it's worth considering for wealthy people.
Most long term care insurance experts say that the insurance is best suited for people who are either not poor or those who are not very wealthy. Those who benefit most from LTC insurance are those "in-between" people who have some wealth, but not enough to self-insure for long term care. So, it is not recommended for wealthy people who can afford to self-insure.

[Ponygirl]

I went through this with my mom a few years ago before her death last year She was stubborn and wanted to live in her home in PA and not with me which I respected Then came the hospital and rehab cycle

When time for long term care came the nursing home gave me the whole spiel abt how the state takes over the house and assets to pay the bills and I choose another course of action

I chose a wonderful (after much research) personal care facility over a nursing home that I paid out of pocket. (Much less than 9000/month) They were wonderful and hospice provided services at the end of life they were very kind and caring and it was a great experience

[nn0wheremann]

About 80 to 90 percent of fulltime nursing home residents (not rehab) are on Medicaid. When you move in, they actually have an office to calculate your "spend down" time plan to spend all of your money before applying for Medicaid. Your lawyer is probably talking about a plan to give most of your money away to make you eligible for Medicaid and avoid spending it all at the nursing home. To be eligible for Medicaid, you need to be almost broke, and they include a 3 to 5 year "look back" period to prevent people from gifting their money just prior to entering a nursing home. I don't know if you need a lawyer, but a gifting plan is a good idea to avoid spending all of your money at the nursing home. Most people cannot afford to live in any nursing home. Note that Medicare does not cover nursing homes.
So tell me this, if you have the means to pay for your nursing home bill, why do you want to pull off financial shenanigans to qualify for welfare? Why stick the taxpayers for your care when you can full well afford to pay your own way? So you can give it to your children? Once upon a time children were supposed to take care of their parents, not slough them off upon the taxpayers so they can leave a big estate.

[sharonl7340]

Medicare only pays if you are there for rehab. Medicare does NOT pay for long-term care. Medicaid pays for long-term care, but only after you have spent all your money and have nothing left.

So start giving away your money to your heirs now, to establish a pattern and so that they get something from you.

This is correct. Medicare will NOT pay for long-term care. Medicaid will, but only after you have spent down the assets. One of the only things Medicaid does not require is the liquidation of the home if the other spouse still lives there, but I believe they still count it as an asset.

[sharonl7340]

You can place some of the assets in a trust and that would count as "liquidating them." An eldercare lawyer told me I could take the amount of money my mom got that was over the Medicaid limit could be placed in a trust and then she would qualify. the amount was $200 every month, but we would have had to readjust the amount every year to account for the COLAs she received. Then the nursing home would have taken every penny for expenses. A little-known fact is that Medicaid can continue to go after the family for the expenses not covered by the agency and the amount of money they took each month.

[sharonl7340]

Giving away your money is not the answer. They look back and if you have given to much you pay a penalty.Look back 5 years so do it now and hope you have 5 healthy years in front of you.

The lookback period is different for each State. My mom was in Alabama and the look-back was 7 years. You need to research to see what the lookback period is in your state.

[elle123]

I’m sure some of you have these questions or have actually experienced these circumstances. I am talking about Medicare nursing facilities, not private. Private ones run about $9000.00 a month so for me that’s out of the equation. Been to seminars where they tell you you can protect your assets including sale of your house and just your s.security will cover cost. A lawyer quoted me $5000 to do the paperwork. My lawyer who has done my wills in a phone conversation asked me why I would I spend $5000 and have no idea if I would or my spouse would ever go in a nursing home. You can fill out the paper work the day before you would go in or even after you go in. My lawyer does not charge like the ones in fancy offices, has a small office in a tiny strip mall in Eustis. Used to be in summer field but closed that one.
"Medicaid typically only looks back at an applicant's income and asset transfers for a period of five years when determining eligibility for nursing home care, this is often referred to as the "look-back period" and is used to ensure individuals haven't deliberately transferred assets to qualify for Medicaid benefits." In Florida to qualify for Medicaid you can only possess $2,000 in total assets.
So in effect you must be indigent.

[retiredguy123]

So tell me this, if you have the means to pay for your nursing home bill, why do you want to pull off financial shenanigans to qualify for welfare? Why stick the taxpayers for your care when you can full well afford to pay your own way? So you can give it to your children? Once upon a time children were supposed to take care of their parents, not slough them off upon the taxpayers so they can leave a big estate.
According to the dictionary, shenanigans are "secret or dishonest activity or maneuvering". I don't condone shenanigans. But, I don't see anything wrong with following the Medicaid law to a person's best advantage. There are 91 million people currently enrolled in the Medicaid program. These are not just poor people. If you are eligible for a Government benefit, why not use it? And, if the Government wants children to take care of their parents, why pay for their nursing home care? Change the law.

[sharonl7340]

I have to say that you have had no experience with this. Medicaid makes you liquidate all of the assets, including the home and land that have been in your family for 5 generations, and anything else of value, including your great-grandmother's ring. I didn't mind paying our fair share, but why does it not preserve some assets? It takes everything you have (including that cushy 2nd home you have) to get the bare minimum of care. Otherwise, you are forced to care for your loved one at home with around-the-clock care when your loved one cannot speak, chew, move, or have any kind of quality of life.

I get angry when I read these kinds of posts. You have never been there, you don't know the anguish, the agony, the exhaustion. And to say there should be wards with beds with shared bathroom facilities is ludicrous. When my mom was mobile, there was plenty of time there was feces and urine everywhere because she had no control. We cleaned the bathroom 5-6 times per day many weeks.

You people don't know what you are talking about. You are assuming that the loved ones in these situations can walk, talk, feed themselves, and entertain themselves. IT. IS. NOT. TRUE! They reach points where they can not even chew and swallow but still don't qualify for full-time skilled nursing care because you provided TOO well for your spouse to be taken care of. I will get off my rant now, but go visit the nursing homes and follow the CNA around for a day and see if your mind changes.

[sharonl7340]

Something not mentioned in this thread is what is called "Aid and Attendance" for veterans. It is a monthly amount to pay for in-home assistance for those not able to take care of daily chores by themselves. If you are a veteran, look it up.

We applied. I spent several days off work running around and getting the documentation to apply. We submitted the paperwork and 4 months later got a letter that said my mom was eligible (well duh! She was the widow of a retired veteran). Three months after that, we received a letter that said she was eligible but not qualified because her monthly income was too much. They advised me to spend down the assets and then reapply in 6 months, but I would need all new documentation in order to do it.

If you can get it, great, but if you are living here, you will not meet the income guidelines.

[Ptmcbriz]

Let me bring up a solution no one (so far) as mentioned that I’m planning on doing. I’m very familiar with facilities in The Villages. My 93 year old father was progressing in Alzheimer’s 3 years ago when I needed to find a memory care facility. Most high end assisted living facilities offer a memory care unit with controlled environments, special trained staff, and special activities all geared just for Alzheimer’s patients. I had a specialist helping me find a nice facility and there are many here. Btw, there are no facilities in The Villages that accept Medicad. You would have to go outside the bubble to find one. Cost was $6700/mo. Gorgeous facility that had daily live concerts, beautiful dining room, spa, pool, gourmet meals, private rooms ( you provide the furniture), wine bar, hundreds of activities. A wonderful place. Most times when a person has to go into a facility they last less than 2 years. Up until that point you can pay for home assistance a few times a week until that’s not enough. How do you pay for $7000+ month and live your last couple years in luxury? You sell all your assets and use the equity gained from your house to pay for it. Most living in The Villages own a home which will have hundreds of thousands in equity once sold. Use that nest egg. (instead of savings or investments).

[Mobrien]

It is not ripping off the Government if you follow the rules that the Government established within the program. And, people have every right to give away their money to anyone they want. I would also point out that, in 2023, 91 million people were enrolled in Medicaid, not just the very poor or destitute.
Are you saying 25% (91m) of the population is enrolled in Medicaid?

[retiredguy123]

Are you saying 25% (91m) of the population is enrolled in Medicaid?
Yes. One thing that the Affordable Care Act did was to greatly expand the Medicaid health care eligibility. I think the income eligibility expanded to 4 times the poverty level, so some people making more than $40K per year became eligible for Medicaid.

[Aces4]

The travesty is the cost and quality of long term care, and this country's entire medical system.

Get back to me about that travesty after working in a long term care facility for a couple of months.chilout

[Aces4]

Are you saying that people who follow the rules shouldn't take advantage of a Government benefit, like Medicaid? Medicaid allows them to gift their money to avoid paying for nursing home care out of pocket. If done timely and correctly, they are entitled to the benefit.

Don't you mean people who follow the loopholes can get on the public dole while their kids get their dough?

Who do you think pays for Medicaid? YOUR KIDS and their kids and so on. That little piggy will break the bank eventually.

[Aces4]

It is tough from either point of view! I have had several family members go through the spend down Medicaid process. The taxes we have paid in all these years is being put to use.

Your taxes are about to increase mightily as seniors dump their assets and get on the public dole.:evil6:

[Aces4]

Who pays for the nursing homes? Our tax dollars. We have all paid taxes for years right?

And it's about to get worse. Let's get the word out on riding the public dole for our old age, watch your's and your children's taxes go crazy. Hang on world!:highfive:

[Aces4]

Medicaid was setup for people who are very poor or destitute. By hiding or giving away money or assets you are ripping off the government and the taxpayers.

It's amazing how many old people turn into crooks in their later years.

[Aces4]

It is not ripping off the Government if you follow the rules that the Government established within the program. And, people have every right to give away their money to anyone they want. I would also point out that, in 2023, 91 million people were enrolled in Medicaid, not just the very poor or destitute.

So a great number of low-life have learned how to cheat the government, we should all drop our morals and do the same?

[Aces4]

Yes, because not everyone living in a nursing home is bedridden. If you need a certain level of medical care, you may not be eligible for assisted living.

If you are in a nursing home you won't be out shopping and needing new furniture.

[Aces4]

According to the dictionary, shenanigans are "secret or dishonest activity or maneuvering". I don't condone shenanigans. But, I don't see anything wrong with following the Medicaid law to a person's best advantage. There are 91 million people currently enrolled in the Medicaid program. These are not just poor people. If you are eligible for a Government benefit, why not use it? And, if the Government wants children to take care of their parents, why pay for their nursing home care? Change the law.

The Medicaid program is intended for the poor and destitute and yes, maneuvering is in full force to get one's butt in the program if they aren't poor or destitute. Maybe it's time to make children responsible for their parents if the parents "have no money".

[Aces4]

Most long term care insurance experts say that the insurance is best suited for people who are either not poor or those who are not very wealthy. Those who benefit most from LTC insurance are those "in-between" people who have some wealth, but not enough to self-insure for long term care. So, it is not recommended for wealthy people who can afford to self-insure.

But isn't the plan that "wealthy" people shouldn't have to self-insure? Just divest their assets early and jump on the dole.

[retiredguy123]

Don't you mean people who follow the loopholes can get on the public dole while their kids get their dough?

Who do you think pays for Medicaid? YOUR KIDS and their kids and so on. That little piggy will break the bank eventually.
I don't disagree with you. But, that is the system the people voted for. Every time someone proposes to cut it, it is soundly defeated. These programs continue to grow and grow, and most people don't know it, but the ACA greatly expanded Medicaid. I don't know what you mean by a loophole, but that is the way the program works. The Government could eliminate any "loophole" they want to.

[Aces4]

I have to say that you have had no experience with this. Medicaid makes you liquidate all of the assets, including the home and land that have been in your family for 5 generations, and anything else of value, including your great-grandmother's ring. I didn't mind paying our fair share, but why does it not preserve some assets? It takes everything you have (including that cushy 2nd home you have) to get the bare minimum of care. Otherwise, you are forced to care for your loved one at home with around-the-clock care when your loved one cannot speak, chew, move, or have any kind of quality of life.

I get angry when I read these kinds of posts. You have never been there, you don't know the anguish, the agony, the exhaustion. And to say there should be wards with beds with shared bathroom facilities is ludicrous. When my mom was mobile, there was plenty of time there was feces and urine everywhere because she had no control. We cleaned the bathroom 5-6 times per day many weeks.

You people don't know what you are talking about. You are assuming that the loved ones in these situations can walk, talk, feed themselves, and entertain themselves. IT. IS. NOT. TRUE! They reach points where they can not even chew and swallow but still don't qualify for full-time skilled nursing care because you provided TOO well for your spouse to be taken care of. I will get off my rant now, but go visit the nursing homes and follow the CNA around for a day and see if your mind changes.

I have seen nursing homes and elder care. In our situation, generational assets were sold to family members who wanted to preserve and live in that generational home. The profits held by the owner were then used to pay for long term and memory care. That is the purpose of providing for one's old age.

My statement about wards for patients was meant for achieving care for every senior in this country if we all go on the public dole. And there will never be adequate care because enough caretakers cannot be hired to handle each personal situation. There isn't enough money to make most people do that difficult work.

[Aces4]

I don't disagree with you. But, that is the system the people voted for. Every time someone proposes to cut it, it is soundly defeated. These programs continue to grow and grow, and most people don't know it, but the ACA greatly expanded Medicaid. I don't know what you mean by a loophole, but that is the way the program works. The Government could eliminate any "loophole" they want to.

That's all well and good but just remember when you're receiving terrible care in overcrowded, underfunded facilities from loopholes you don't understand, your Government had your back.

[G.R.I.T.S.]

Not empty your bank account? This past year, a friend paid $30 per hour for around the clock care, plus time-and-a-half overtime, which coincidentally happened every week. That’s over $5000 PER WEEK. I’d say that would empty a bank account! Our biggest asset is our home so no giving heirs their share. We will most likely utilize the state financed route. According to our attorney, you choose the facility.

[retiredguy123]

That's all well and good but just remember when you're receiving terrible care in overcrowded, underfunded facilities from loopholes you don't understand, your Government had your back.
If you are calling planned "gifting" a loophole, I have to disagree. Planned gifting to become eligible for Medicaid and other benefits has been the name of the game for many years. If the Government disapproved of it, they could have changed the law years ago. Hiding assets is illegal, but planned gifting is not.

[Aces4]

If you are calling planned "gifting" a loophole, I have to disagree. Planned gifting to become eligible for Medicaid and other benefits has been the name of the game for many years. If the Government disapproved of it, they could have changed the law years ago. Hiding assets is illegal, but planned gifting is not.

Planned gifting? That's an insult to everyone's intelligence and it is exactly that, hiding assets in one's children or mistress or whomever.

[RoseyRed]

According to the dictionary, shenanigans are "secret or dishonest activity or maneuvering". I don't condone shenanigans. But, I don't see anything wrong with following the Medicaid law to a person's best advantage. There are 91 million people currently enrolled in the Medicaid program. These are not just poor people. If you are eligible for a Government benefit, why not use it? And, if the Government wants children to take care of their parents, why pay for their nursing home care? Change the law.
Your point of view is one to consider. I have worked and paid taxes my entire life with NO welfare, even though I could have due to physical issues. Many family members are irresponsible and depend on my tax money to keep them up which infuriates me! If someone is disabled or in a low time of their life that is one thing, but looking to the government (my taxes) to keep them up is another! How many welfare recipients truly deserve my tax money? How many are too proud to ask for help? With that in mind, I agree with following the law to the best advantage for us law abiding tax paying citizens :)

[Sandrak]

Wonderful solution.

[Aces4]

Your point of view is one to consider. I have worked and paid taxes my entire life with NO welfare, even though I could have due to physical issues. Many family members are irresponsible and depend on my tax money to keep them up which infuriates me! If someone is disabled or in a low time of their life that is one thing, but looking to the government (my taxes) to keep them up is another! How many welfare recipients truly deserve my tax money? How many are too proud to ask for help? With that in mind, I agree with following the law to the best advantage for us law abiding tax paying citizens :)

Just fine, and as stated earlier, get ready for horrific care and circumstances because there isn't enough money to float that canoe if everyone gets on board. After what I've read about the devious intentions here, I'll look into the same scheme and pass the word. Good luck!

BTW, if there are divorces in your family after you have "gifted" your assets, the departing spouse will be very grateful to you.

[Plinker]

According to the dictionary, shenanigans are "secret or dishonest activity or maneuvering". I don't condone shenanigans. But, I don't see anything wrong with following the Medicaid law to a person's best advantage. There are 91 million people currently enrolled in the Medicaid program. These are not just poor people. If you are eligible for a Government benefit, why not use it? And, if the Government wants children to take care of their parents, why pay for their nursing home care? Change the law.

I agree.
Since when does following the law set up by state and federal legislators cause you to be labeled a grifter? Could they not amend the rules if they chose to? I have no issue with those who decide to spend down all of their assets to pay for care as they age but I am not in that group if there are laws that offer an alternative.

[BumpaOompa]

For whatever reason some people don’t pay for insurance. They don’t have home insurance and when the house burns down or a hurricane destroys it they hold their hand out. They don’t have auto insurance and when they get in an accident they hold their hand out. They don’t have long-term care insurance and when they need it they hold their hand out. I realize insurance is expensive and not everyone wants to make those payments but if you don’t pay for the insurance you need then accept the consequences for the path you chose instead of trying to scheme a way around it.

[ithos]

Who pays for the nursing homes? Our tax dollars. We have all paid taxes for years right?

Yes but we also voted for politicians who have created a government debt of 37 trillion dollars and made commitments which have created unfunded liabilities of over 70 trillion dollars.

Eventually it may be Social Security that might be at risk. Let's hope AI comes to the rescue.

[kingofbeer]

I agree.
Since when does following the law set up by state and federal legislators cause you to be labeled a grifter? Could they not amend the rules if they chose to? I have no issue with those who decide to spend down all of their assets to pay for care as they age but I am not in that group if there are laws that offer an alternative.
My experience spending down my mother's asset to get her "medicaid" eligible was horrible. In retrospect, I would have only had 1 checking account for her. And one savings account. She had multiple accounts, and ira's etc. Because I had to send the state's medicaid department 5 years worth of statements printed out which was hundreds of pages. She was in assisted living for a few years. My mom entered the hospital, went to the rehab in the nursing home for a while. I think you need to go to hospital first, then rehab, then transition over to nursing home. Because my sister decided a nursing home would be best for her. Plus, my sister was good friends with the president of this well established, expensive, clean nursing home. Because my system was friends with someone on the inside, which allowed my mom to enter quickly, normally there is a 1 to 2 year waiting list for this facility. Once her assets where spent down, she was on medicaid. But the nursing home did not give me any legal advice or anything. They told me to contact an attorney which I did not want to do. Best thing to do is spend down, well in advance of entry into a nursing. However, this is hard to anticipate.

[Aces4]

I agree.
Since when does following the law set up by state and federal legislators cause you to be labeled a grifter? Could they not amend the rules if they chose to? I have no issue with those who decide to spend down all of their assets to pay for care as they age but I am not in that group if there are laws that offer an alternative.

Yeah, this free loading has been going on for a long time. Just depends if one wants to stick one's toe into the yellow river.

I saw a couple sell a large acreage, buildings and a home and then proceeded to hand all their money out to their kids who didn't need it. They proceeded to live in one of their daughter's basement, not a walkout, and hated it for the next 5 years. Then they went into low income housing, because they qualified... wink-wink, and he died within a short time from cancer. She lived into her nineties in that less than lovely situation. Neither one of them needed nursing home care that wasn't covered. But they sure shot a hole in what should have been some of the nicest years of their life. To each their own.:clap2:

[Lea N]

I’m sure some of you have these questions or have actually experienced these circumstances. I am talking about Medicare nursing facilities, not private. Private ones run about $9000.00 a month so for me that’s out of the equation. Been to seminars where they tell you you can protect your assets including sale of your house and just your s.security will cover cost. A lawyer quoted me $5000 to do the paperwork. My lawyer who has done my wills in a phone conversation asked me why I would I spend $5000 and have no idea if I would or my spouse would ever go in a nursing home. You can fill out the paper work the day before you would go in or even after you go in. My lawyer does not charge like the ones in fancy offices, has a small office in a tiny strip mall in Eustis. Used to be in summer field but closed that one.

Talk with an elder care attorney about every detail. Medicaid has a lookback period of 5 years. Any money you give away during the five year period is your responsibility to pay if needed in a nursing home. You are allowed to keep your home, and your car - or it used to be that way. You are allowed living expense money and it used to be $2K a month, I believe. Not sure what it is today.

When I was a caregiver to my father we met with an elder care attorney. She gave us the laws that were in place at that time. She told me to call her every few months to find out if any laws had changed and if we needed to do anything because of the new laws.

Another option that doesn't work for everyone, if you want to stay in your home is to pay someone that you know and trust to take care of you at an hourly rate that is usually minimum wage or a little above minimum wage. If there is a family member you trust, and they are able and willing to take care of you this might be an option. If you go this route the caregiver must keep excellent and detailed records involving the work they do. Most caregivers don't want the added hassle. This isn't for everyone. I had a friend a long time ago that did this for their spouse and it worked for them. The caregiver gets paid for taking care of their loved one at home, cooking, cleaning, dressing, bathing, medication management, travel to doctors, grocery shopping, etc. Since taxes aren't taken out of their income they would have to talk with a CPA ahead of time. An elder care attorney can give you more insight into this option.

[Arlington2]

I had a friend a long time ago that did this for their spouse and it worked for them. The caregiver gets paid for taking care of their loved one at home, cooking, cleaning, dressing, bathing, medication management, travel to doctors, grocery shopping, etc. Since taxes aren't taken out of their income they would have to talk with a CPA ahead of time.

Interesting, but I don't understand the merit of this. If the caretaker is a spouse they usually have joint ownership of assets. Is this intended as a means to spend down? Or is there some other reason to pay the spouse?

[retiredguy123]

If you really need the services of a fulltime time nursing facility, substituting in-home care will usually cost more money. That is because you need to pay for fulltime staff, and still maintain your house. The house requires taxes, utilities, insurance, maintenance, transportation to medical appointments, etc. If you can sell the house and move into a nursing facility, you will usually save money. Of course, If you have a spouse who still lives in the house, it can make a difference.

[GoldenBoy]

Stop reading this drivel. Find an elder care attorney and make a plan. No one on this site is qualified to give any useful information.Find an ElderCare Attorney and make a plan.

[jimjamuser]

What a joke, dump your money on your heirs so they can live the good life while the rest of the population pays for your fanny. I think to stop this practice, which has been going on for a long time, long term care should be beds in wards, shared public bathrooms and very, very basic care including the food. How about your kids take you in, provide the care and you pay them? That would be far more equitable for the American people.

I have watched so many couples dump their money to the kids to live off the public coffers. Talk about a travesty...barf
I agree in principle. Also, ALL the rules for medicaid could change in the next year.

[jimjamuser]

What a joke, dump your money on your heirs so they can live the good life while the rest of the population pays for your fanny. I think to stop this practice, which has been going on for a long time, long term care should be beds in wards, shared public bathrooms and very, very basic care including the food. How about your kids take you in, provide the care and you pay them? That would be far more equitable for the American people.

I have watched so many couples dump their money to the kids to live off the public coffers. Talk about a travesty...barf
Some people say that the quality of a society or country can be determined by how well they take care of their aging population. I wonder where the US ranks compared with Canada and Switzerland?

[jimjamuser]

Not sure I understand your post. I have spent time in nursing homes, but not as an employee. They had the required number of employees, but they were not first class. In one that I remember, the call bell rang 24/7 because there were not enough staff to respond, but apparently, the Government required the bell. I think nursing homes are very profitable for the owners. But my point is that I don't blame people who want to keep some of their money.
I had that same experience with the bell ringing constantly at a V.A. Hospital after midnight.

[Arlington2]

Some people say that the quality of a society or country can be determined by how well they take care of their aging population. I wonder where the US ranks compared with Canada and Switzerland?

Canada appears to be developing a scary approach. "Medical Assistance in Dying (MAiD) is an end-of-life option for Canadians accounting for 2% of all deaths in Canada in 2019. Adults over 80 years old represent a significant proportion of these deaths..."
Characteristics of Older Adults Accessing Medical Assistance in Dying (MAiD): a Descriptive Study - PMC (https://pmc.ncbi.nlm.nih.gov/articles/PMC8629503/)

And there is discovery of further abuse as reported in a Oct 2024 article. "Assisted dying is being abused in Canada with doctors coercing patients into ending their lives, members of the group who helped to legalise it have admitted."
Access Denied (https://www.telegraph.co.uk/us/news/2024/10/26/assisted-dying-abused-canada-admits-group-legalised/)

[jimjamuser]

If we could somehow get rid of Medicaid entirely, then the calculus would change. That has its own moral problems, but I think it would be better.
Medicaid and Medicare programs are SOCIAL programs designed to give the US a better, more stable SOCIETY. If there were no Medicaid then MANY older retired people would be FORCED to turn to a life of CRIME in order to eat and have a roof over their heads. If this many people turned to crime, it would cost SOCIETY MORE than the costs of Medicare and Medicaid are today.
.......Social programs give a country stability. To be a 1st world country you need stability and the rule of law.

[OrangeBlossomBaby]

Yes. One thing that the Affordable Care Act did was to greatly expand the Medicaid health care eligibility. I think the income eligibility expanded to 4 times the poverty level, so some people making more than $40K per year became eligible for Medicaid.

Not in Florida. That expansion was a state-specific thing. Obama wanted it to be nationwide, but Capitol Hill didn't like that so much and gutted a lot of the Act, replacing it with bits and pieces that wouldn't be efficient (which is why it's such a mess now).

There's a LOT of misinformation on this thread. No, you don't have to sell your grandmother's jewelry to qualify for Medicaid. In fact, if you're an adult and not disabled, don't have children, and are under 65 years old, you can't get Medicaid at all in Florida.

If Medicaid expansion was implemented in Florida, over 3/4 of a million Floridians would qualify, who currently have no insurance at all.

If your home is valued at under $600,000 (and change, I forget the exact amount), and your spouse is still living in it, then no - you don't have to sell it. It's a non-countable asset.

You CAN have an income - up to $2,829/month (which usually gets ported right over to the nursing home). You can't have assets over $2000 - and that doesn't include personal belongings (like that gold ring), household furnishings, your primary vehicle or your primary home. In Florida, IRAs in payout status are also exempt from asset limits - which means your minimum distribution is being withdrawn.

You can find the details and more information here:
Florida Medicaid Eligibility: 2024 Income & Assets Limits (https://www.medicaidplanningassistance.org/medicaid-eligibility-florida/)

[retiredguy123]

Not in Florida. That expansion was a state-specific thing. Obama wanted it to be nationwide, but Capitol Hill didn't like that so much and gutted a lot of the Act, replacing it with bits and pieces that wouldn't be efficient (which is why it's such a mess now).

There's a LOT of misinformation on this thread. No, you don't have to sell your grandmother's jewelry to qualify for Medicaid. In fact, if you're an adult and not disabled, don't have children, and are under 65 years old, you can't get Medicaid at all in Florida.

If Medicaid expansion was implemented in Florida, over 3/4 of a million Floridians would qualify, who currently have no insurance at all.

If your home is valued at under $600,000 (and change, I forget the exact amount), and your spouse is still living in it, then no - you don't have to sell it. It's a non-countable asset.

You CAN have an income - up to $2,829/month (which usually gets ported right over to the nursing home). You can't have assets over $2000 - and that doesn't include personal belongings (like that gold ring), household furnishings, your primary vehicle or your primary home. In Florida, IRAs in payout status are also exempt from asset limits - which means your minimum distribution is being withdrawn.

You can find the details and more information here:
Florida Medicaid Eligibility: 2024 Income & Assets Limits (https://www.medicaidplanningassistance.org/medicaid-eligibility-florida/)
The post about Medicaid expansion was NOT misinformation. Yes, it was state specific, but 40 states opted in to the expansion. It greatly expanded and increased the cost of the Medicaid program. A lot of people, who were happy with their private health insurance, lost that coverage and were forced to sign up for Medicaid instead. The ACA was an attempt to move closer to a national health care system.

[Grinchie]

Medicaid was setup for people who are very poor or destitute. By hiding or giving away money or assets you are ripping off the government and the taxpayers.
I agree. This is not ‘using our tax money’, it’s cheating the system & morally wrong. This system of spend down to qualify & hide assets was a product of attorneys, not the Department of Health & HS/gov.
The violations in N homes are often understated & are difficult for the public to find online (do check for prior violations before placing someone in a nursing home).

[retiredguy123]

I agree. This is not ‘using our tax money’, it’s cheating the system & morally wrong. This system of spend down to qualify & hide assets was a product of attorneys, not the Department of Health & HS/gov.
The violations in N homes are often understated & are difficult for the public to find online (do check for prior violations before placing someone in a nursing home).
If Medicaid is designed for the very poor and destitute, why are there 91 million people enrolled in it. And, why was the ACA designed for people making $40K to $50K and higher to use Medicaid for their primary health insurance?

[charlieo1126@gmail.com]

I am looking towards another option . I’m most likely going to end up in a place in Thailand ,called Care Resort Chiang Mai . I can afford a nice place here ,but nothing like the place in Thailand . you have your own villa ,many sizes to choose from on beautiful grounds , and can transition from independent to assisted living to memory care ,always being treated with individual care takers , most of the people living at the resort are westerners everything about this place and others around the world are first class , I’m in my mid 80’s and much of my early years were spent in Asia , so ending it there would mean a full circle of my life is complete I’ve researched very nice places here and Boston and you still end up with a parking lot view , that’s not for me

[opinionist]

When I was young, a relative suggested long-term care insurance. I could afford it then and have continued to pay into the plan. I am 70 now and have found that the best insurance for long-term care is to stay healthy. I am not talking about regular visits to an insurance doctor. They only seem to treat symptoms with pharmaceuticals. I am talking about visits to a holistic care doctor focused on the root cause of problems and a cure for what issues you may have. It costs money because insurance will not cover much of what they do. Knowing you are in the best health possible is a wonderful place to be.

[jimjamuser]

Hopefully, DOGE is on the way.
I have read that the DOGE plan is going to eliminate 2 categories of VA health benefits.

[jimjamuser]

The travesty is the cost and quality of long term care, and this country's entire medical system.
That sounds like what I think. Most of the world's top countries have National Health Care which costs the taxpayer less money than the US mess of different insurers with different rules - less cost and better results. With less costs for general medical services and medicine, that leaves MORE money for the elderly in nursing homes. Good care from cradle to the grave, that is the promise in counties OTHER THAN the US of A !!!!!!

[jimjamuser]

We have all worked hard for our money and let’s just hope that we have children to where If we give them money they will save it and use it to take care of us when we need it! I know I trust my son explicitly! And some of the threads I’ve read have said they think it’s awful for people to live off of Medicaid later? Well, I would rather see the government take care of its own senior citizens then spending billions on illegal immigrants, that’s just my opinion.
I agree.

[Aces4]

Medicaid and Medicare programs are SOCIAL programs designed to give the US a better, more stable SOCIETY. If there were no Medicaid then MANY older retired people would be FORCED to turn to a life of CRIME in order to eat and have a roof over their heads. If this many people turned to crime, it would cost SOCIETY MORE than the costs of Medicare and Medicaid are today.
.......Social programs give a country stability. To be a 1st world country you need stability and the rule of law.

If only the truly needy and unable to care for themselves financially were served, Medicaid would be very worthwhile. Right now, Medicaid is a joke.

Are there some older citizens needing assistance? Yes, but most would survive with just a little larger stipend. If they gave their money away early, I have no sympathy.

I would rather save this country than see the kids of senior citizens get a gift to buy a new boat, buy that second home on a lake, a new car, pay off their mortgage rather than paying the tab themselves and so forth. We're not just talking about screwing the country by making it pay for our senior aging, we're talking about breaking the financial back of the USA.

[jimjamuser]

Canada appears to be developing a scary approach. "Medical Assistance in Dying (MAiD) is an end-of-life option for Canadians accounting for 2% of all deaths in Canada in 2019. Adults over 80 years old represent a significant proportion of these deaths..."
Characteristics of Older Adults Accessing Medical Assistance in Dying (MAiD): a Descriptive Study - PMC (https://pmc.ncbi.nlm.nih.gov/articles/PMC8629503/)

And there is discovery of further abuse as reported in a Oct 2024 article. "Assisted dying is being abused in Canada with doctors coercing patients into ending their lives, members of the group who helped to legalise it have admitted."
Access Denied (https://www.telegraph.co.uk/us/news/2024/10/26/assisted-dying-abused-canada-admits-group-legalised/)
Any system can be abused. Or some media person could DECIDE it is being abused, just to publish an article. I would prefer to have the option of ending my life if that future life consisted of all pain and suffering with zero change of improvement. It gives people an additional option. They do NOT have to take that option. Hopefully, the end of life Doctors in Canada should decide in some group fashion to RECOMMEND it to the patient and their family if they have any.
......There should be controls in place so that the concept does NOT get abused.

[jimjamuser]

The post about Medicaid expansion was NOT misinformation. Yes, it was state specific, but 40 states opted in to the expansion. It greatly expanded and increased the cost of the Medicaid program. A lot of people, who were happy with their private health insurance, lost that coverage and were forced to sign up for Medicaid instead. The ACA was an attempt to move closer to a national health care system.
I agree that the ACA is an attempt to move toward a National Health Care. And that is a GOOD THING not a bad thing.

[jimjamuser]

I am looking towards another option . I’m most likely going to end up in a place in Thailand ,called Care Resort Chiang Mai . I can afford a nice place here ,but nothing like the place in Thailand . you have your own villa ,many sizes to choose from on beautiful grounds , and can transition from independent to assisted living to memory care ,always being treated with individual care takers , most of the people living at the resort are westerners everything about this place and others around the world are first class , I’m in my mid 80’s and much of my early years were spent in Asia , so ending it there would mean a full circle of my life is complete I’ve researched very nice places here and Boston and you still end up with a parking lot view , that’s not for me
That is an interesting solution. Probably not for everyone, but I hope that it works out well for you.

[jimjamuser]

If only the truly needy and unable to care for themselves financially were served, Medicaid would be very worthwhile. Right now, Medicaid is a joke.

Are there some older citizens needing assistance? Yes, but most would survive with just a little larger stipend. If they gave their money away early, I have no sympathy.

I would rather save this country than see the kids of senior citizens get a gift to buy a new boat, buy that second home on a lake, a new car, pay off their mortgage rather than paying the tab themselves and so forth. We're not just talking about screwing the country by making it pay for our senior aging, we're talking about breaking the financial back of the USA.
I agree. It seems like there is a lot of potential to ABUSE the system. I am NOT an expert in this subject, so I can't say for certain if the current system is good or bad. I would be happy if the US government looked into the pros and cons of National Health Care and then maybe had a national vote on it.
........But I won't "hold my breath" because it is unlikely to happen.

[DaddyD]

I am looking towards another option . I’m most likely going to end up in a place in Thailand ,called Care Resort Chiang Mai . I can afford a nice place here ,but nothing like the place in Thailand . you have your own villa ,many sizes to choose from on beautiful grounds , and can transition from independent to assisted living to memory care ,always being treated with individual care takers , most of the people living at the resort are westerners everything about this place and others around the world are first class , I’m in my mid 80’s and much of my early years were spent in Asia , so ending it there would mean a full circle of my life is complete I’ve researched very nice places here and Boston and you still end up with a parking lot view , that’s not for me

Ditto!!

I'm likely younger than most people here, but my plan is to find some type of CCRC (Continuing Care Retirement Community) in Asia (Thailand, Philippines, or Vietnam) or Mexico or somewhere in Central or South America. My money will go a LOT further in any of these countries (I'll likely be able to afford a private 24/7 caregiver), and in my opinion, from a cultural standpoint, the elderly are looked up to, not down on, as they mostly are in this country.

I don't know how up-to-date this is, but below is a list of elder care facilities in northern Thailand:

List of care homes in Chiang Mai Thailand (https://chiangmai.care/list-of-care-homes-in-chiang-mai-thailand/)

[Boomer]

We have had a LTC policy for almost 20 years. A few years ago the rates started to go up and the increase has been significant. We just hold our noses and pay the damned bill and write it off to the cost of sleep while hoping we never have to use the policy. We bought it as asset protection for each other. Paying for one in a nursing home would be hard enough on assets. Two would be horrendous.

A non-profit CCRC (Continuum of Care Retirement Community) can be a solution for those who can afford it. A CCRC can take you all the way through from independent living to hospice, if need be. But you have to pay to get in. If you go into independent living, the entry cost can depend on the size of your place, everything from very small on up. Some even have individual houses. There is a monthly fee also in independent living and sometimes meals can be included.

The CCRCs I know about are classified as non-profits and have endowments. They do not kick you out if you run out of money. But their actuaries have to let you in. (I don't know if all CCRCs are non-profits with endowments.)

I think some areas of the country have more CCRCs than others. There is one in Ft. Myers called Shell Point that my BIL looked at a few years ago. He liked it but did not go there. It might be worth looking into for some of you who want to stay in Florida. I don't know how Freedom Pointe in TV works.

You can look places up on medicare.gov and it will tell you if a place is a CCRC. If choosing one of those, starting with independent living seems to be the way to go.

Boomer

[retiredguy123]

We have had a LTC policy for almost 20 years. A few years ago the rates started to go up and the increase has been significant. We just hold our noses and pay the damned bill and write it off to the cost of sleep while hoping we never have to use the policy. We bought it as asset protection for each other. Paying for one in a nursing home would be hard enough on assets. Two would be horrendous.

A non-profit CCRC (Continuum of Care Retirement Community) can be a solution for those who can afford it. A CCRC can take you all the way through from independent living to hospice, if need be. But you have to pay to get in. If you go into independent living, the entry cost can depend on the size of your place, everything from very small on up. Some even have individual houses. There is a monthly fee also in independent living and sometimes meals can be included.

The CCRCs I know about are classified as non-profits and have endowments. They do not kick you out if you run out of money. But their actuaries have to let you in. (I don't know if all CCRCs are non-profits with endowments.)

I think some areas of the country have more CCRCs than others. There is one in Ft. Myers called Shell Point that my BIL looked at a few years ago. He liked it but did not go there. It might be worth looking into for some of you who want to stay in Florida. I don't know how Freedom Pointe in TV works.

You can look places up on medicare.gov and it will tell you if a place is a CCRC. If choosing one of those, starting with independent living seems to be the way to go.

Boomer
Freedom Pointe is the best place to go in The Villages, if you can afford it. You pay an entry fee, based on the size of the independent living condo, and a monthly fee. Then, you can move to assisted living or to the nursing home as needed. The other places are just rental apartments where you don't even get a lease. I have always considered long term care insurance to be a ripoff.

[Boomer]

Freedom Pointe is the best place to go in The Villages, if you can afford it. You pay an entry fee, based on the size of the independent living condo, and a monthly fee. Then, you can move to assisted living or to the nursing home as needed. The other places are just rental apartments where you don't even get a lease. I have always considered long term care insurance to be a ripoff.


That’s a wide brush you’re paintin’ there with…….

Rip off?

For you? Maybe. For us? Maybe. Maybe not. What we have paid into it over the past almost 20 years, even though it is a lot, would not cover even one year in a nice place. The policy we have also covers home care.

We decided to buy the policy after we saw what care in a nice facility could do to a couple’s assets. We also knew someone in memory care which I think must be the most expensive of all. Memory care can go on for a very long time. Like I said, we pay a lot for something we hope to never use, but if we do, it will make things easier. Caregiving by family members can become exhausting. I have seen that happen with friends and their parents and one friend with her spouse.

And spending down to Medicaid was not an option as we saw it. Therefore, buying a policy was the choice we made.

ymmv

Boomer

[retiredguy123]

That’s a wide brush you’re paintin’ there with…….

Rip off?

For you? Maybe. For us? Maybe. Maybe not. What we have paid into it over the past almost 20 years, even though it is a lot, would not cover even one year in a nice place. The policy we have also covers home care.

We decided to buy the policy after we saw what care in a nice facility could do to a couple’s assets. We also knew someone in memory care which I think must be the most expensive of all. Memory care can go on for a very long time. Like I said, we pay a lot for something we hope to never use, but if we do, it will make things easier. Caregiving by family members can become exhausting. I have seen that happen with friends and their parents and one friend with her spouse.

And spending down to Medicaid was not an option as we saw it. Therefore, buying a policy was the choice we made.

ymmv

Boomer
I don't know all the details of long term care insurance, but, if you end up in a nursing home, you will get the same level of care as a Medicaid patient. With a gifting plan, you can qualify for Medicaid and still have your money held by family members. If long term care insurance provided a better level of care than Medicaid, it may be worth it, but I don't think it does. Another thing I don't like about long term care insurance is that the insurance company decides when you are eligible for benefits, not an independent third party. So, if they deny benefits, what can you do about it?

[LuvtheVillages]

I don't know all the details of long term care insurance, but, if you end up in a nursing home, you will get the same level of care as a Medicaid patient. With a gifting plan, you can qualify for Medicaid and still have your money held by family members. If long term care insurance provided a better level of care than Medicaid, it may be worth it, but I don't think it does. Another thing I don't like about long term care insurance is that the insurance company decides when you are eligible for benefits, not an independent third party. So, if they deny benefits, what can you do about it?

You are assuming that all nursing homes provide the same level of care. That is not so.

Homes that have mostly Medicaid patients provide a minimum level of care. Constantly short handed. Call buttons go unanswered. Sometimes smelly.

More costly homes with few, if any, Medicaid patients will take better care of you. That is what the LTC insurance provides.

[retiredguy123]

You are assuming that all nursing homes provide the same level of care. That is not so.

Homes that have mostly Medicaid patients provide a minimum level of care. Constantly short handed. Call buttons go unanswered. Sometimes smelly.

More costly homes with few, if any, Medicaid patients will take better care of you. That is what the LTC insurance provides.
Almost every nursing home I have visited had about a 90 percent Medicaid occupancy. I thought that LTC insurance benefits were based on a daily payment rate that was usually not enough to pay for most nursing homes. Are there any nursing homes located near The Villages that do not accept Medicaid patients, but still are reasonable enough to be covered by LTC insurance? Most people do not have LTC insurance and cannot afford to pay about $10K per month for a nursing home. Also, the average LTC insurance benefit is between $130 and $160 per day, which is nowhere close to covering any nursing home.

[Eg_cruz]

I’m sure some of you have these questions or have actually experienced these circumstances. I am talking about Medicare nursing facilities, not private. Private ones run about $9000.00 a month so for me that’s out of the equation. Been to seminars where they tell you you can protect your assets including sale of your house and just your s.security will cover cost. A lawyer quoted me $5000 to do the paperwork. My lawyer who has done my wills in a phone conversation asked me why I would I spend $5000 and have no idea if I would or my spouse would ever go in a nursing home. You can fill out the paper work the day before you would go in or even after you go in. My lawyer does not charge like the ones in fancy offices, has a small office in a tiny strip mall in Eustis. Used to be in summer field but closed that one.
This is done for a special needs trust which will cover both you and your spouse. Why now vs later, the sooner you do it the more the trust can protect when one goes into care and want to apply for Medicaid. If you have enough assets to paid for your care and are not worried about the cost then there’s your answer. Unfortunately LTC Insurance is dying. Have you looked at Life Insurance with. LTC rider, it’s not for everyone but there is always benefit to someone, but even those aren’t as good as they used to be.
You might want to just puts funds a side into guaranteed investment and just that pay for your care

[Grinchie]

I’m sure some of you have these questions or have actually experienced these circumstances. I am talking about Medicare nursing facilities, not private. Private ones run about $9000.00 a month so for me that’s out of the equation. Been to seminars where they tell you you can protect your assets including sale of your house and just your s.security will cover cost. A lawyer quoted me $5000 to do the paperwork. My lawyer who has done my wills in a phone conversation asked me why I would I spend $5000 and have no idea if I would or my spouse would ever go in a nursing home. You can fill out the paper work the day before you would go in or even after you go in. My lawyer does not charge like the ones in fancy offices, has a small office in a tiny strip mall in Eustis. Used to be in summer field but closed that one.

If you redo your RE deed & replace with a Lady Bird deed naming beneficiaries after the surviving spouse dies (if single, after your death), then ownership of the property will automatically transfer to your beneficiaries (without Probate, which normally triggers Medicaid reimbursement).
If you put POD (pay on death) on your bank accounts, that person(s) cannot access your money, but upon your death, all they have to do is present a certified copy of your death certificate & the bank will turn the money over to them.
Can also put beneficiaries or use Transfer on Death form for investments. (No Probate on these methods).
Qualified Income Trusts (Aka Miller Trusts) can be used if income is too high to qualify for Medicaid. Surplus income placed in Trust must be used to enhance the medical care of the person entering nursing home.
See a local attorney; these are cheap protections for Estates, especially if people qualify for Medicaid. All people may benefit from no Probate required & faster transfer of assets to beneficiaries & no Executor trying to resolve arguments amongst heirs.

[JMintzer]

I don't know all the details of long term care insurance, but, if you end up in a nursing home, you will get the same level of care as a Medicaid patient. With a gifting plan, you can qualify for Medicaid and still have your money held by family members. If long term care insurance provided a better level of care than Medicaid, it may be worth it, but I don't think it does. Another thing I don't like about long term care insurance is that the insurance company decides when you are eligible for benefits, not an independent third party. So, if they deny benefits, what can you do about it?

For someone who admits they "don't know all the details of long term care insurance", you are sure making a lot of assumptions...

We bought our policies decades ago, starting at just over $1K/year each.

We just received our annual bill and its Just under $2.5K/year each... (it went up when we hit 65).

Our annual bill wouldn't even cover 1 month of home care or living in an assisted facility. Since we bought it when we were young, it's been a bargain.

What we've spent in total (premium wise) wouldn't cover 1 year in a nice assisted living facility, yet it's included in our policy.

To compare, our next door neighbor pays about $15K per year each (they waited to buy their policies...)

For us, since we bought our policies early, it's a bargain.

We had our financial planner review all of our insurance policies and he told us to NEVER miss a payment on those long term policies. That they were worth their weight in gold and that you cannot even buy a similar policy any more...

I will gladly pay $2.5K/year for in home care or an assisted living facility if/when needed...

[Grinchie]

Are you saying 25% (91m) of the population is enrolled in Medicaid?

Most people on welfare are covered by Medicaid. That includes all children in a family on welfare.

[retiredguy123]

Most people on welfare are covered by Medicaid. That includes all children in a family on welfare.
Also, many people using the ACA for health insurance are on Medicaid. See Post No. 50.

[CoachKandSportsguy]

Stop reading this drivel. Find an elder care attorney and make a plan. No one on this site is qualified to give any useful information.Find an ElderCare Attorney and make a plan.

oh please. . you type like an attorney looking for work

there are many experienced people here who are intelligent and have gone to elder care attorneys, and are relating their experiences. Relating experiences is not the same as legal advice, but its a good place to get familiarized before seeking legal advice and some can be better than an inept lawyer, there are some out there. .

been to two personally, and one was much better than the other.


free seminar tomorrow at 1PM from Trotterlaw.com by eldercare attorneys.
must call (352) 205-7245 for reservations. ..