Need help with elder law? Need help with Medicaid? Have you recently retired? Have elderly parents? We can help.
Long-Term Care Insurance Review
LTC insurance can be a valuable part of your long term care planning. There are many policies and options from which to choose. We will review these policies to give you a second opinion about your policy choices. Because we do not sell any form of insurance, we can provide a totally independent and objective opinion.
Medicaid is joint federal and state program that helps pay for medical services including nursing home care. Medicare and Medicaid were enacted in 1965 as part of the Great Society legislation. The purpose of this legislation was to provide older and disabled individuals with access to medical care. For individuals 65 and older, as well as certain disabled individuals, payment for medical care such as hospital visits and doctor visits are covered by Medicare. However, Medicare has no significant provisions to assist those same people with long term care needs. The Medicaid program, in addition to providing medical coverage to the less well off, also provides coverage for long term care.
To obtain Medicaid you must be both financially eligible and require the level of care given in a nursing home. Your income and your assets must both be below certain set levels. In general, to determine the level of income you can have and still qualify for Medicaid, you add the monthly Medicaid rate for the nursing home you wish to enter with your monthly medical expenses. If your income is below the sum of those amounts, you will qualify (assuming other qualifications are met). For example, if the monthly Medicaid rate for a nursing home is $5,000 and your medical expenses are $300 and your monthly income is less than those two amounts combined ($5,300), your income will allow you to qualify for Medicaid assistance. In some cases if your income is above that amount, but below the private pay rate of the facility you may also qualify.
In addition to needing your income to qualify, you have to possess no more than $2,000 in countable assets. Various assets, such as a home and car, are often exempt and will not count against you. However, it is important to note that assets in the name of the Medicaid recipient, even if exempt, may be subject to estate recovery for payments made at a later time.
Finally, to qualify for Medicaid a person must generally need a certain level of assistance with various activities of daily living. Activities of daily living include eating, bathing, transfer, bed mobility, locomotion, toileting and medication management.
While most individuals would like to avoid nursing home care, there are situations where it is unavoidable. In such a situation, you may want to explore the long term care benefits provided under the Medicaid program. If you or a loved one would like assistance with qualifying for these benefits please contact us.
Washington COPES Program
For most people the thought of spending their final years in a nursing home is incredibly unpleasant. However, many individuals who need assistance can stay in their homes or in another residential setting and still receive the care they need. As a way to help pay for such in-home style care, Washington State’s Medicaid program has a separate program that allows for payment for individuals who are not receiving institutional care in a nursing home. This program is called COPES (Community Options Program Entry System).
COPES, like the general Medicaid program, is needs based. To qualify to receive money under this program a person must need some form of medical assistance as well as financial assistance. More specifically, to qualify for COPES a person must generally need assistance with two or more of the activities of daily living. Activities of daily living include eating, bathing, transfer, bed mobility, locomotion, toileting and medication management.
Additionally, to receive payment under COPES, a person must be both income and resource eligible. That means a person’s monthly income, minus reductions, must not exceed certain levels. Similarly, a COPES recipient can have no more than $2,000 in countable resources in order to qualify for assistance. Various assets, such as a home and car, are often exempt and will not count against you. However, it is important to note that assets in the name of the COPES recipient, even if exempt, may be subject to estate recovery for payments made at a later time.
Once you qualify for COPES assistance, the amount you receive is determined by the level of care needed, the type of place you are residing (home, adult family home, assisted living facility) and your location. For instance you may receive slightly more money if you reside in an assisted living facility in Seattle rather than an adult family home in Everett.
To find out if you or a loved one qualifies for COPES, and if you need assistance protecting your assets while qualifying for COPES, please contact us.