Medicaid Planning

For many families, Medicaid benefits represent the only means of affording long-term care for an elderly or disabled loved one. But only individuals whose incomes and assets fall below certain thresholds qualify for Medicaid. People whose assets exceed these limits need Medicaid planning to qualify for Medicaid benefits. That’s where a New York Medicaid planning lawyer from Amoruso & Amoruso LLP can come in.

If you and your family need help with Medicaid planning, contact Amoruso & Amoruso LLP. With nearly six decades of combined legal experience, our attorneys provide comprehensive estate planning, elder law, and Medicaid planning. We will take the time to get to know you and develop a holistic, personalized plan tailored to your needs and goals.

If you already have a long-term care Medicaid plan, allow Amoruso & Amoruso LLP to give it a thorough review. We’ll identify any areas that could use revisions or corrections and advise you on options for making it better based on your individual goals. Be assured that, if no changes are needed, we will tell you and you will have the peace of mind that your plan accomplishes your objectives.

Contact us today to learn more about what an experienced New York Medicaid planning attorney can do for you.

What Is Long-Term Care?

Long-term care is the collection of services designed to help people meet their essential health and personal care needs as they age. Long-term care focuses on assisting with daily activities, such as bathing, toileting, dressing, eating, and moving around. Many people receive long-term care at home from family and friends. Professional home health care services also exist to provide in-home long-term care. Alternatively, people may move to an assisted living facility or nursing home to receive long-term care.

How Do You Pay for Long-Term Care?

Professional long-term care services at home or moving into an assisted living facility or a nursing home can become expensive. It is even more costly when a person needs long-term care for years or decades. Some of the most common methods that individuals and their families use to pay for long-term care include:

  • Long-term care insurance, which differs from traditional healthcare insurance. It covers the cost of long-term support services at home or in an assisted living or nursing facility; however, policies reimburse the cost of long-term care services up to a daily coverage limit.
  • Cash, which forces people to deplete their hard-earned retirement funds.
  • Medicaid, which is available to qualifying people whose assets and income fall within the Medicaid limits for New York to pay for long-term care.

What’s the Average Cost of Long-Term Care?

Based on our experience, average costs for standard long-term care services in New York include the following:

  • Approximately $14,000 to $18,000 per month for a room in a nursing home
  • Approximately $4,000 to $11,000 per month in an assisted living facility (depending on the level of care)
  • $25 to $32 per hour for a home health aide

Various factors can affect long-term care costs, including:

  • Geographic location
  • The time of day or week when hourly service providers come
  • Number of hours of care per day, per week
  • Level of care needed (unskilled personal care versus skilled care)
  • Whether assisted living facilities or nursing homes provide an all-inclusive rate or offer extra services

Does Medicare Cover All Long-Term Care or Nursing Home Bills?

Unfortunately, Medicare does not cover the cost of long-term care. Medicare will only provide limited coverage for skilled nursing services (i.e., physical, occupational, and speech therapy) for up to 100 days if eligible. Days 1-20 are free of charge, while days 21-100 have a 20 percent co-insurance. Thus, enrollees must cover 100 percent of the costs of non-covered long-term care. However, enrollees can turn to the Medicaid program to help with long-term care services.

How Do I Become Eligible for Medicaid Benefits?

People wishing to apply for Medicaid benefits must meet the eligibility requirements set by their state of residency. Recipients must be U.S. citizens or qualifying non-citizens, such as lawful permanent residents. Applicants must fall under one of several categories of individuals, including:

  • Children
  • Pregnant women
  • Certified visually impaired individuals
  • Certified disabled individuals
  • Individuals over 65

People with disabilities or those over age 65 must also meet the Medicaid program’s resource test. This test examines an applicant’s household income and assets. Also, an applicant’s assets or other financial resources must be under a limit that changes regularly to account for inflation. The amount of financial resources and income an applicant may possess also depends upon whether they seek Medicaid home care or nursing home Medicaid.