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In the United States, advances in science, technology, and medicine have dramatically increased our average life expectancy over the last century. Nevertheless, almost 70 percent of people aged 65 and older will suffer a physical disability or cognitive impairment and about 40 percent of them will need long-term care. Long-term care (LTC) planning ensures that your wishes will be honored if you need LTC and that you can afford the cost of that care.
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The U.S. Senate Special Committee on Aging explained the difference as follows: “It [long-term care] differs from other types of health care in that the goal of long-term care is not to cure an illness, but to allow an individual to attain and maintain an optimal level of functioning….Long-term care encompasses a wide array of medical, social, personal, and supportive and specialized housing services needed by individuals who have lost some capacity for self-care because of a chronic illness or disabling condition.”
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For seniors who need assistance with the daily tasks of living or who require less extensive medical care, there are alternatives to nursing home care, including home health care, adult day health care, and assisted living facilities. In addition, Medicaid waiver programs in most states will pay for in-home and community care that is aimed at keeping seniors in their own homes.
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One of the most important reasons to incorporate nursing home planning in your estate plan is to ensure that you can afford the cost of that care if you need it. As of 2021, the average nationwide cost for a year in LTC was over $100,000. In Vermont, the average was over $130,000 a year.
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This is a common assumption; however, while you may depend heavily on Medicare to cover health care expenses as a senior, Medicare only covers long-term care following a hospital admission, and even then, only for a short period of time. Most private health insurance policies also exclude nursing home expenses.
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Doing your homework when searching for a nursing home is crucial to ensuring that the care you, or a loved one, receive is the best possible care. There are several websites that can be used to help you find nursing home care in your area and even compare the quality of care offered at the facilities. Two excellent federal resources are Medicare.gov (the federal government’s official site for Medicare) and the Vermont Division of Licensing and Protection.
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Medicaid is a healthcare program that is primarily funded by the U.S. federal government; however, it is administered by the individual states, and they have the option to contribute additional resources. Consequently, the eligibility guidelines and benefits offered can vary somewhat from one state to the next. There are different eligibility categories within Medicaid, however, every state has at least one category under which seniors can potentially qualify for benefits.
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For most people, the answer is “yes.” Unless you have the resources to cover the cost of nursing home care out of pocket for an indefinite period, you should anticipate the need to qualify for Medicaid because Medicaid will cover LTC expenses. Currently, over half of all seniors in nursing home facilities rely on Medicaid to help cover the high cost of care. To be eligible, you must meet the very low “countable resources” limits that could put your retirement nest egg at risk if you failed to plan accordingly. Medicaid planning ensures that your assets are protected and that you do qualify for benefits if you need them at any point during your life.
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Contact Us
If you have additional questions, contact the experienced Essex Junction elder law attorneys at Unsworth LaPlante, PLLC by calling (802) 879-7133 to schedule your appointment today.
