It’s a common occurrence. Far flung family members return home to visit elderly relatives for the holidays. Upon arrival, they notice that things seem … off. There’s expired food in the fridge, and items strewn haphazardly about the residence. Throughout the visit, they notice changes in their elderly relative’s demeanor, with questions asked repeatedly and usually tidy appearances unkempt. The children agree – Dad can’t live alone any longer. It’s time to explore other living arrangements for him … and figure out how to pay for his care.
Types of Facilities
There are multiple options for elderly individuals who can no longer live alone, but the differences between them are frequently misunderstood.
The biggest difference is between assisted living facilities and skilled nursing facilities. While both provide lodging, meals, and assistance with eating, bathing, toileting, dressing, medication management, and transportation to their residents, skilled nursing facilities (also called “nursing homes”) offer more comprehensive health care services. Personal care homes are another type, providing assisted living-type accommodations on a smaller scale.
Paying for Care
The question of how to afford to pay for the residential care of an elderly family member is one that weighs heavily on the family. In many cases, the elderly loved one was the caregiver for the very individuals who are now trying to figure out how to pay for the care. With the roles reversed, it can be emotional to try to navigate how to keep your own parent or grandparent safe and protected.
Here are some common ways that care for an elderly family member is paid for:
♦ Long term care insurance (also called “LTC insurance”) – not many elderly individuals have insurance to cover their residential facility stay, but some do, so it’s worth investigating! These policies can be a lifesaver, paying for care for an indefinite time period, or paying until a cap is reached.
♦ Veteran’s benefits – if your loved one (or their spouse) served during certain times of war, is over the age of 65 or disabled, and received an honorable discharge, he or she may be entitled to certain programs which pay for care through the Department of Veterans Affairs.
♦ Private pay – if your elderly loved one has financial accounts or other assets, he or she may elect to pay the cost of their residential facility from those assets. If he or she doesn’t have assets to pay, the family might decide to each chip in to pay for the care. Can’t afford that? Don’t give up hope just yet – keep reading.
♦ Sell (or mortgage) the house – if your elderly loved one owns a home, it may make sense for that home to be sold (or for a mortgage to be taken out against the property) in order to finance the care for your loved one.
♦ Medicaid – If your loved one has limited financial means (or even if he or she doesn’t), Georgia’s Medicaid program may provide financial assistance to cover the cost of their residential care.
More about Medicaid
Georgia has two types of Medicaid programs worth considering if your elderly loved one needs assistance. The first type covers residential care and is commonly called “Nursing Home Medicaid.” The second type provides limited in-home assistance (less than 40 hours per week), and is called the “Community Care Services Program.” Generally speaking, those who qualify for one of these programs will qualify for both because the financial eligibility requirements are the same.
There are four eligibility criteria that must be met for an individual to qualify for Georgia’s Medicaid programs:
♦ Citizenship/legal alien qualification – an individual must have a valid Social Security number, and be a citizen, a legal alien who entered the U.S. prior to 1996, or a qualified legal alien who entered after 1996.
♦ Needs qualification – an individual must be over 65, blind, or disabled, and must meet medical level of care requirements established by the state of Georgia.
♦ Income qualification – in 2019, an individual who receives income of less than $2,313 per month passes the income qualification test for Georgia Medicaid. If your loved one has income greater than $2,313 per month, it may still be possible for him or her to qualify for Medicaid using a legal technique called a “Miller Trust.” As long as the guidelines for that trust are strictly met, your loved one can still pass the “income test” to qualify.
♦ Asset qualification – in 2019, to pass the “resource test” a single person may only have assets of $2,000. For married couples, that number jumps up to $128,420. However, many of the things that you and I would usually consider as “assets” do not count for the purpose of determining Medicaid eligibility. For example, your loved one’s residence, household furnishings, personal belongings, and car are not considered assets for the purposes of the “resource test.” Additionally, there are legal planning opportunities available to reduce assets so that your loved one can pass the “resource test.”
As you can see, there are a variety of options for caring your loved one – and for paying for the cost of that care.
Unfortunately, there are also a lot of myths out there – like Medicare will pay for long term care (it won’t), most Georgia facilities don’t accept Medicaid residents (that’s untrue – 96.9% of facilities in Georgia accept Medicaid as payment), or the state will take everything after my loved one dies (that’s only one possibility among many). There are also real repercussions to self-help remedies, with the government looking for transfers which occurred before the care was needed to determine if any property or assets were gifted away by the elderly person.
So, if your loved one is need of long term care, consult an elder law attorney to decide how to get the care he or she needs while protecting his or her assets.