Medicaid attorneys at Clarity Legal Group®, serving Raleigh, Cary, Durham , Chapel Hill and surrounding areas, provide help affording the costs of nursing home care. The Genworth Cost of Care Survey details costs of different kinds of residential care you may require. A one-bedroom single occupancy unit in an assisted living facility – which provides very limited services – runs up a median cost of $36,000 annually in North Carolina. For seniors who require more services, a nursing home will be necessary. The median annual rate for a semi-private room in a nursing home in North Carolina is $75,190. For a private room, the median cost rises to $82,125. 
These costs are far too high for most people to pay. Unfortunately, the costs won’t be covered by most insurance. Many turn to Medicaid, which will pay for certain types of care – provided you can qualify for Medicaid coverage.
Many seniors aren’t able to get Medicaid because Medicaid is a means-tested program with asset limits. Seniors may have too much wealth after having worked their whole lives, and so cannot be covered by Medicaid. Clarity Legal Group®’s Medicaid Attorneys can help with this problem by working with you to protect assets, as the law allows, and get you covered.
Why You Need Medicaid to Pay for Nursing Home Care
Seniors who are covered by Medicare often believe they don’t have to worry about the high costs of nursing home care, but this couldn’t be further from the truth.
Medicare pays for some limited types of skilled nursing care for a very limited period of time. But, long-term care simply isn’t covered under the Medicare program. Further, a lot of the help and care people need falls well short of skilled nursing care. For example, people who need help taking their medication, cooking, bathing, or have memory problems really need help, but may not need skilled nursing care. Sometimes, people with these needs end of squeezed into skilled nursing care because Medicaid will pay for this (if they qualify) and there are no other options.
Medicare provides no coverage at all for this kind of custodial care, nor do most other health insurance policies including Medigap and Medicare Advantage plans. For people who need help with activities of daily living but not skilled nursing care, there are very few options outside of simply paying for it from your savings. In North Carolina, the Special Assistance Program may be of some help. This program is strictly limited to low income North Carolinians who have countable assets no greater than $2,000.00. This benefit can support the recipient in assisted living or certain adult group home custodial care situations. Other custodial care needs may be met by a PACE program, which may be covered by Medicaid for qualifying individuals and which provides day-care and home-based care.
Because Medicare won’t pay for care, seniors need to find an alternative. Buying long-term care insurance also isn’t a viable option for most, in part because premiums tend to become prohibitively expensive with advancing age, and in part because of the fact that most long term care policies have daily payment limits or other restrictions that make them ineffective in fully covering the care seniors need.
This leaves few choices for people who have not planned well in advance. Unless seniors are eligible for benefits from the Veterans’ Administration, the only choices they have are typically paying out of pocket or trying to get Medicaid coverage. If a senior has too many assets to get Medicaid, then he will often end up paying out of pocket and impoverishing himself. Only after his chance to leave a legacy is gone will the senior be able to get Medicaid to begin picking up the tab for nursing home care.
The process of impoverishing yourself to get Medicaid can, however, be avoided or mitigated with help. Medicaid attorneys at Clarity Legal Group® will work with you to make certain you are able to protect as much of your wealth as possible while getting Medicaid to pay for the nursing home care you need.
Getting Help from Medicaid Attorneys
Creating a comprehensive Medicaid plan is important to ensure that you do not lose your chance to leave a legacy because you happen to get sick and need nursing home care. You should not try to handle Medicaid planning on your own because mistakes—like simply giving away assets—could cost you by causing you to become temporarily disqualified from Medicaid coverage.
Ideally, an aging adult is able to plan at least five years in advance of the time he or she needs to qualify for Medicaid to protect the maximum value of assets. Clarity Legal Group® can help you to put an advanced plan in place so you can keep as much wealth as possible safe.
Nevertheless, there are always things to be done, even if the need for skilled nursing care is immediate. Always see the Medicaid Attorneys at Clarity Legal Group® or another experienced team of lawyers which include elder law as a focus of their practice before you apply for Medicaid.
Give us a call at 919-484-0012 or contact us online today to find out more about the ways in which our legal team can assist you.
- Is a Beneficiary Defective Inheritance Trust Right for My Business Succession Plan? - December 5, 2023
- Understanding Assisted Living in North Carolina - December 5, 2023
- 10 Estate Planning Tips to Help You Create a Successful Plan - July 11, 2023
Leave a Reply