Establishing a North Carolina Medicaid Plan now can help with long-term care later

Jackie Bedard
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Attorney, Author, and Founder of Carolina Family Estate Planning

Pre-Crisis Medicaid Planning
Crisis Medicaid Planning
Long-term care can include any service that helps people who have a prolonged illness. The illness could be a physical disability or a cognitive impairment such as Alzheimer’s or Parkinson's disease or Dementia.  The services may include help with activities of daily living, home health care, adult day care, hospice care, nursing home care, or care in an assisted living facility.  The level of assistance required can include physical therapy, administration of medication, and help with daily activities such as bathing, eating, and dressing.

Contrary to what many people believe, Medicare coverage will not pay for most of the long-term care they will need if they suffer from a long-term illness. According to a 2012 MetLife survey, the average costs in the Raleigh-Durham area of North Carolina in 2012 were:

  • $196/day for a semi-private room in a nursing home
  • $242/day for a private room in a nursing home
  • $3,446/month for care in an Assisted Living Facility

Here, in the Cary, North Carolina area, that could mean paying more than $75,000 per year to a nursing home.

It’s easy to fall into the trap of thinking that because you are healthy now, you don’t need to worry about long-term care, but consider this (from the U.S. Department of Health and Human Services):

  • About 70% of people reaching age 65 are expected to require long term care at some point in their lifetime.
  • The average length of long term care needed is about 2.2 years for men and 2.7 years for women.
  • About 20% of people reaching age 65 are expected to require long term care for 5 years or longer.

If you add up those numbers, you'll quickly see how financially devastating the costs of long term care can be to families.  So how do most people afford such long-term care?  Through a combination of long term care insurance, paying out of pocket, Medicaid, Veteran's benefits and other public assistance programs.

What is Medicaid?

Medicaid is a federal program that provides health coverage for people with limited assets and income. It covers the cost of nursing home care for those who meet the program's eligibility requirements. Although it is a federal program, Medicaid is administered by the states. This means that application of these rules can vary significantly from state to state and sometimes even from county to county.

People who have excess assets and income often wish to start the process of protecting their assets so that if and when the time comes that they require nursing home care, they will be eligible to receive Medicaid benefits. Medicaid planning can also be done even if your loved one is already in or is about to enter a skilled nursing facility. However, the earlier you begin your planning, the more options you will have to protect your assets and your loved ones.

While North Carolina Medicaid laws can be complex, it’s important to understand this:  Medicaid is there to help families like yours, and Medicaid planning is a great way to insure that if needed, you can qualify as quickly as possible, to protect your family from the financial strain of nursing home care. 

First, it’s important to understand that there are two kinds of Medicaid Planning that families face: Medicaid Pre-Planning and  Medicaid Crisis Planning.

Pre-Crisis Long Term Care & Medicaid Planning

Pre-Crisis Medicaid Planning is for individuals or married couples who are currently healthy, but want to put together a plan to protect against the very real possibility, that someday one or both may become incapacitated and require long-term care.  They want to ensure that they won’t have to deplete their savings or assets and ensure that their spouse and family will be protected from financial devastation.

As you read above, the reality is that although you’re healthy now, statistically, there is a high probability that one or both of you will need assisted living or a nursing home in the future…and that expense.

What many don’t realize is that we can help you today by developing a comprehensive asset protection plan.  These plans contemplate the possibility of a long-term nursing home stay and are designed to help you get qualified for Medicaid as quickly as possible, all while protecting as much of your assets as legally possible.

The documents that many traditional estate planning lawyers use tend to focus on after-death planning, with little thought or attention paid to how your affairs should be managed in the event of a disability.  But what happens if you don't die, but instead wind up impaired with dementia, Alzheimer's, a stroke, or similar illness?  Unlike those traditional estate planning lawyers, at Carolina Family Estate Planning, we'll work with you to create a holistic plan that also provides detailed instructions regarding a potential disability and considers the best way to structure your assets for maximum protection.  Plus, we won't just focus exclusively on Medicaid planning, but we'll also take a look at other long-term care planning options to help ensure that you receive the right care and protection for your needs and goals.

The ultimate goal of Pre-Crisis Long Term Care & Medicaid Planning is to give you peace of mind.  You teach us about your family, goals and concerns.  We’ll teach you about the law.  Together we’ll create a plan that will work when you need it, so you can sleep soundly at night knowing that you and your family are protected if the unthinkable should occur.

Crisis Long-Term Care & Medicaid Planning

Crisis Long Term Care & Medicaid Planning involves an individual who has either already been admitted to a nursing home facility or is about to be placed in a nursing home and they have been told, or they assume, that they have too much money or too many assets to qualify for Medicaid or other assistance.  This may be a single individual, one half of a married couple, or both spouses of a married couple.

If this is you or a loved one, your family could be facing nursing home costs of $6,300 per month or greater (that’s over $75,000 per year!)!) in the Cary, North Carolina area.  Typically, the only source of funds to pay for such expenses comes from the hard-earned life savings of the individual or couple.  Given the high spending rate of over $75,000 per year (which can be even magnified if we still have a healthy spouse at home with living expenses), it doesn’t take long to go broke. 

The government will not step in and help pay for your nursing home stay until you’ve met the financial tests for Medicaid assistance.   Yet many people receive flat-out WRONG advice about how to qualify for Medicaid, often from well-intentioned family and friends.  Following that advice can often have major negative consequences.  For example, if you give everything to your children, you will actually delay how quickly you qualify for Medicaid benefits, not speed it up.

Unless you work in this area, you’re likely not aware of the many ways to legally preserve the maximum amount of assets and income and still qualify for Medicaid benefits in the shortest among of time possible, whether you’re an individual or a married couple.   And while pre-planning often leaves you with more options, even in a crisis scenario there are generally several planning options still available.

This is your life savings.  The things you’ve worked hard for over your lifetime.  You owe it to yourself, your spouse and your family to do what you can to protect them.  You don’t have to go broke or lose your home to qualify for Medicaid.  

Additional Information on North Carolina Medicaid Assistance for Nursing Home Care:

Download a free copy of Jackie Bedard’s book, The Ultimate Guide to Paying for Nursing Home Care in North Carolina, to learn the nursing home and Medicaid secrets you need to know to avoid going broke in a nursing home and leaving your family penniless.