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-   -   Long term care (https://www.talkofthevillages.com/forums/medical-health-discussion-94/long-term-care-354997/)

ROCKETMAN 12-07-2024 09:16 AM

Long term care
 
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 12-07-2024 09:31 AM

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 12-07-2024 09:47 AM

Quote:

Originally Posted by ROCKETMAN (Post 2391516)
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 12-07-2024 10:21 AM

Look back
 
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 12-07-2024 11:32 AM

Quote:

Originally Posted by LuvtheVillages (Post 2391542)
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 12-07-2024 11:55 AM

Quote:

Originally Posted by Aces4 (Post 2391586)
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 12-07-2024 12:14 PM

Quote:

Originally Posted by Aces4 (Post 2391586)
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 12-07-2024 12:29 PM

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

:popcorn::popcorn:

ThirdOfFive 12-07-2024 12:44 PM

Quote:

Originally Posted by ROCKETMAN (Post 2391516)
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 12-07-2024 01:17 PM

Quote:

Originally Posted by dewilson58 (Post 2391595)
Protect 1/2 of your assets now...............Divorce your spouse.

:popcorn::popcorn:

Sad but true.

Aces4 12-07-2024 01:23 PM

Quote:

Originally Posted by retiredguy123 (Post 2391589)
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 12-07-2024 01:44 PM

Quote:

Originally Posted by Aces4 (Post 2391611)
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 12-07-2024 03:12 PM

Quote:

Originally Posted by ROCKETMAN (Post 2391516)
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 12-07-2024 03:36 PM

Quote:

Originally Posted by retiredguy123 (Post 2391617)
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 12-07-2024 05:31 PM

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.


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