Caring for a parent or family member as they age is something most of us will have to deal with at some point in our life. This task comes with many difficult decisions. Should I care for my parent at home, pay for in home care, or find a facility that can properly provide care and comfort? The most pressing question is usually how to pay for care. Nursing care in Pennsylvania averages over $10,000 and can easily reach $15,000 and even higher for some facilities.
Most families are not able to pay such high bills for very long. The Pennsylvania Medical Assistance program will cover the cost of nursing home care but there are many complicated rules that must be followed in order to qualify for this program. Most people have never heard of these rules or misunderstand the process. Below are 5 common questions asked by families considering nursing home care:
Can the Nursing Home take my House?
The short answer is no. A nursing home is a private institution and does not have the ability to take your house. If you do not have enough money to pay for the nursing home’s monthly fees, they can discharge and individual unless they have submitted an application for Medical Assistance. There are strict rules about how much property and savings you can have in order to qualify for this program, however in most cases, a person’s personal residence is exempt and they are not required to sell or dispose of the house to qualify. Gifting or transferring the house may create a penalty that could prevent you from qualify for Medical Assistance.
Can I gift all my assets and then qualify for Medical Assistance?
Although Pennsylvania’s Medical Assistance program requires an individual to have little to no property or savings in order qualify, they also do not permit a person to gift or transfer assets in order to qualify. Any gifts or transfers for less than full price within 5 years of the application will create a penalty period. If a penalty period is assessed by Pennsylvania then the applicant will not receive benefits until the period has run.
The nursing home only has a certain number of Medicaid Beds so we cannot qualify for Medicaid?
While it is true that not all nursing homes take Medical Assistance, if the nursing home does take medical assistance, there is no limit to how many individuals at the facility can be on Medicaid. Some nursing homes will try to skew this fact because they receive much more money from residents who private pay over Medical Assistance patience. Often a nursing home will have a contractual requirement that a resident pay privately for a certain period of time (often 12 to 24 months).
Isn’t Medicaid for Poor People?
Pennsylvania’s Medical Assistance Program (the state implementation of the Federal Medicaid Program), has several different programs, including a program specifically for residents of long term care, or for individuals whoa receiving in home care. Medicare does not cover a stay in long term care for more than 30 days so a resident’s only options are private pay or to qualify for Medical Assistance.
You have to be Broke to Qualify for Medical Assistance?
The rules for qualifying or Medical Assistance are complex and not easily understood without lots of research and experience. The strict rules for Medical Assistance is that the applicant cannot have more than $2,000 in order to qualify, but the reality is that the rules allow for many different strategies and exceptions to protect and save property, especially if the individual is married and their spouse is not in a nursing home. Often we can save hundreds of thousands of dollars and still allow the individual to qualify for Medical Assistance.
Planning for and paying for nursing home care is daunting and complicated. The best option for families is to meet with an attorney who is experienced in elder law. Our attorneys can create a custom plan for your loved one that can preserve their life savings and allow them to get the care and comfort that they need.