When a family is spread out across the country with parents in Colorado and children in Boston and San Francisco, who provides additional care for mom and dad? When is it time to investigate assisted living or nursing home options?
For these types of families, it requires open and honest communication. When family care is not an option, it is also crucial to get answers about nursing home costs in Colorado and Medicaid eligibility. Advance planning is necessary, because any gifts made within 60 months (five years) of applying for Medicaid are closely scrutinized.
What percentage of older Americans stay in a nursing home?
A Rand Center for Study of Aging study found that 56 percent of those currently between 57 and 61 will likely spend at least one night in a nursing home during their lifetime. Previous estimates by the US Department of Health and Human Services of about a third probably underestimated the chances.
The average stay for those who needed this higher level of care was 272 nights. Ten percent of those in study group stayed much longer. Having children did not lessen the odds of needing care, but it was correlated with shorter stays.
When medical treatment plateaus, Medicare generally ceases. Medicaid, however, may pay for custodial-type care subject to eligibility requirements.
In 2018, the income limit for a single person is $2,250 per month. The asset limit for nonexempt items remains $2,000. When both spouses require Medicaid assistance, the couple can have assets up to $3,000.
Some nonexempt assets include:
- Home equity up to $572,000 – while the home is technically not a countable asset, Medicaid may request repayment from the proceeds of a sale in probate court.
- A vehicle if specially equipped for a handicapped person or a vehicle used to get to medical appointments up to a certain value.
- The value of a burial plot
It is permissible to shift some assets from countable to exempt by remodeling a home or buying an exempt vehicle. Before doing so, however, get advice to ensure that your plan is allowable and will not have unintended consequences.
Community Spouse Resource Allowance (CSRA)
A spouse who is not in need to skilled nursing care can retain a larger amount of assets without impacting eligibility. In 2018, this amount is capped at $123,600 in countable assets.
Because of Medicaid recovery statutes, it’s important to anticipate and plan for long-term care as parents and other aging loved ones reach their mid- to late-70s.