According to a 2019 Cost of Care Survey (Genworth), 10,000 baby boomers turn 65 every day, and 7 out of 10 people will require long-term institutional or home health care assistance during their lifetimes.
Seniors have saved their entire lives to buy financial freedom — the freedom to spend their resources as they see fit. Perhaps they want to travel the world, buy a summer home, donate to charities, or pay for their grandchildren’s education.
Seniors have come to reckon with the reality that for all their best-laid plans and dreams for their retirement years, they could all be upended by the devastating cost of long-term care. The National Care Planning Council indicates that the average length of stay in a nursing home in the state of New York is nearly two and a half years costing more than $150,000 per year. In some parts of New York, the annual cost of nursing home care is significantly higher — e.g., in Westchester County, it averages $177,000, and, in Manhattan and in Long island, it averages $191,000,
The bottom line is that nursing home care costs in New York for an average stay per senior resident – 2 ½ years – can approach $500,000, a staggering number that would be overwhelming to most.
Similarly, for seniors who remain at home with home health aide assistance, the home health care costs range from $25 to $35 per hour. For 24/7 care, then, the annual cost ranges from $100,000 to $200,000. Understandably, these prohibitive cost factors present stark choices for seniors.
Many seniors are left then with the painful prospect of exhausting their life savings to help secure their essential health care.
The attorneys at Ely J. Rosenzveig & Associates, P.C., are trained to help families struggling with substantial health care cost issues. We are totally committed to finding innovative, cutting-edge solutions that help our clients secure Medicaid health care benefits, while at the same time protecting their assets, within the limits of the law.
No person wants to believe that they will need at some point in their lives the assistance of a skilled nursing facility or a medical professional in their home to care for them. Unfortunately, planning for long-term care has become a necessity due to the astronomical costs of these services. While medicine and science have advanced our ability to live longer, it has also increased the need for long-term care.
There is often the false assumption that long term care costs are covered under Medicare. They are not. Seniors who are in need of care must figure out a way to pay for it. They can either pay out of pocket, purchase a long-term care policy to cover such care, or apply for Medicaid.
Given the exorbitant costs of care, most current long term care policies only cover some of the care costs. It is important for most people, therefore, to consult with an elder law attorney to determine whether planning for and / or applying to Medicaid is an effective option for them.
In many cases, seniors rely on Medicaid for long-term care. Medicaid is a government benefits program funded by the federal government and the individual states, established as an amendment (Title 19) to the Social Security Act in 1965. Medicaid can provide either chronic care in a nursing home, or long-term care in one’s own home, for those who are deemed financially eligible. Ely J. Rosenzveig & Associates, PC, helps individuals in the tri-state area adapt their circumstances, and implement planning strategies to help them qualify for Medicaid benefits.
It is important to understand that Medicaid programs and services vary from state to state. The rules regarding Medicaid remain complex, and seniors do not need to reach financially destitute levels to receive Medicaid long-term health care benefits.
In the State of New York, there are two Medicaid programs: Chronic/Institutional Medicaid and Community Medicaid. Chronic Medicaid covers nursing home care. Community Medicaid covers care provided at home, often by a personal care aide, or at certain assisted living facilities. These services are not covered by Medicare, and therefore seniors will need to either apply for Medicaid, purchase long-term care insurance or simply pay for the costs out of their own personal finances.
In the state of New York, nursing home or assisted living facilities could cost more than $150,000 yearly, as noted above. These kinds of costs could completely wipe out a person’s lifetime of savings quite quickly. Therefore, any elderly person who may need a nursing home or assisted living facility may be eligible to receive substantial financial benefits from Medicaid.
Chronic Medicaid covers nursing home care. To be eligible for Chronic Medicaid, a person must be disabled, and have no more than $15,750 (for the year 2020) in non-exempt or countable assets or resources. A person’s home is not automatically exempt from the calculation of resources for the person applying.
To become financially eligible for Chronic Medicaid benefits, it is ideal that any asset protection be done more than five years before the need for care is anticipated. The state of New York will “look back” five years (i.e., 60 months) for any transfer of wealth or assets to determine eligibility for Chronic Medicaid.
That being said, there are still a number of effective ways for people in need of immediate nursing home care to qualify for Medicaid benefits, even without the benefit of five years of planning. It is these situations that necessitate what we call a customized crisis plan. This planning can save you and your family substantially.
Additionally, there are not only certain exempt (non-countable assets) when assessing Medicaid eligibility (for example, qualified retirement accounts in payout status), there are also certain exempt transfers that are allowed, and that are not penalized even when transacted within the lookback period. One prime example of such an exempt transfer is a spousal transfer, followed often by a spousal refusal election.
In the state of New York, spousal refusal is still recognized, which allows the community (non-institutionalized) spouse to retain resources and assets to maintain their standard of living, even beyond the maximum allowable community spouse resource allowance of $128,640 for 2020, rather than contribute to the expenses associated with their loved one receiving care in a nursing home.
We are able to assist our clients in maximizing asset protection planning even when it seems like there are no options, other than just spending down assets. Consulting with our firm can save you an enormous amount of money, and make a real difference in your life, and in your families’ lives as well.
Oftentimes, an elderly person wishes to remain in their own home. These seniors may not be able to perform everyday tasks, and require assistance. Medicaid provides seniors with the option to apply for Medicaid and use the program to receive quality in-home care for the assistance they need on a daily basis. Medicaid actually provides substantial long-term care services in a personal home through several different programs administered through the Department of Social Services in the state of New York.
Community Medicaid covers care given to a senior at home, such as a personal assistant, or home health aide. To be eligible for Community Medicaid, a person must also meet the same requirements as for Chronic Care, and be age 65 or older, disabled, and, in 2020, have no more than $15,750 in non-exempt resources (assets). There also needs to be planning for issues pertaining to a community Medicaid applicant’s monthly income that exceeds the Medicaid threshold ($875 per month, for the year 2020). With Community Medicaid as well as Institutional Medicaid, there are certain assets which are considered available or non-exempt, and are therefore counted against financial thresholds, while other assets are considered unavailable (for example, a qualified retirement account in payout status
For Community Medicaid, the look-back period is now two and a half years (2.5 years), effective October 1, 2020. Ideally, advance planning is recommended. However, just as with chronic care Medicaid, there are ways to protect assets even in a crisis situation, where we don’t have the benefit of a 2.5 year lead time, and care is needed immediately.
There are many legal strategies available for seniors to protect their wealth as well as ensure that they receive the health care they need as they age. Some of the ways that a senior can protect their assets include the following:
You worked hard your entire life to gain financial security. Consider visiting with our experienced Medicaid and asset protection attorneys to ensure that you take advantage of the laws established to help seniors in the state of New York. The laws are nuanced and complex. With the recent changes in the Medicaid laws in connection with financial eligibility and access to Medicaid home care benefits, it is all the more important to have appropriate legal guidance to protect your assets as well as your health.
With the cost of health care growing exponentially in this country, make sure that you do all that you can to secure your wealth, leave a legacy to your family, and ensure that your health care is well provided for, safely and securely.
Contact our experienced attorneys at Ely J. Rosenzveig & Associates P.C. either online or at (914) 816-2900. We welcome the opportunity to visit with you and answer your questions regarding your specific health care needs, Medicaid benefits, and how we may help you to protect and preserve your assets.