The possibility of Nursing Home care is a very real prospect for a large number of senior citizens today. Statistically nearly one-half of us will require some type of long term care during our lifetimes.
After having sacrificed and saved throughout our lives to set aside a nest egg for a comfortable retirement, the concern that our health care needs will rapidly deplete those life savings is a very real fear that must be addressed.
Quality Nursing Home Care in the South Florida Region can presently cost as much as $8,000 per month, sometimes even more !
In certain circumstances one may qualify for financial or other assistance under Medicaid's Institutional Care Program (ICP) or for an exemption pursuant to an existing Mediciad Waiver Program. Of course, it must first be determined by Medicaid that such individual's physical condition requires the stated level of assistance with the Activitites of Daily Living (ADL's). Such a determination is customarily made by a local Medicaid official in accordance with the then current criteria. However, such a decision is made only after submission of (i) a formal application, (ii) a follow up investigation and (iii) a detailed review of the applicant’s financial eligibility.
The rules of Medicaid Eligibility are complex and detailed. Experience with the prevailing regulations is essential. Over the years various amendments have been made to Medicaid laws generally through the Consolidated Omnibus Reconciliation Act of 1986 (OBRA), the Spousal Impoverishment Act of 1989, the Omnibus Reconciliation Act of 1993 (OBRA) and the Deficit Reduction Act of 2006, all of which require consideration in any given situation.
It has been our experience that an individual about to file a Medicaid Application with any governmental agency can benefit by first consulting with an Elder Law Specialist with a thorough knowledge of the then applicable law and current rules. The results of a faulty application are sometimes “set in stone” and a negative final assessment should be avoided whenever and wherever possible. Specific governmental policies relating to asset transfers, property retention and client eligibility do apply and appropriate prior planning is essential. Of course, as with all planning, the earlier a strategy is undertaken the greater the benefit.