What Happens If Your Loved One Suddenly Needs Nursing Home Care?

Your 85-year-old mother has always been on her own after your father died, but a sudden slip-and-fall in the bathroom could make her bedridden for an indefinite period. Saving her assets may be the last thing on her mind, but a lifetime of savings could be gone in a very short time paying for the costs associated with long-term care in a nursing home.

The cost of nursing home care can be prohibitive, especially if your loved one's stay is longer than six months. One option is applying for Medicaid coverage. But there are complex asset limits and spend down provisions. Estate recovery and property liens can be placed because states are mandated to recover reimbursement from a person's estate after they pass away for certain benefits provided to people aged 55 and older, including for nursing home services, home and community services, hospital expenses, and prescriptions.

The Medicaid application process can be confusing and overwhelming on your own. Eligibility and exceptions may not make sense when you are struggling to complete it on behalf of a family member. Saving your loved one's assets when a medical crisis arises is a difficult process without the help of experienced Medicaid planners. At Berkley Oliver PLLC, our attorneys have experience helping clients get the medical assistance they need without completely depleting their hard-earned savings and assets. Call or text our office in Shelbyville at 502-205-9005 to learn more.

What Is A "Look-Back Period" And Why Does It Matter?

In 2006, the federal Deficit Reduction Act of 2005 (DRA) was enacted into law placing restrictions and penalties for people reducing the value of their assets by gifting them to family to qualify for Medicaid benefits. People who moved their assets from their name to their family's, or to a trust, were penalized if they did so within five years of applying for Medicaid.

The "look-back period" for the penalty is five years. If a Medicaid applicant's assets are transferred for lower than the value they are worth within five years of the application for long-term services and supports (LTSS), the applicant may be deemed ineligible for Medicaid benefits and will be denied coverage.

There are exceptions to the look-back period restrictions. Your loved one's car, prepaid funeral plan and income-producing property used for a business, for example, could be exempted. The applicant's home is generally not counted toward the Medicaid asset limit if certain conditions apply, including whether they and/or their spouse are living in their home and the total value of the home is less than a certain amount. Estate recovery and liens are also subject to exceptions. The state is not allowed to recover from the estate of a person who is survived by a spouse, a child under the age of 21, or a disabled or blind child, or if recovery from the estate would cause undue hardship.

The state is permitted to place a lien on the home of a person permanently in a nursing care facility or another institution, except if that person's spouse, child under 21, or disabled or blind child lives in the home. A sibling living in the home who has an equity interest in the home may also qualify the home for an exemption from a lien. The state is required to remove the lien once the Medicaid recipient is discharged from the nursing facility and returns home.

Contact Our Firm For Help Qualifying For Medicaid And Crisis Planning

Early planning for a nursing home or community-based health services is not always possible. When you need knowledgeable elder law help in Kentucky, call or text Berkley Oliver PLLC at 502-205-9005, or please email us by completing our online form. Our lawyers will answer your questions and concerns about Medicaid planning.

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