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Spousal Medicaid Considerations for Long-Term Care Planning

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Preparing for the possibility that you will at some point require long-term care, either in a nursing facility or at home, is an often overlooked aspect of estate planning. This third blog in a series of six on the topic of long-term care planning will discuss Medicare and Medicaid coverage, as well as spousal Medicaid rules and requirements that should be taken into consideration.

The first blog of this series provided an overview of topics related to elder care planning in WV, KY, and OH, and the second presented choices and insights about long-term care insurance.

Important Information about Spousal Medicaid Rules and Requirements

As mentioned previously in this series, Medicare coverage does not pay for long-term care. This gap in health care coverage often catches families by surprise. When a family member requires long-term custodial care or services, it can drain an estate of its savings and assets quickly.

For those who qualify, Medicaid can cover long-term care expenses. But planning in advance is necessary to protect your estate and the quality of life of your spouse, who could still be living in your home at the time you require long-term care.

Medicare Coverage Limits: What Is Short-Term vs. Long-Term Care?

Medicare does cover some care that occurs in a long-term facility, but only under specific conditions. This coverage is limited to 100 days of care with the patient responsible for a coinsurance payment after day 20.

Generally, Medicare only covers to short-term medical treatment and care that might occur in a long-term care location, such as a skilled nursing facility. When personal care or assistance with activities of daily living (ADL) become a requirement, additional payment or coverage options will need to be in place.

Medicaid Requirements and Spousal Medicaid Considerations

For those who cannot afford private pay or do not have long-term care insurance, Medicaid can cover some costs of long-term care when eligibility requirements are met. However, the expenses of long-term care combined with the income and asset requirements to qualify for Medicaid can leave a community spouse-a spouse who remains in the home-with quickly diminishing resources.

Spousal Medicaid Rules: The Role of the Community Spouse Resource Allowance in Elder Care Planning in WV, KY and OH

To prevent spousal impoverishment, Medicaid allows a community spouse to retain certain income and assets that would otherwise be subject to Medicaid spend down requirements. This community spouse resource allowance can help the husband or wife of a Medicaid recipient in long-term care maintain a semblance of the couple's previous standard of living.

Community spouse resource allowance permissions can also apply to additional dependents living in the home of the Medicaid recipient, but assets that have been saved with the intention of inheritance by adult children are not protected.

A WV Long-Term Care Attorney Can Help You Protect Your Estate

The community spouse resource allowance only provides a modest level of protection for the assets you have accrued over the course of your lifetime. Estate and elder care planning in WV, KY, and OH play a key role in allowing individuals to pass more of their hard-earned wealth and property to their families upon their death.

There are legal and ethical financial strategies that can protect your assets as you age and in the event that you require long-term care. The next blog in this series will focus on asset protection in long-term care and will discuss some of these potential approaches and how they fit in an estate plan.

When it comes to elder care planning in WV, OH, and KY, sooner is better. If you have questions about Medicare, Medicaid, the community spouse resource allowance or general spousal Medicaid considerations, and the significance of each in your specific estate and long-term care plan, For more information, contact an experienced WV long-term care attorney at Jenkins Fenstermaker, PLLC by phone at (304) 523-2100 in West Virginia or toll-free at (866) 617-4736, or by completing our online contact form.

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