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Time Urgent Window For Seniors
By: Larry Klein
By the time you read this, the President will have signed into law significant
restrictions to the Medicaid law. This article describes the opportunity for
seniors to take action and protect themselves. These restrictions are intended
to stop abuse of the Medicaid system by middle income and even wealthy seniors
who think of Medicaid as the last resort for senior insurance. Until now, the
Medicaid law has been so liberal, anyone could qualify for Medicaid supported
long-term care. For example, a home has been a non-countable asset, so one could
own a $10 million home (or an apartment building in which they reside) and still
qualify for Medicaid. No more such loopholes in this senior insurance program.
Anyone with more than $500,000 in home equity cannot receive long term care
benefits from Medicaid. Additionally, one will be penalized if they have given
any type of gift within the last five years (the look-back period was previously
three years). The gifts taken into account include college tuition for
grandchildren, emergency help for family, Christmas, birthday, wedding and
graduation presents, charitable and church donations. In other words, Congress
is attempting to insure that the only people who use Medicaid for long term care
will be those that normally don't have enough money to give gifts anyway. Use
caution making gifts or donations as they will penalize your ability to obtain
Medicaid benefits for long term care for the next 5 years. This senior insurance
program will no longer be available to many.
The new law starts the penalty period when the senior applies for Medicaid, not
when the gift is given. For example, if Mrs. Jones gave a $40,000 donation four
years ago (within the five year look-back period) and if Medicaid needs to pay a
local long term care facility $4,000 a month, then Medicaid will not make any
payments for 10 months. In other words, Medicaid penalizes assistance for the
value of the gift. Even if Mrs. Jones is now broke, Medicaid will not provide
support until she has been in a long term care facility for 10 months.
Also be aware that nearly every state is tightening their implementation of the
general Medicaid rules. Do not automatically assume that an annuity is an exempt
asset or that the residence cannot be attached for recovery. These rules are in
flux and favor the state, so you must maintain contact with your state agency
that administers Medicaid or an Elder Law attorney.
So what should the average senior do? Middle income and wealthy seniors no
longer have a substitute for long term care insurance. They cannot rely on the
government as their supplier of senior insurance. Of the three choices that have
been available for dealing with long term care: a) self-insurance, b) private
long term care insurance, c) position assets to collect Medicaid, the list is
now down to two options: a) self-insure or b) private long term care insurance.
In other words, if you've delayed buying long term care insurance thinking that
you had the government as a safety net, that safety net is now gone.
Note that Medicaid was never a good option anyway. Someone with private long
term care insurance that can pay “full fare” for long term care gets a nice
sunny private room with big windows. The senior on Medicaid gets shoved in an
interior room with two other people, no windows. As much as this is illegal or
people want to deny it happens, as stated by the National Senior Citizens Law
Center: “Many common nursing home practices are illegal. For example, although
the Federal Nursing Home Reform Law requires that all residents receive
high-quality care, many nursing homes provide lesser care to residents whose
care is paid through Medicaid.”
Why don't seniors just get private long term care insurance? The most common
reason is the expense. But it's a bad excuse because an experienced financial
advisor can show you how to keep the cost down or make a one time payment rather
than annual payments (using an immediate annuity or a “combo policy,” its
possible to make one single deposit and avoid annual payments). In some states,
insurance companies can provide a return-of-premium option. With that option, if
you never use the policy, your heirs get all of your premiums returned. But
don't delay. One negative comment in your medical records can preclude you from
ever getting insured so get the coverage now.
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