Medicaid Planning & Elder Law

Lawyers in our firm are familiar with the special issues that face our clients as they get older or become disabled. We have extensive experience dealing with:

• Protecting hard-earned family assets from nursing home bills/Medicaid Planning (see below)
• Disability and disability planning
• Health care, including Medicare and Medicaid
• Health insurance and managed care, including payment for health care
• Issues relating to Social Security
• Long-term care, home care and nursing home issues
• Housing options for the elderly-assisted living, residential homes
• Assisted Living issues

The average basic cost of nursing home care in the Chicagoland area has ballooned to $10,000 per month and that figure does not include additional services that are not included in the basic monthly cost. Even a healthy amount of lifetime savings can quickly dwindle to nothing when an individual pays for a stay at a long-term care facility. Individuals turn to Illinois's Long-Term Care Medicaid benefit to meet the care costs of a nursing home or supportive living facility.

Medicaid's Long-Term Care program was established by the Federal government. The program is administered by the state of Illinois through the Department of Human Services. The benefit provides assistance to those individuals whose medical expenses exceed their income and who have few available assets with which to pay for long-term care themselves.

Since the Long-Term Care benefit is a public assistance program it carries eligibility requirements for both income streams and accumulated assets. Medicaid may require a certain amount of income and certain amount of assets to be "spent down" for care. Income is spent down on a monthly basis and assets are spent down to certain income levels before the Long-Term Care benefit will cover the stay at a facility.

The program requires individuals pay their monthly income to the facilities and Medicaid pays the rest of the monthly cost. Individuals are allowed to pay for health care coverage and retain a $30 amount each month, but all income, except up to certain amounts in the cases where there is a spouse living a home, must be paid to the facility on a monthly basis. There are also income allowances for disabled or minor children.

Generally, Medicaid requires that individuals spend down their assets to certain levels. There are some assets that Medicaid exempts from being spent down that Medicaid allows individuals to keep the assets and still be eligible for Long-Term Care benefits. This is where asset protection planning is key.

Asset protection planning involves preserving an individual's wealth while maintaining their Long-Term Care Medicaid eligibility. The asset protection process uses proven legal strategies to avoid paying more for nursing home care than absolutely necessary by utilizing the Medicaid rules themselves. Medicaid asset protection planning takes the greatest advantage possible of current Medicaid regulations by reallocating at-risk assets that would otherwise have to be spent-down on nursing home care. The goal is to use assets that would be required to be spent down to acquire assets that are exempt.

Assets are used to purchase or improve exempt assets such as a family home, pre-paid funeral arrangements, burial plots, or an automobile. Remaining assets may be allocated to an irrevocable trust and Medicaid compliant annuities to preserve the maximum amount of assets for the individual and their family.

Asset protection planning may help maintain the dignity of the nursing home resident by protecting funds for necessities that are not covered by Long-Term Care Medicaid such as glasses, dentures, hearing aids, clothing, etc. These items are sometimes lost or need replacement and health insurance will not cover the costs. Asset protection planning intends to fill this gap. Otherwise, the individuals may go without essential medical aids, clothing, or other basic items if their family is unable to pay out-of-pocket for the items on their behalf.

Using the Medicaid rules, individuals may also be able to provide for the well-being of the spouse and children. Under the right circumstances, asset protection planning may preserve the family home for a spouse, disabled children, siblings that share ownership in the home, or children that provide in-home care to their parents. In the case of a disabled child, the individual may also be able to fulfill the desire to provide for the child financial security by protecting assets over and above the home.

Without creating the right asset protection strategy, years of hard work and savings can be lost to expensive nursing home bills.

In addition to asset protection planning for Medicaid Long-Term care benefits, our practice assists seniors with contract review of long-term care facility contracts, as well as life care contracts. Each of these types of contracts involve a significant commitment by each party. It is imperative that seniors understand the expenses, responsibilities, and rights have under each contract. Every facility has a specific contract, so a case-by-case review is necessary.

Along the same lines, seniors who are able to stay at home would need guidance on strategies to enable to senior to age in place instead of entering a long-term care facility. Such strategies may include review of at-home caregiver contracts, assessing the pros and cons of using agencies against directly contracting caregivers; real estate tax exemptions and deferrals; and review of special rules regarding family members providing care.

These are just some of the issues that arise for seniors more regularly than others. Our firm's Medicaid Planning and ElderLaw practice is here to help you or someone you love who may need assistance.