For an adult child, it can be extremely difficult to watch a parent succumb to the physical and/or mental deterioration that occurs as a result of the natural aging process. It can be even harder to watch a parent’s deterioration caused by Alzheimer’s or another dementia disease. If you find yourself in just such a position, you will likely reach a point at which you can no longer care for your parent by yourself. Long-term care, in some form, will be necessary. Unless you or your parent can afford to pay for that care out of pocket, you probably need to consider Medicaid as a potential source of help covering the high cost of long-term care. The Hartford Medicaid attorneys at Nirenstein, Horowitz & Associates, P.C. help you figure out if your parent is likely to qualify for Medicaid or not.
Why Might Your Father Need Medicaid?
For most seniors, the potential need to qualify for Medicaid starts with the likelihood of needing long-term care (LTC). Statistics tell us that the likelihood is high. When your father enters his retirement years, around age 65, he will already stand a 50 percent chance of needing LTC at some point before the end of his life. If you have been caring for your father, and he is already showing signs of needing LTC, it is past time to consider how your father will afford the cost of that care. Nationwide, the average cost of a room in LTC was almost $90,000 per year in 2018. LTC costs in Connecticut, however, are among the highest in the country with an average annual cost of just over $160,000. Although it is impossible to know how much time your father might spend in LTC, the average time in LTC is about three years. Consequently, in Connecticut, an average LTC bill would run close to half a million dollars.
Most people cannot afford to pay half a million dollars out of pocket for LTC. Although your father may rely on Medicare to cover most health care expenses as a senior, Medicare will not pay for LTC. Neither will most basic health insurance policies, Consequently, over half of all seniors currently in LTC rely on Medicaid to help with the high cost of that care.
Medicaid for Seniors in Connecticut
If your father does ultimately need LTC, you will undoubtedly try to get him qualified for Medicaid. Connecticut’s Medicaid program is referred to as “Husky Health.” Connecticut has several different Medicaid long-term care programs for which Connecticut seniors may be eligible. A number of factors go into eligibility for the various Medicaid LTC programs, including marital status, geographic location within the state, income, assets, and medical (functional) eligibility requirements. The programs for which a senior might be eligible include:
- Institutional / Nursing Home Medicaid – this is an entitlement program. This means anyone who meets the requirements will receive assistance, which is provided only in nursing home facilities.
- Medicaid Waivers / Home and Community Based Services (HCBS) – with these programs, there are a limited number of participant enrollment slots. Therefore, wait lists may exist. Benefits are provided at home, adult day care, or in assisted living.
- Regular Medicaid / Elderly and Disabled – this is an entitlement program. Benefits are provided at home or adult day care.
For many seniors, the biggest hurdle to Medicaid eligibility is the asset limit. For a single applicant, the asset limit for all three of the above programs is just $1,600. For a married applicant with both spouses applying, the asset limit is $3,200 for Institutional and HCBS or $2,400 for Regular Medicaid. The rules become more complicated when a married applicant is applying but the other spouse is not. Although some assets are considered exempt, meaning they are not counted, seniors often find themselves facing the Medicaid “spend-down” requirement if they did not plan ahead because they have assets valued above the limit. In essence, the spend-down rules require an applicant to rely on his/her excess assets to cover LTC expenses until those assets are gone. Only then will the applicant be approved for Medicaid benefits. The best way to protect assets from the Medicaid spend-down requirement is to include Medicaid planning in your estate plan long before the need for LTC arises.
Contact Hartford Medicaid Attorneys
For more information, please download our FREE estate planning worksheet. If you have additional questions or concerns about Medicaid eligibility in Connecticut, contact the experienced Hartford Medicaid attorneys at Nirenstein, Horowitz & Associates, P.C. by calling (860) 548-1000 to schedule an appointment.