Planning for Medicaid

I recently attending the Circle of Caring conference put on by the Northern California Alzheimer’s Association. It’s a full day with lots to learn and I find it hard to choose the break out session that is the most important for me and my clients. It was very tough to choose between “Person Centered Care” and “Planning for Medicaid” but I ultimately chose the Medicaid planning presentation. This is such an important issue for many caregivers I meet.

The song from “Cabaret” says “money makes the world go ‘round.” It certainly is a driving force in the caregiving world. Many options that increase you and your family member’s happiness and safety and reduce stress require money.

I wish I could say that I learned some specific, juicy tidbits to share with all of you to make the process simpler. Here is what I did learn. I came away from the presentation with two predominate thoughts. The first, it is possible to shelter assets with the right advice. The second, “Wow this stuff is complex, you need assistance with the planning process”.

Here are three key things to avoid when considering Medicaid (MediCal in California).

  1. Don’t assume or let someone tell you that the only way your parent will qualify for Medicaid is by spending all his or her money. There are other options to help your parent preserve her estate. You need to find a Medicaid expert who can guide you through your options. To find a trustworthy expert in your local area use NAELA (National Academy of Elder Law Attorneys) referral service and any personal recommendations you can find.
  2. Don’t let anyone tell you there is only one way to preserve your parent’s estate. An expert who tells you that only one particular method or financial vehicle will work may be a less trustworthy expert than you believed. Get a second opinion.
  3. Don’t move assets around or change the title to real property without expert advice. Once a senior adds someone else to an account or title, they risk losing control of the asset. Most likely your attempt to “shelter” assets in this way will not work and mayl delay your family member’s eligibility for Medicaid.
The biggest mistake I see families make is not knowing the rate at which their parent is using up assets to pay for care. I know it can be scary to look at the numbers but it’s necessary. Once a senior starts paying for long term care whether it is a helper at home or a move to a senior living community, she may not have enough income to cover the cost and will be drawing on savings. Calculating when she will run out of money is critical.

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