Planning for medical care during our senior years is a daunting project. In-home care, assisted living and nursing facilities are more expensive than ever and it is difficult to make a life’s savings last. This is exactly why long-term planning is so important. The earlier planning is started, the more effective it can be in helping to find a way to pay for the care needed later in life and to still provide for one’s family.
Long-term care is a range of services and supports you may need to meet your personal care needs. Most long-term care is not medical care, but rather assistance with the basic personal tasks of everyday life, sometimes called Activities of Daily Living (ADLs). You can never know for sure if you will need long-term care. Maybe you will never need it. But an unexpected accident, illness, or injury can change your needs, sometimes suddenly. The best time to think about long-term care is before you need it.
In thinking about long-term care, it is important to consider where you will live as you age and how your place of residence can best support your needs if you can no longer fully care for yourself.
Assisted living is designed for individuals who require assistance with everyday activities such as meals, medication management or assistance, bathing, dressing and transportation. Some residents may have memory disorders including Alzheimer’s, or they may need help with mobility, incontinence or other challenges. Residents are assessed upon move in, or any time there is a change in condition.
Medicaid is a joint federal-state program that provides health insurance coverage to low-income children, seniors, and people with disabilities. In addition, it covers care in a nursing home for those who qualify. Medicaid is one option that is available to help pay for care. However, applicants can face penalties for financial decisions made up to five years prior to their application. Although we often help clients with more immediate planning needs, earlier planning can avoid these penalties.
Medicaid regulations are complicated and the application process can be confusing. We help clients in good health or those who have just been diagnosed with an illness plan in advance as well as families of seniors who are unexpectedly hospitalized or in a nursing home. No matter when you are looking to apply, we can help to navigate this process.
The PACE program (Program of All-inclusive Care for the Elderly) provides care for a limited number of Medicaid eligible persons. PACE is a non-profit program combining Medicare and Medicaid funds to provide comprehensive health and social services in the home, in the PACE community day care center, and in the nursing home. For a patient to be accepted in PACE, in addition to meeting Medicaid qualification rules, the patient must be able to live safely in the community.
The Community Alternatives Program (CAP) programs are Medicaid home and community-based services waivers granted by the Health Care Financing Administration (HCFA).
The CAP programs allow North Carolina to use Medicaid funds to provide home and community-based services to Medicaid recipients who require institutional care (placement in a nursing facility), but for whom care can be provided cost-effectively and safely in the community with CAP services. CAP participants must meet all Medicaid eligibility requirements.
Copyright © Salines-Mondello Law Firm, PC.