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.

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.

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.

"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.

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 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.

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.

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).

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.

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

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.

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

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:

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

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

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

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".

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

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.

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.

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.

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.

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.

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 :)

Wonderful solution.

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.

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.

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.

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.

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.

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:

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.

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?

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.

long term care
 

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.

I agree in principle. Also, ALL the rules for medicaid could change in the next year.

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?

I had that same experience with the bell ringing constantly at a V.A. Hospital after midnight.