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Medicaid planning for assisted living

If you have older family members, you may have to think about their long-term care. Whether they move into an assisted living, nursing home or other long-term facility, the costs can be astronomical for most families. 

However, Medicaid can help provide financial assistance to eligible individuals. If you would like to learn more about Medicaid planning or nursing homes in Wisconsin, here is our guide for families. 

Asset Protection Options

While Medicaid can help with the costs of assisted living, nursing home care and other long-term care, prior to qualifying for Medicaid long-term care costs can quickly drain your loved one’s finances. Sometimes, families choose to protect their assets instead of using them to pay for care and medical costs. 

There are mainly two ways to protect assets from long term care costs. The first option is preplanning using a special irrevocable trust. This option transfers assets into a trust to protect them from Medicaid spend-down requirements. This can be an effective way to guard assets while still qualifying for Medicaid assistance. However, this option requires years of foresight in order to ensure the assets are protected. If clients would like to use this option we usually have these trusts set up three to five years before they may need to enter assisted living or a nursing home.

On the other hand, the second option is a “Long Term Care Crisis Plan.” We use these protection strategies for those clients who did not pre-plan using an irrevocable trust. These clients typically have high costs of care for themselves or a loved one and want to explore their options to preserve some of the assets. For example, if one spouse requires nursing home care but the other doesn’t, the one who remains in the community will retain a share of their assets. As a result, the other spouse can receive care without depleting their shared assets.  

Along with asset protection strategies, families must also consider the balance between personal preferences and financial realities. You may want to choose a nursing home that aligns with your loved one’s preferences. However, there are also financial implications of assisted living and nursing home costs, so think about Medicaid eligibility when making these decisions. There are public and private counselors that can help with the decision about which facility is a good fit for your loved one. We regularly work with these counselors to help our families find the right fit for care.

Wisconsin’s Medicaid Program

This Medicaid program caters to older adults and individuals with disabilities. Individuals will have access to nursing home care, home-based care, and community-based support. 

When applying for Medicaid in Wisconsin, applicants must meet specific eligibility criteria based on income, assets, and medical needs. First, there must be a medical need for Medicaid. For example, you must show that your loved one requires long-term care, such as assisted living or a nursing home. In these cases, documentation from healthcare providers can demonstrate the necessity for ongoing medical assistance or support.

Next, income limits apply, accounting for both individual income and household size. However, some income is exempt from these calculations. 

Along with that, there are also asset limits. Couples are allowed to have certain assets that will not disqualify them from Medicaid. How much a couple can have together depends on multiple factors including the type of assets they have and whether or not both spouses need care. Keep in mind that these limits can change at any time. 

Medicaid Coverage for Assisted Living or Nursing Homes

If you or your loved one become an assisted living or nursing home resident, your income and assets will be used to pay for your care costs. After those options are exhausted, Medicaid will pay for the remaining expenses. 

Medicaid can cover all the expenses for nursing home care, such as room and board, medical services, and therapies. However, other costs may be included as well. The program often covers personal care services, nursing care, and prescription medications. 

With that, the nursing home will receive reimbursement from the Medicaid program. However, coverage and costs can vary from one facility to another. For that reason, you will want to discuss this issue with your preferred nursing home or long-term center to see if the program will cover your costs. 

Let Us Help With These Important Questions

Medicaid can provide a financial lifeline for those who need medical care assistance. However, you will want to use a few strategies to make sure these expenses do not deplete your loved one’s assets and income.  Medicaid planning for assisted living facilities or nursing homes in Wisconsin can be complicated.

If you would like to learn more about Medicaid and potential asset protection strategies, reach out to Collins Law Firm. Schedule your free and confidential consultation today. Contact us or call (414) 207-6292.

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