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Home » Life Care Planning and the Medicaid Waiver

Life Care Planning and the Medicaid Waiver

October 14, 2021 by Wendy S. Hillmuth

Medicaid waiverPeople routinely prepare for their active retirement years, but most of them do not see a holistic picture. Yes, you have to accumulate the resources that you need to live well during your golden years, but an additional transition will probably enter the picture.

Living Assistance

More than half of senior citizens will need paid living assistance, and many others will receive assistance from unpaid caregivers. You should prepare for this eventuality in advance, and the first step is to acknowledge the fact that you will probably need help with your activities of daily living.

Aging in Place

A move into a long-term care facility would be an option, but many (if not most) people would rather stay in their own homes. When you stay put, you are in familiar surroundings, and you can maintain long-standing relationships with your neighbors.

The modifications that units in long-term care communities have are part of the appeal, but they do not have a monopoly on living in place adaptation. There are builders that are aging in place experts, and you can engage one of these contractors to modify your living spaces.

Possible modifications include outdoor ramps, walk-in showers and tubs, smart home technology, motion sensor faucets, slip resistant flooring, stair chairs, and elevators.

This is just a partial list, but there are countless different adjustments that can be made to address mobility challenges. Aging in place concepts are also useful for adult child caregivers that want to modify their own homes to accommodate parents that are moving in with them.

In-Home Care Costs

The cost factor is not an issue if you are getting the assistance that you need from family members, friends, and/or neighbors. However, some people need a level care that can only be provided by a paid home health aide.

You can expect to pay over $5000 a month for a home health aide in the Burlington, Vermont area. Just over half of people that need paid living assistance incur the bills for more than a year, so the expenses can be considerable.

A lot of people assume that Medicare will pay for in-home care or a stay in a nursing home or assisted living community. In fact, Medicare does not cover long-term custodial care.

Medicaid Home and Community-Based Services Waiver

Medicaid will pay for nursing home care, and there is a Medicaid Home and Community-Based Services Waiver that will assist with in-home care costs. Of course, there is an asset limit because Medicaid is a need-based program.

This limit is $2000 in the state of Vermont, so you have to divest yourself of assets to become eligible, but this is easier said than done. There is a five-year look back period, so if you give your love ones their inheritances in advance, there would be a five-year period of ineligibility.

You may not be in a position to live comfortably for the next five years if you give income producing assets to your children. This is fully understandable, and an irrevocable, income only Medicaid trust can be the solution.

The trust would be funded with assets that are producing income and other resources. The principal would not count if you apply for Medicaid if you don’t violate the look back. However, you could receive distributions of the trust’s earnings while you are living independently.

In closing, we should touch upon the program’s treatment of a home. Your home is not a countable asset, but they can put a lien on the property after your death during the Medicaid estate recovery phase.

For this reason, you can convey your home into the trust as well. You would be able to live in it rent-free as usual, but it would be protected during the estate recovery process.

Implement a Plan For Aging!

We can help you establish a plan for aging that will allow you to enjoy your retirement with peace of mind. If you are ready to get started, you can schedule a consultation at our Essex Junction, VT elder care planning office if you call us at 802-879-7133.

There is also a contact form on this site you can fill out if you would rather send us a message.

  • Author
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Wendy S. Hillmuth
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Filed Under: Uncategorized Tagged With: Medicaid Home and Community-Based Services Waiver, life care planning, Elder Law, Medicaid trust

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