Elder Law Blog
Paw Paw Estate Planning - Elder Law Blog

Medicaid Coverage for Long-Term Care:

Posted December 5, 2018

Medicaid is a joint federal and state government program that helps people with low income and assets pay for some or all of their health care bills. It covers medical care, like doctor visits and hospital costs, long-term care services in nursing homes, and long-term care services provided at home, such as visiting nurses and assistance with personal care. Unlike Medicare, Medicaid does pay for custodial care in nursing homes and at home.

Overall program rules for who can be eligible for Medicaid and what services are covered are based on federal requirements, but states have considerable leeway in how they operate their programs. States are required to cover certain groups of individuals, but have the option to cover additional groups. Similarly, states are required to cover certain services, but have the option of covering additional services if they wish to do so. As a result, eligibility rules and services that are covered vary from state to state.

Medicaid covers nursing home services for all eligible people age 21 and older. Medicaid also covers home and community-based services for people who would need to be in a nursing home if they did not receive the home care services. In most states, Medicaid will also cover services that will help you remain in your home, such as personal care services, case management, and help with laundry and cleaning. Medicaid will not pay for your rent, mortgage, utilities, or food. Check to see whether your state Medicaid program offers alternatives to nursing home care services.

www. longtermcare.gov

Elder Care and the VA:

Posted November 25, 2018

The Department of Veterans Affairs (VA) pays for long-term care services for service-related disabilities and for certain other eligible veterans, as well as other health programs such as nursing home care and at-home care for aging veterans with long-term care needs. The VA also pays for veterans who do not have service-related disabilities, but who are unable to pay for the cost of necessary care. Co-pays may apply depending on the veteran’s income level. The VA has two more programs to help veterans stay in their homes:

The Housebound Aid and Attendance Allowance Program. This program provides cash to eligible veterans with disabilities and their surviving spouses to purchase home and community-based long-term care services such as personal care assistance and homemaker services. The cash is a supplement to the eligible veteran’s pension benefits

A Veteran Directed Home and Community Based Services program (VD-HCBS). This program was developed in 2008 for eligible veterans of any age. The program provides veterans with a flexible budget to purchase services. Counseling and other supports for veterans are provided by the Aging Network in partnership with the Veterans Administration

www. longtermcare.gov


Alzheimer's Disease:

Posted October 14, 2018

In general, planning for long-term care is like planning for dementias like Alzheimer’s disease. While many of the same planning steps apply, certain steps take on added importance. The loss of executive function associated with dementia can create hardships for caregivers in arranging or paying for care. The ability to comprehend finances and care choices is often among the first signs of dementia. To avoid problems in planning, the following steps can be taken:

  • Advanced Care Directive — to make sure care choices reflect preferences
  • Medical Power of Attorney — to make sure decisions can be made for persons no longer able to communicate their wishes
  • Power of Attorney — to make sure financial and estate decisions can be made to pay for care, apply for assistance (i.e. Medicaid, state based programs) or for the ongoing management of an estate.

Once symptoms appear, dementia makes the long-term care planning process more complex. It causes a specific set of challenges that also must be considered when deciding what your next steps will be. Among these are:

  • Safety issues specific to people with Alzheimer’s
  • Working with caregivers that understand the symptoms of dementia and how to respond effectively
  • Medical specialists and products that may add to the cost of care, especially in regards to drugs specifically tailored to your loved one’s needs
  • Adult day services that provide socialization and activities in a safe environment to both provide a break to the caregiver as well as giving the people with Alzheimer’s positive stimulus
  • While people with dementia can stay in the home for some time, for most there will come a time when professional help, or living in a facility, becomes necessary. Today’s options for facility care may include assisted-living arrangements that specialize in care for people with dementia. Here are just a few of the possibilities commonly available:
  • Specialized dementia care facilities, also known as “memory care” assisted living, generally offer supports and protections that go beyond traditional assisted living communities. For example, having specialized staff training, secured exits, and enhanced visual cues to help residents feel more at ease in unfamiliar surroundings can be part of one of these facilities
  • Nursing homes include all the services of an assisted living facility with the added service of full-time nursing care, 24-hours a day. Some are designed specifically for people with Alzheimer’s

www. longtermcare.gov