Have You Received the Best Advice ?
By CRAIG WATSON
Harry is a 78-year-old man whose beloved wife has had dementia for years . The couple ’ s children , while supportive , do not live near enough to help . Sally ’ s condition has worsened to the point that Harry has no choice except to admit Sally to a memory care center . Harry is very sad and feels like he has failed his wife because he cannot care for her at home any longer . They have about $ 90,000 in savings and a $ 90,000 home . His depression was made worse by the realization that he can ’ t afford her care . They still make monthly payments on loans for their home , car and preneed funeral plans . The nursing home personnel suggested that he get some free counseling available at a council of governments office regarding qualifying Sally for Medicaid assistance . His outlook sunk deeper when the case worker told him his only choice was to pay for Sally ’ s care until half the couple ’ s savings was gone at which time Sally would be able to qualify for Medicaid . Further , they didn ’ t even tell him how to protect his house from a Medicaid Estate Recovery Program ( MERP ) claim if he were to unexpectedly die before Sally .
Harry ’ s brother suggested consulting with a local elder law attorney . After Harry provided the attorney with detailed information about the couple ’ s income , assets , debts and expenses , the attorney devised a plan that preserved all of the couple ’ s assets for Harry ’ s security and allowed Sally to qualify immediately for Medicaid . Harry was so relieved ! Harry considered it a bonus that the attorney also suggested a special type of deed which would allow the house to pass to the couple ’ s children and avoid a MERP claim . Harry was very appreciative when the elder law attorney told him that this plan would also allow both of their estates to avoid probate , thereby saving their children money .
The above story is true ; the names have been changed to protect the client ’ s confidentiality . Today ’ s senior citizens are members of the Greatest Generation . They were taught that our government is “ of the people , by the people and for the people .” They would trust just about any government entity because , in their mind , the government is supposed to serve them as a taxpaying citizen . However , the cost of long term care is a big deal and protecting the financial security of today ’ s trusting senior citizen is not a priority for the government .
The fact is that a man paying for his wife ’ s memory care pays a higher monthly fee than Medicaid would pay even though the level of care is exactly the same . Most senior citizens think fairness would dictate that the government would not negotiate a better deal for itself than it allows a taxpayer to get but that is not the case with respect to the price paid for care in a long term care facility . Because a nursing home receives more money per month from a private citizen than it would for the same service rendered to a Medicaid patient , the nursing home has no incentive to refer a private citizen to an elder law attorney .
In fact , the nursing home is incentivized to refer the private citizen to a counselor that will advise the citizen in such a way to keep the citizen on “ private pay ” for as long as possible because the nursing home will receive more monthly revenue for the same care from a private citizen than it would from Medicaid . Obviously , the government would also like to see each citizen spend all of their money on their own long term care . However , Congress has provided a set of statutes that outline what is required to qualify for Medicaid assistance . It is the elder law attorney ’ s job to know those statutes inside and out in order to apply the law to each client ’ s particular , special set of facts . He also helps clients plan to protect their assets even though there is no current indication that they will ever need a nursing home .
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