Collin County Living Well Magazine March/April 2018 | Page 31

Paying for Long-Term Care:
Know
By Leu & Peirce, PLLC
your Options
ne of the greatest myths
O
surrounding
planning
for long-term care is that
Medicare will cover all
of our health care needs
as we age. Unfortunately, that is wrong.
Medicare is health insurance for individ-
uals who paid into the system and are
age 65 or older. Medicare does not pay
for custodial care or personal care ser-
vices. Misconceptions about Medicare
prevent many individuals from pursuing
the planning assistance they need, so
when the time comes to implement long-
term care, they are not financially pre-
pared. Prudent planning for long-term
care begins with learning the facts and
knowing your options.
In-Home Care is an option for individ-
uals who want to remain in their homes,
but need additional support. In-Home
Care can range from assistance with
daily chores and meal preparation to
help with bathing, toileting, and dress-
ing. Medicare covers only healthcare
prescribed by a doctor in certain circum-
stances, not assistance with other issues
such as meals or daily chores that are
provided by In-Home Care.
Assisted Living Facilities offer their
residents a secure place to live, typically
in an apartment-like setting, with meals.
For an additional cost, residents may be
able to receive assistance with activities
of daily living, such as bathing, groom-
ing, incontinence care, and medication
management. Medicare does not pay
for Assisted Living.
Memory Care is a type of assisted liv-
ing that has been specifically designed
and structured to support individuals
with dementia. Memory Care tends to
offer specialized programs aimed at off-
setting common obstacles for their resi-
dents, such as separating day from night
and avoiding boredom. Medicare does
not pay for Memory Care.
Skilled Nursing Facilities are for in-
dividuals who require a higher level of
medical care. Skilled Nursing Facilities
provide 24-hour nursing care and usu-
ally provide speech, occupational, and
physical therapy to residents. At most,
traditional Medicare and a Medicare
Supplement (MediGap) policy will cover
100 days of rehabilitation in a skilled
nursing facility. Medicare Advantage
plans cover much less.
Some people are fortunate to have the
ability to private pay for long-term care,
which ranges from $3,000 to $16,000/
month in the Dallas-Fort Worth area.
Long-term care insurance is another op-
tion for funding long-term care. Newer
policies allow for coverage of care pro-
vided in all types of settings, including
In-Home Care, Assisted Living, Memory
Care, and Skilled Nursing, thus provid-
ing some flexibility and ability to choose
the proper level of care. However, long-
term care policies may not be available
if you have certain existing health prob-
lems, and the costs can rise as you age.
Therefore, the earlier you apply and the
more you shop around, the better your
policy may meet your needs.
Beyond private pay and long-term care
insurance, the only remaining option is
to seek public assistance, which includes
VA benefits or Medicaid. VA benefits are
limited to veterans (and their surviving
spouses) who served a 90-day continu-
ous period in the military, at least one
day of which occurred during a wartime
period, and who were honorably dis-
charged. Medicaid is a federally fund-
ed, state-managed program. Eligibility
requirements and services covered vary
widely from state to state. Both VA ben-
efits and Medicaid are needs based, so
income and assets must be evaluated to
determine eligibility. While VA benefits
will reimburse all types of long-term care
costs, in Texas, Medicaid is primarily a
skilled nursing benefit.
An analysis of whether to apply for VA
benefits requires consideration of the po-
tential need for Medicaid to avoid future
penalties caused by transferring assets.
Providing advice on Medicaid eligibil-
ity includes the interpretation of statutes
and administrative rules and constitutes
the practice of law according to Texas
statutes. Only attorneys are legally al-
lowed to provide assistance with Medic-
aid eligibility. Applicants should beware
of the non-attorney individuals and com-
panies who try to profit from their need
for Medicaid assistance. These persons
are operating illegally, often charge
more than attorneys, and are within the
realm of those who prey on seniors for
their own financial gain.
How will you pay for long-term care
needs that lie ahead? Making smart de-
cisions now ensures that when the time
comes, you will be able to afford the
quality and level of care you need. For
a better understanding of your funding
options for long-term care and to find an
Elder Law attorney in your area, go to
www.naela.o rg.
Lori Leu, Erin Peirce, Lauren Olson, Laura Chavero, and Brisha Gardner are Elder Law attorneys with
Leu & Peirce, PLLC in Plano, Texas. They can be reached at 972-996-2540.
COLLIN COUNTY Living Well Magazine | MARCH/APRIL 2018
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