Long-term care planning can be difficult, but there’s also a strong chance that you or someone in your family might need help from a nursing home. The high costs of nursing home care mean that many people turn to Medicaid for financial assistance, but the government designed the Medicaid program for those with little to no assets. Working with an estate planning lawyer can help you get support for navigating this process.

Read on to learn more about some of the most important things to know about qualifying for and getting Medicaid in NC.

Patient and caregiver sit outside nursing home

  1. Medicare Does Not Pay for Long-Term Nursing Home Care

Many people mistakenly believe Medicare will take care of all health care needs during retirement, but this is not the case. Medicare was signed into law by President Lyndon B. Johnson in 1965, and since its inception, very few changes have been made to the benefits covered by Medicare. In 1965, the average life expectancy was only about 70 years old vs. today’s life expectancy of about 79 years. In 1965, nursing homes were not nearly as prevalent. That’s because medical care was not as sophisticated and dementia was not as prevalent. In 1965, a major heart attack or stroke was likely to be fatal, whereas today, such events are less likely to be fatal. This has led to longer life expectancies but a greater likelihood of needing nursing home care due to Alzheimer’s disease, dementia, or physical impairments.

All of this is to say that when the Medicare program was created, the need for long-term nursing home care wasn’t really anticipated. Medicare only pays for short-term care for things we are expected to recover from such as rehabilitation after a hip break, but Medicare does not pay for long-term nursing home care leaving Medicaid as the primary government assistance program available.

  1. When it Comes to Medicaid Planning, It’s Always Best to Plan Ahead

Planning ahead is the best-case scenario because you have more options available to you, and there’s a greater likelihood you can protect more or all of your assets. You can discuss potential scenarios with your elder lawyer, such as retirement ages and what might happen if you or your spouse were to need long-term care at certain ages. Advanced estate planning means that you can put some guardrails in place to make it easier to take action if something happens to you or your spouse in the future.

  1. If You Haven’t Planned Ahead and a Spouse or Loved One is Already in a Nursing Home, It’s Not Too Late.

Most people assume that there’s nothing else they can do with Medicaid once a loved one has already entered the nursing home. This is not true. Of course, you’ll have more choices when you’ve done some advanced Medicaid planning, but an elder law attorney can still step in to assist you and get your ducks in a row if a loved one is already in the nursing home.

Beware of trying to ask the nursing home staff for help applying for Medicaid. While they might agree to do it, they don’t have a vested interest in helping you get approved or helping you protect your assets. In fact, the nursing home generally stands to benefit if you get denied because the private pay rates at a nursing home (i.e., the rate you pay) are typically higher than what the nursing home would get paid by Medicaid. Further, your caseworker will not offer much help with your application since their primary role is not to preserve your assets or get you qualified as quickly as possible. However, your NC Medicaid planning attorney cares about helping you and your family get the support you need to be eligible for Medicaid.

  1. You Must Work with a Qualified Elder Law Attorney

Only an elder law attorney understands the unique issues involved with qualifying for Medicaid and doing so in a timely fashion. At Carolina Family Estate Planning, we work with many different people preparing to go into a nursing home or who are already there. We know how hard this can be on your family and why you need to think about taking action quickly with the support of an elder lawyer.

  1. Medicaid Planning Should Be Viewed Like Tax Planning. 

When the IRS receives your submitted tax forms, they are looking to make sure you submitted everything correctly. But if you missed a deduction or credit you could have claimed, they’re not going to reach out to you to make sure you get those savings. Much like you would hire a CPA to leverage the best tax strategies possible, a Medicaid planning lawyer is there to look at all the rules and strategies available to help you get the best possible support.

A Real-Life Client’s Medicaid Story

One of our clients was told she’d have to spend $60,000 for her husband’s nursing home care after being declined for Medicaid. She was also informed she’d have to forfeit his life insurance policy with a six-figure benefit. With over $160,000 at stake, her family member’s call to our office was critical for protecting those funds and allowing her husband to get the care he needed.

Contact Carolina Family Estate Planning in Cary, NC Today

We know how hard it is to figure out the Medicaid application process. We work hard on behalf of our clients to ensure you get the peace of mind that comes with knowing you’ve got an ally and a resource if long-term care is needed. No matter what questions you have, take advantage of the opportunity to speak with an experienced and dedicated elder lawyer today. Schedule a needs assessment call with our experienced, caring, and dedicated legal team at Carolina Family Estate Planning at 919-443-3035 or complete our online form. We look forward to discussing your Medicaid and estate planning goals.

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