As much as a son or daughter would want to be able to take care of a sick loved one, we all know that sometimes health problems are just too serious to handle without the help of a professional. Debilitating strokes, early stages of Dementia, Alzheimer's disease, Parkinson's, etc., are just a few reasons why somebody may need long-term care in a nursing home or other facility.

Unfortunately, the cost of providing round-the-clock care can be steep. It would not take long for a family to deplete their life savings quickly if an unexpected health problem leaves a person unable to care for herself. Sadly, even if a patient planned and bought long-term care insurance, it is not always enough to cover the high cost of hiring 24-hour care. Nor does Medicare pay for most long-term care situations.

That is why we urge all families to explore their options for the "what-ifs." In addition to private long-term care insurance, Medicare, and paying out-of-pocket, Medicaid can help bridge the coverage or cost gap many families face.

Because Medicaid is made available to those with a low income, a common myth is that anyone with assets would not be eligible. This is not always the case. Planning ahead and protecting your assets in certain ways can help your eligibility. Taking the proactive steps now to plan for Medicaid in North Carolina will ensure that the benefits kick in the moment you need them. Also, rest assured that if the medical crisis hits before the plan is in place, help is still available.

Establishing A North Carolina Medicaid Plan Now Can Help With Long-Term Care Later

Long-term care can include any service that helps people with 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 Genworth Cost of Care Survey, the average costs in the Raleigh-Durham area of North Carolina in 2023 were:

  • $244/day for a semi-private room in a nursing home
  • $265/day for a private room in a nursing home
  • $5,716/month for care in an Assisted Living Facility

Here, in the Cary, North Carolina area, that could mean paying more than $91,000 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 3.7 years for women.
  • About 20% of people reaching age 65 are expected to require long-term care for five years or longer.

If you add up those numbers, you'll quickly see how financially devastating the costs of long-term care in North Carolina 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, 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 the 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 ensure that, if needed, you can qualify to protect your family from the financial strain of nursing home care. 

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 require assisted living or nursing home care in the future.

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 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 $7,200 per month or greater (that's over $86,000 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 $86,000 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 significant 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 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. 

Seek Guidance From An Experienced Medicaid Planning Attorney in Cary, North Carolina

The best way to learn about both Pre-Crisis and Crisis Long Term Care and Medicaid Planning is to speak with one of our experienced elder law and estate planning lawyers. Call Carolina Family Estate Planning at (919) 443-3035 to schedule your needs assessment call or register for a workshop to get started.

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