Medicaid
Medicaid, the welfare program, provides funding for approximately 45% of all long-term care expenses in the United States.
Medicaid is a needs-based program and eligiblity
is determined by an evaluation of a person's assets and income. The
rules are complex, vary between states, and are subject to change every
year.
There are 2 main issues to look at when considering Medicaid as an option for paying for long-term care:
1. Accessibility to Care
Since Medicaid licensed facilities are reimbursed
by the government at a lower rate than the private pay rate, patients
who are private pay will receive priority admission. As a result, there
is often a waiting list for Medicaid recipients, even if there are
empty beds available.
In addition, the choices for high quality care at
home or in an assisted living facility are not available to medicaid
patients.
2. Quality of Care Issues
There is an ongoing debate regarding the
difference between the quality of care received by Medicaid
beneficiaries and care received by private pay patients.
Evidence that there may be a quality of care
deficency was brought to light in 2001 by the ERISA(Employment
Retirement Security Act) Advisory Council with the statement, "Medicaid
reimbursement rates are so low that they may compromise quality of
care...."
Read about the experience we had concerning quality of care issues with my wife's grandmother:
When the Money Under the Mattress is Gone
Medicaid Planning
Medicaid Planning is the process of positioning your income and assets
so that you can legally qualify for Medicaid. Despite stories of Millionaires on Medicaid, the vast majority of people who enlist professional assistance this process are not wealthy.
Due to the quality of care deficiencies with
Medicaid, it would be foolish for individuals who can afford private
pay care to divest their assets for the purpose of receiving government
paid care.
But Medicaid Planning may be the only option for
people who are unable to qualify for LTC insurance due to health
problems, or who truly don't have the financial resources to pay for
care themselves.
If you do investigate this as an option, beware of
practitioners whose real purpose is to expose your assets for the
purpose of selling you financial products that may or may not be
appropriate for your situation.
The most ethical planners are licensed attorneys
who are regulated by their state bar associations, and who utilize a
process that guides you through the myriad of complicated rules.
Estate Recovery
Estate Recovery, the program that reimburses
the government for money spent by Medicaid for a beneficiary's care, is
now a required process in every state.
The money is recovered from the deceased Medicaid
beneficiary's estate. Family members do not receive any part of the
estate until the government is reimbursed.
Return from Medicaid as an Option for Paying for Long-Term Care to Paying for Long-Term Care
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