I’m asking this question, because I constantly see articles and receive advice from family/financial/ estate planning about getting Medicaid coverage, and how to “protect” the aging’s assets so they can qualify for Medicaid.
Here’s my question, if your loved one spent their whole life saving for “retirement” trying to put themselves in a good financial position, however started experiencing health problems, why is it a goal to put them in a position where they only qualified for Medicaid level care? Wouldn’t you want their hard-earned money to go towards a quality of life?
I think Medicaid is great for those who don’t have the financial means to care for themselves, are disabled and could never build a proper income , or perhaps towards the end of life, when assets run out, they aren’t put out on the street.
I’m just wondering what the other reason is besides moving their assets so the family can inherit after their passing when it should technically be theirs? What is the benefit for the aging loved one, that I’m not seeing?
Recently became POA for my mom who suddenly started to decline and only come across advice on trusts and Medicaid when I know my mom worked hard and made good decisions for what she has. I’m thinking what was originally meant for her retirement, should go towards quality care for her. What else am I missing??
My father passed two years ago after three months in memory care and one month for rehab after breaking his hip. This was paid for out of their savings. I helped my mother sell the house and move her to the lovely retirement community she couldn’t convince my father to move to. Her common refrain was “after your father passes, I will move to Rossmoor, and then I’ll be happy.“
The PA who ran in my dementia support group warned me that after my father passed I would notice the deficits in my mother. Boy did I. She had been mismanaging money for awhile. She had cancelled my Dad’s medigap insurance and had to pay out of pocket for his rehab after his hip replacement. When her financial planner told her not to worry about paying off her home equity loan until after the house was sold she stopped paying altogether, adding $20,000 to the bill. I wrote these off as hearing mistakes. The new hearing aid hasn’t helped.
I have had mixed feelings about this trust. If I were the state of California I would be trying to eliminate these trusts which allow families with an expendable $8,000 to bilk the state out of billions in estate taxes. However, when my mother spent $500 on a paper shredder because she is an important business person and had three months of $1,000 PG&E bills after she “adjusted” her thermostat, I am grateful that she does not have access to the money from the house sale. Scammers abound, and I am sure you’ve heard the stories of seniors giving their money to bad actors.
The deal with the trust is that I am not allowed to use the money to directly benefit her. But how I spend my money is my business. This requires me to move trust money to my account before putting it into hers when her expenditures exceed her bank account.
My thoughts on trusts are that while they are legal, they are not exactly ethical—a convenient loophole for people with money to hang on to their money. However, as my mother has been recently diagnosed with dementia, I will use trust money to take care for her when her savings run out. As memory care in her neighborhood runs $12,000 to $14,000 a month, this is a distinct possibility. If she outlives that, we will have no choice but to apply for Medicaid on her behalf as I my husband and I need to save our money for our possible care.
My 96 yr old Dad worked and saved and had a nice nest egg that us 4 daughters thought we'd be divinding once he past but last year with his dementia worsening, he needed 24 7 Care.
Im the youngest and lives the closest so I've always done everything for my Dad as he aged like Dr's Appointments, Groceries, manage his money, pay his bills, ect. I am also the Executrix of his Will.
My Dad always wanted to stay in his own home and not go to a Senior Home and I promised him that would happen.
So, as of a year ago, I informed everyone that Dad would no longer be giving out money for Xmas and Birthdays and No Loans to anyone that he needed his money for Home Care.
I hired Cargivers and my Dad had 24 7 Care.
I had my son install Nest Cameras so I can check in and see and hear my Dad 24 7 and make sure the Caregivers are treating him right.
24 7 Home Care is very costly and hopefully his money doesn't run out.
Aflyer a year of 24 7 Care doing their shifts. I'm now thinking to make his money go farther, I'm going to look in to hiring a Live In which would be 1/3 of what is being paid for multiple Caregivers doing their shifts.
People should only concern themselves with what the Loved One wants, not be selfish and spend and or hide the loved ones assets so they can qualify for Medicaide which you could end up in a not so desirable place to lay til you die where they are just a bed to most and where they will feel sad, abandoned, lonely, scared and will lose their will to live.
Im sure they're are some nice places but even the nice places that look pretty and are made to sound so great is only for your observance and it's a different story behind closed doors.
The Loved ones should be able to live out their last years doing whatever they want.
Do to them what you would want done for yourself.
Tall to them, they know what they want. Make it happen for them.
Only if and when the money is gone should you seek Medicaide.
Best thing one can do for an aging Senior is let them live out their life in their own home where it's familiar to them.
Even
There will be no inheritance. I just want her comfortable, medically taken care of.
But often, not ALWAYS its basically a scam to have taxpayers pay for ones care rather than oneself. I have seen plenty of examples in that in my own extended family.
I'm the owner of this home (2d marriage for both of us), but he may be considered part owner, I'm not sure. I, too, get a pension from where I worked, Social Security, long-term care insurance, but I've saved like crazy including 2 annuities. I also normally am a freelance worker. (Covid currently has unemployment coverage for freelancers.) I'm concerned when I read the Spousal Impoverishment rules <https://www.medicaid.gov/medicaid/eligibility/spousal-impoverishment/index.html> . I'm not concerned about what either his or my kids might inherit, but have tried responsibly to plan for the financial "joys" of old age. I'm the one who talked him into the long-term care policy because I knew he had some health issues.
Yes, we'll pay privately (home health care?) while we can, but that doesn't look like it will continue to be enough? Does this mean I need to give up on my own continued work and savings? I'm glad there's at least some provision, but it sure doesn't speak well to those of us trying to be responsible.
However, you have to use your funds on only yourself, and cannot transfer/gifts assets or funds to anyone within the last 5 years in order to qualify. If you do, you will have to figure out how to “pay back” that amount before Medicaid starts (or pay a penalty.)
Because, depending on where you live and the level of care that you need, nursing homes and/or assisted-living can cost anywhere from $2000-$10,000 a month, you can see how quickly you can burn through your assets, and end up on Medicaid.
I speak with experience. My husband has been a private-pay long-term resident for the past five years. He entered long-term care at age 59 due to frontotemporal degeneration. Some time next year, we will run out of money to pay 100% of his nursing home bills. He will still be able to pay about 50% of the bill. To extend his private-pay status, I will take out a mortage on my paid-up condo, which I should be able to pay off in five years. I also fully intend to pay Medicaid back every cent they pay for his care, even if I am into my ninth decade. Once I begin taking Social Security at age 68, I will voluntarily contribute about $10K annually to his care. That will decrease the amount I must reimburse Medicaid.
There are legal ways to shield assets. A competent elderlaw or estate planning attorney can help. Our attorney will convert what is left in my retirement accounts to a Medicaid-compliant annuity. The good news: I get to keep the money. The bad news: it's a fixed income stream.
1. A couple has assets but spends freely, having every possible luxury, and save nothing. So they go into a nursing home later in life and Medicaid foots the bill.
2. A couple live frugally, doing without luxuries, and accumulate a sizable savings account. So they go into the same nursing home and use their savings to pay for their care.
3. A couple with considerable wealth sign over their assets to their children well before the five year look back period. So they go into the same nursing home and Medicaid foots the bill.
it seems that the couple that scrimped and saved lost out!
My parents had money & a big CA house near the beach. Then dad got cancer & they spent all savings/reverse mortgage to pay for his non-helpful chemo then experimental drugs. Poverty & dementia hit my mommy hard as soon as dad's funeral was done.
Moved her in with me, her only child, until while I'm at work, she walked into highway traffic thinking she was "crossing" her childhood street. Again.
With my own health, job, & finances in tatters to juggle care for her at home, I relented to Medicaid for mommy's 24 hour memory care because there's no personal money left. Awful. Heartbreaking. With COVID I can never kiss or hug her. But, she is safe now & is "ok" with her routine. I'm thankful for Medicaid for my mommy's protection & care.
Medicaid was NEVER the plan. It's a safety net.
In our case with my stepfather his old age during which he needed assistance and oversight lasted 10 years, from the time he was 80 until he was 90. And he needed ultimately to be in a nursing home (about $140,000 a year in the New York metropolitan area and the place didn’t take Medicaid). There were all sorts of other expenses as well. Luckily there were few painful procedures and he had a DNR so without a great deal of oversight, things might not have gone well so far as making the money last.
My mother is now 90 and although seeing to her needs and keeping her company has begun to really intrude upon my lifestyle, especially with COVID19 looming, financially she and he provided well for themselves. Generally people get involved in spending down in order to safeguard their own resources, and to get their parents the care they need although they haven’t been able to save for it. Also one hears that some elders would prefer to leave their children or grandchildren provided for and to scrimp on their own care. Sometimes children and grandchildren can move them in that direction. So there are many issues here.
The desire to leave a legacy becomes very powerful for those who have worked hard all their lives without having much to show for it. But the big question here is usually whether the elder will be able to stay in her home (she will eventually need help she approves of probably in addition whatever you can do yourself) or whether she may need assisted living or nursing care. If so, then a minimum of at least weekly visits are part of the expense. If the elder lives far from you, this too can run into money, not to mention time if you, yourself, are not retired.
I find that the biggest need for both of my parents wasn’t actually financial in nature, and that was the need for congenial adult companionship and attention.
In our case with my stepfather his old age during which he needed assistance and oversight lasted 10 years, from the time he was 80 until he was 90. And he needed ultimately to be in a nursing home (about $140,000 a year in the New York metropolitan area and the place didn’t take Medicaid). There were all sorts of other expenses as well. Luckily there were few painful procedures and he had a DNR so without a great deal of oversight, things might not have gone well so far as making the money last.
My mother is now 90 and although seeing to her needs and keeping her company has begun to really intrude upon my lifestyle, especially with COVID19 looming, financially she and he provided well for themselves. Generally people get involved in spending down in order to safeguard their own resources, and to get their parents the care they need although they haven’t been able to save for it. Also one hears that some elders would prefer to leave their children or grandchildren provided for and to scrimp on their own care. Sometimes children and grandchildren can move them in that direction. So there are many issues here.
The desire to leave a legacy becomes very powerful for those who have worked hard all their lives without having much to show for it. But the big question here is usually whether the elder will be able to stay in her home (she will eventually need help she approves of probably in addition whatever you can do yourself) or whether she may need assisted living or nursing care. If so, then a minimum of at least weekly visits are part of the expense. If the elder lives far from you, this too can run into money, not to mention time if you, yourself, are not retired.
I find that the biggest need for both of my parents wasn’t actually financial in nature, and that was the need for congenial adult companionship and attention.
Also, get as much education about Medicaid and how it actually works in the state your Mom lives in. Medicaid is a program funded by both the federal government and each state government. Each state has a state Medicaid program and determines what is covered under that program within the requirements set by the federal government. State Medicaid programs are entitlement programs, which means all who qualify will receive the benefits covered by their state's programs. There are also Medicaid waiver programs that each state applies for. Each waiver covers benefits that are determined by the state. Many states cover Home and Community Based Services under state Medicaid waivers. A very important point to understand is that Medicaid waivers are not entitlement programs, and that states can and do set limits on the number of enrollees. This means that a person could qualify for Medicaid, but still not receive benefits provided under state Medicaid waivers if the enrollment cap has been exceeded. This means that person will go on a waiting list to receive the benefits covered by that waiver. If the only care available under the state Medicaid program is nursing home care, is that okay with your mother. Obviously, this situation should be discussed by all people involved - the care recipient, each caregiver, and other family members involved. So, if it's possible, talk to your mother about what she wants. Contact the state government department or agency that manages the state's Medicaid program and find out what is covered under the state Medicaid program and what is covered under that state's Medicaid waivers. My prayers go out to you.
Congrats!
Hopefully you have enough care set up to take care of mom (you indicate keeping her in her home as long as possible) for at least a few months, even better if longer, or at least only take on a few hours yourself!
Caring for a newborn AND yourself can be taxing enough without having to also care for another person.