- Serving seniors and families in Western PA and WV
- (412) 788-2000
The cost of long term care will be the greatest threat to your home and finances.
If you think “I’ll never need long term care,” unfortunately the statistics show otherwise: 7 out of 10 people will need some type of long term care.
Nursing home care costs are astronomical, and rise every year. In 2020, the average cost for a nursing home in Pennsylvania was $10,038 per month (Source). With an average stay being about three years, that is $361,368!
Private in-home care is even more expensive, with 24-hour care costing $17,472 per month. The average senior needs care for about three years, costing $628,992.
With cost of living increases, coupled with the growing number of people who are enrolling in these facilities, long term care costs are becoming too expensive for most families to manage on their own. Even after years of disciplined saving, nursing home bills or in-home care costs can quickly drain your bank account in a matter of months.
Most families don’t know that there are programs available in Pennsylvania to help pay for a loved one’s nursing home care.
In the video below, I discuss Elder Law, which is the type of planning that can help your loved one who is in a nursing home, or may need care soon.
A large part of Elder Law involves Medicaid planning. Medicaid is the largest provider of financial assistance for nursing home residents in the United States. Medicaid is a federal program administered by the State of Pennsylvania.
With proper Medicaid planning, you can save your assets from the costs of long-term care. Most people aren’t aware that Medicare and private health insurance do not cover long-term nursing home care, except in very limited circumstances.
How does someone qualify for Medicaid? There are strict laws for Medicaid eligibility. There is both a financial and medical qualification.
Financially, in order to be eligible, one must have assets under the state’s limit. What most people don’t know is not all assets are countable for Medicaid purposes. For example, you may still own:
If proper Elder Law planning is done prior to submitting a Medicaid application, you may be eligible despite owning relatively substantial assets.
Many people think they can simply gift their money, property, and other assets away to loved ones to become eligible for Medicaid. That is not true. Once you apply, the Medicaid office will review all asset transfers from the previous 5 years (called the look-back period).
Asset transfers or gifting must be done properly, with the aid of an attorney. Severe penalties are imposed on improper gifts including the denial of benefits for several years.
The process of applying for and receiving Medicaid benefits is a complex task. The Medicaid office requires extensive records along with the application. Even after supplying all necessary information, time consuming appeals are often necessary to secure benefits.
Our office strives to make the Medicaid application process as smooth as possible. We can help you become eligible for Medicaid while still protecting the nest egg that you’ve built over your lifetime. It’s never too late to protect your life’s work. Click here to get started.
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5 Must Ask Questions When Choosing a Nursing Home
No. While there are strict requirement to meet for both income and assets, with proper planning you may become Medicaid eligible before spending all of your assets.
There are certain assets that can be placed in a non-countable category for Medicaid purposes, such as your primary residence, car, and personal items.
If you have a healthy spouse, your spouse can also keep a portion of your assets and you may still qualify for Medicaid benefits.
We caution you when giving away or transferring your assets in consideration of Medicaid eligibility. Gifting and transfers must be done properly, with the aid of an attorney. Severe penalties are imposed on improper gifts including the denial of benefits for several years.
Watch my YouTube video “What does an Elder Law Attorney do?” to learn more.
No. Medicare does not cover nursing home care except in limited circumstances.
People are often confused over the differences between Medicare and Medicaid. Though their names are very similar, the programs are quite different.
Medicare is a health insurance program that most people enroll in when they turn 65 years old. There are no financial qualification rules.
Medicare Part A may cover a short term stay (up to 100 days) in a skilled nursing facility, but the rules for coverage are very strict. You must first have a qualified hospital stay, and the facility must admit you for the illness or injury that you were receiving hospital care for.
Medicare does not pay for long term care and they will often stop paying with just days notice. Many families are shocked to learn this and are left scrambling to figure out how they will pay for care. That’s when it’s important to contact our office, so we can determine your eligibility for Medicaid, Veteran’s Benefits, or another program to help cover the long term nursing home expense.
You’ll find the price of Elder Law services varies based the level of planning you need. Someone with significant assets requires more robust planning. The attorney may have to use techniques like spending down and protecting a home and other assets with an Irrevocable Asset Protection Trust.
If you don’t own a home and only have a few thousand dollars to your name — assuming you did not gift your assets away — you may be eligible for Medicaid with little to no planning.
In general, to get someone qualified for Medicaid most attorneys charge you the equivalent of one month of nursing home care costs. Here in the greater Pittsburgh area, a month of nursing home care is around $10,000.
Keep in mind that once you are qualified for Medicaid, the monthly nursing home bill is now covered. By spending $10,000 on attorney services today, you stop spending $10,000 on nursing home care every single month. It’s easy to see how quickly you recoup your investment.
Yes. Medicaid has benefits called Home and Community Based Services (HCBS) available to assist you in your home if you qualify. Currently, the Department of Human Services administers 12 HCBS programs. Each program has its own eligibility requirements and services.
Benefits of this program can include nursing, personal assistance, respite care and adult day care.
Schedule a free call with us if you’d like to learn more about the HCBS program.
Most of our clients aren’t used to meeting with a lawyer. In fact, our office is the first law firm that many of our clients have worked with.
As you evaluate your options, make sure you ask a potential attorney these questions before making the decision to hire him or her:
You should also consider: Do I genuinely like this person? They are going to be taking a deep-dive into your finances, so hire someone you will feel comfortable working with.
Watch my YouTube video “What questions to ask an Elder Law Lawyer?” to learn more.
Make smart choices to protect your loved ones. Download our FREE guide.
Since 1940, our Elder Law & Estate Planning Law Firm has proudly served Pennsylvania and West Virginia.
We help clients throughout Western Pennsylvania, including but not limited to: Pittsburgh, Oakdale, Imperial, West Allegheny, Moon Township, Robinson Township, Kennedy Township, Sewickley, Carnegie, Crafton, Rennerdale, South Fayette Township, North Fayette Township, Mount Lebanon, and Upper St. Clair.
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Disclaimer: The information you obtain at this site is not, nor is it intended to be, legal advice.
You should consult an attorney for advice regarding your individual situation.
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