Bridge of Life Planning (Part 4) – Paying for Nursing Home Care with Government Benefits

Today, we are going to discuss a few ways to help a parent or declining spouse pay for long-term care expense in a nursing home by utilizing government benefits. In our last blog post, we mentioned that it was critical that Momma sit down and write out her preferences; what does she want to happen in the event that she is incapacitated before she dies? Specifically, if her health declines even more, where does she want to receive care?

  1. At home?
  2. In an assisted living facility?
  3. In a nursing home?

Then, we discussed the sobering reality of Momma’s preferences; unless money is available to pay for her long-term care, what she wants is unlikely to happen. In other words, preferences may not matter if you haven’t taken care of the money part. There are two primary ways to take care of the money part:

Financial Planning

Last time, we discussed the benefits of financial planning and what items to discuss with your financial advisor. If you missed that post, just click on the link to catch-up. The bottom line is, if Momma has enough available assets, she should meet with her financial advisor. Have the advisor adjust Mom’s portfolio so that it will generate enough monthly income to pay for her long-term care expenses. Alternatively, she may have some type of insurance product that will pay for her care.

Government Benefits Planning

But what if Momma doesn’t have a large portfolio that can be tweaked to pay her long-term care expenses? In this case, we need to look at other options. The government has programs available to help pay for any long-term care expenses she may have. Here are a few options:

1. Medicare

Medicare will help pay for short-term rehabilitative care. Generally, Medicare pays for up to 100 days of rehabilitative care in a nursing home. Medicare’s basic requirement is a need for rehab in a nursing home following a hospital stay greater than 2 days. Momma would need to be admitted to the hospital for 3+ days. Medicare and what it will pay is a very broad topic. Some of the major bullet-points to know are discussed in a blog post on our Elder Law Practice Site. The post is entitled, “Does Medicare Pay for Nursing Home Care?” Warning: Reference is made to Arkansas state law. Laws are very different from state to state, so do not rely on this information or any other legal information in this blog. Instead, meet with your Elder Law Attorney to see how this program works in your state.

2. Veterans Administration

The Veterans Administration (VA) has many programs available for those who qualify. One of the most popular is VA Aid & Attendance. In this program, VA will pay an improved pension amount for necessary care; whether care is received at home or in a facility setting. However, there are two big catches

  1. You must qualify to receive this care
  2. VA Aid & Attendance usually is not enough to pay for skilled nursing care.

VA Aid & Attendance is a great resource for Veterans who are having to pay for outside caregivers to help with their care at home or at an Assisted Living Facility. However, the extra amount received from the VA Aid & Attendance benefit is usually not enough to pay the high cost of Nursing Home care. Usually this program requires the Veteran to have substantial pension income or other retirement income. For this reason, many Seniors (even Veterans who would otherwise qualify for VA Aid & Attendance benefits) are forced to seek assistance from Medicaid to help pay their monthly Nursing Home expenses.

3. Medicaid

Medicaid is the primary payment source for Nursing Home care for most seniors in America. Once you qualify, Medicaid will pay the total shortfall amount (defined as cost of care minus patient’s monthly income) for necessary Nursing Home care. There are substantial qualification requirements to receive Medicaid. Applying and qualifying for Medicaid is not a do-it-yourself project.

If you have a spouse or declining parent who looks like they may need nursing home assistance soon, you should contact your local Elder Law Attorney for assistance. One tip: contact them way before you run out of money; with proper planning, you can often save a substantial amount of money. Once you spend down all of your money and sell all of your property to pay for your care, it’s too late to check on your planning options. The money is already spent! There are often options to protect substantial amounts of your hard earned assets. Again, check with your Elder Law Attorney sooner, rather than later.

Next time, we will discuss one more part of the Bridge of Life Planning process: Legal planning. This area of planning we define as the types of documents that are needed to effectively set forth your plan. Hopefully you have reviewed these different segments of the Bridge of Life Plan and will put yours into action. This is one of the most effective things that you can do to make sure that you get the care that you need, have a way planned out to pay for that care, and have the legal strategy in place to make it happen.

Bridge Pictures

By the way, I hope you have enjoyed the bridge pictures that have been featured in this course. My buddy David, who helps with this blog is a pastor in Eastern Europe (currently Poland). The bridge featured in Bridge of Life Planning (part 3) was a picture he took while in Romania. The bridge picture this week is from a bridge that he saw while in Poland. Please comment below to let him know what you think. I love Bridges and think these pictures are pretty incredible.

What About YOUR Plan?

If you are one of the adult children reading this, now is the time to do your plan. Don’t wait until too late to do the type of planning that would be necessary to make a real difference for your family. Thanks for reading; we will see you again next time when we discuss the last segment of the Bridge of Life Planning process.

Remember, if your declining parent hasn’t done their Bridge of Life Plan, and they have capacity to do so, please encourage them to meet with their Elder Law Attorney and financial advisor as soon as possible to get their plan in place before it is too late.

In the meantime, feel free to download our short FREE Overview entitled Bridge of Life Planning – A Simple 3-Part Overview. This will help pull all of this together to give you a better understanding of the Bridge of Life Planning process.

Until next time, keep up the great work with your Bridge of Life Planning process.