Long-Term Care Planning

At some point in your life, you may need some form of long-term care. You may need to be hospitalized for an extended time. You may require in-home care, a skilled nursing facility or some other form of assisted living. You have options regarding how you choose to pay for such long-term care, including:

Private Pay

If you or your family have the funds, you can directly pay for your long-term care needs.

Long-term Care Insurance

Long-term care insurance is available to provide for in-home care, skilled nursing care and assisted living facilities. You need to know exactly what your insurance pays for. For example, you want to know the answers to the following questions:

  • When does coverage begin?
  • What kinds of care are covered? In-home companion care? Board and Care Facilities or only Skilled Nursing Facilities?
  • Are there limits to the length of coverage?
    • What are those limits?
    • Can you choose where you live?

Medicare

Medicare is federal program administered by the Social Security Administration. It will provide some health care payments to qualified people. Medicare only pays for skilled nursing home care after you have been hospitalized for at lest three (3) nights, and will only pay for a maximum of 100 days. Medicare does not pay for board and care facilities.

Medi-Cal

In California, the federal Medicaid program is known as Medi-Cal. Medi-Cal benefits will often cover long-term care in a skilled nursing home. However, a Medi-Cal beneficiary must still pay a share of the costs for a nursing home as determined by the Medi-Cal rules.

Medi-Cal does not cover custodial board and care facilities which provide only assistance with the necessities of daily living such as dressing, bathing, walking, eating, etc.

To qualify for Medi-Cal, you must meet specific criteria. This can be very complicated. You may have to “spend down” your assets in the proper manner, change the form of some or all of your assets, transfer some property and take other steps well in advance of applying for Medi-Cal benefits. The Medi-Cal laws are very technical and are constantly changing, so be sure to get advice from an experienced elder law attorney before you take action if you are considering obtaining Medi-Cal for long-term care needs.

Long-term care laws are very complex. Thus, always consult with an experienced professional before resulting to self-help solutions.

HELPFUL HINT: Do not give away your house to qualify for Medi-Cal!