Collin County Living Well Magazine Fall 2013 | Page 24
peace of mind
By Aaron R. Miller
the miller law firm creates personalized plans addressing both estate planning and medicaid qualification issues.
hen faced with the unexpected cost of long-term care for the first time, people are often concerned about their ability to pay for care for themselves or for their parents. Typically, there are three ways one can pay for long- term care: private pay, insurance, or a government option, such as Medicaid. Frequently private pay isn’t an option, or you can see the writing on the wall that the money will not last. Although insurance with a longterm care component is a great option, many people do not have it. This leaves a government option, such as Medicaid. Medicaid is a benefit available to seniors to offset the cost of longterm nursing home care. Frequently confused with Medicare, this benefit is often misunderstood, resulting in uncertainty and concern about whether or not a loved one will qualify for assistance. Medicare is a federal health insurance program currently available to seniors 65 and over who qualify for Social Security. Although there are many types of Medicaid, this particular benefit is a federal nursing home payment program that insures that our seniors who cannot afford nursing home care are provided for. Since the average monthly cost of nursing home care in our local area is now almost $5,000, this is an especially important program that every senior should know about. A common misconception is that nursing homes that accept Medicaid payments are substandard or that the quality a Medicaid patient will receive will be less than a patient who private pays. A nursing home is not required to participate in the Medicaid program, and may choose not to do so. However, many top-rated nursing homes participate in the Medicaid program in order to fill empty beds and improve their profit margin. Why might a nursing home not want to participate in Medicaid? As with any contracted service, the government reimburses the nursing home at a lower rate than a patient not on Medicaid would pay for that same service. If a nursing home is able to fill their beds to capacity at a higher private-pay rate, then that nursing home will be less interested
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in contracting with Medicaid. It is in a nursing home’s best interest to have a patient self-pay as long as possible before applying for a Medicaid bed. This may not always be in the patient’s best interest, however. It is in this circumstance that an elder law attorney can protect the patient’s best interest by helping the patient qualify for Medicaid sooner rather than later. There are three criteria for Medicaid qualification:
1. You must show medical necessity for nursing home care. 2. You cannot have income in your name over a certain monthly amount. 3. You cannot have countable assets in your name over a certain amount.
The Medicaid applicant must: • Be admitted to a nursing home that accepts Medicaid payments • Be in a Medicaid allocated bed in that nursing home • Be able to show medical necessity for nursing home care • Not have income in his or her name over a certain amount*
MILLER LAW FIRM, PLLC
Elder Law | Estate Planning
www.aaronmillerlaw.com
214-292-4225
About the Miller Law Firm, PLLC
The Miller Law Firm, PLLC is an Elder Law and Estate Planning law ?rm located in Collin County, Texas with o?ces in Plano and Wylie. The Miller Law Firm o?ers free, informational workshops three times per month, as well as private consultations. Call us to ?nd out more information about our services. Principal O?ce: Wylie, Texas. Plano o?ce by appointment only.
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Collin County Living Well Magazine • Fall 2013
© 2012 Miller Law Firm, PLLC