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Are You Worried About Going Broke Paying for In-Home Care or Nursing Home Care?

At the law firm of Santa Barbara Estate Planning & Elder Law, we can help you with the following (and more):

  • Getting the quality care your parents need;
  • Relieving the family member caregiver;
  • Protecting the family assets from being depleted on care;
  • Understanding the hidden Medi-Cal benefits and VA Benefits planning

It seems like before we know it, our kids are grown up. As they enter adulthood, our parents also begin a new phase in life. One of our greatest blessings is that our loved ones are now living longer, allowing us more priceless time and memories together.

But with that comes great concern for those loved ones who may not have prepared financially to live through these extended years. This can cause both our aging loved ones and our extended family distress.

As our loved one’s age, they may begin to require more and more help with daily activities. Family members (statistically the adult daughter) usually step in first to help, but in time realize they can’t provide the necessary level of care.

While they want to meet their moral obligation to loved ones by helping them with daily activities, managing medical and financial decisions, and securing safe living arrangements, the family caregiver often becomes overwhelmed trying to continue living their lives amid these important duties. The family caregiver usually begins to experience high stress, anxiety, guilt, and even depression.

Eventually, family caregivers look for outside help to ensure their aging loved one has the complete care they need. They are often shocked when they find out that securing in-home or long-term care is very expensive. The average monthly cost for nursing home care is now $10,000 in California!

Family members panic and begin looking at all possible options as they realize that their aging loved one will likely run out of money paying for long-term care. Family members might look first at their financial resources but quickly realize they can’t afford the high cost of long-term care while supporting a family of their own and are unequipped to provide the needed level of care personally.

Why Long-Term Care Insurance Isn’t Always an Option

While some seniors can afford private care, the cost of long-term care can easily wipe out the savings of all but the wealthiest families in a matter of years. Those who have planned by purchasing long-term care insurance have a degree of certainty and peace of mind knowing they need less to rely on other sources in the future.

Unfortunately, many can’t afford the high cost of long-term care insurance or, worse, because of age or medical conditions, cannot qualify for long-term care insurance. If you have long-term care insurance, you should know what your policy covers.

Many policies have high deductibles or a waiting period before they will provide a period of care in a medical facility. Many who have long-term care insurance still have to resort to state and federal government benefits to pay for their care.

While the state and federal governments have financial resources available to assist aging loved ones with long-term care costs, the aging loved one must qualify. Unfortunately, once your loved one exhausts all financial resources, your options for quality care greatly diminish.

This adds another level of distress and helplessness, as family members worry that their loved ones will not have the quality of care they desire and will not be permitted to age with dignity.

Need Help? That’s Where We Come In.

Our law office can help your loved one secure government benefits to fund in-home care, long-term care, or custodial care in Santa Barbara County without spending their hard-earned assets. This is accomplished legally and ethically through robust medical and financial powers of attorney, gifting strategies, trusts, and other Medi-Cal estate planning tools that help your aging loved ones retain their financial security and age with dignity.

Proactive Planning – Pre-Medi-Cal Planning

Far too often, seniors wait until they fall ill and require care to seek the assistance of elder law attorneys. Unfortunately, in waiting for a crisis, seniors and their caregivers often encounter more hurdles for qualification and high-stress levels during an already difficult time.

We are a traditional estate planning firm that can assist clients with pre-Medi-Cal planning and developing a long-term care plan that seeks to protect assets through traditional estate planning functions and asset protection tools – such as irrevocable trusts. We do this while coordinating private insurance, veterans’ benefits, and other resources available to pay for future elder care. The goal is to avoid draining all of the family’s assets or having assets subjected to California estate recovery.

Helping You Qualify for Medi-Cal

Even if you still need to plan for Medi-Cal eligibility requirements, several tools are available to obtain eligibility. We assist clients who are just starting the process and need to qualify immediately. In these situations, we work directly with seniors, geriatric care managers, caregivers, social workers, care facilities, and healthcare providers to identify the best environment for your ongoing care.

Our law office will work with you to complete the Medi-Cal application and, when necessary, “spend down to qualify” in a meaningful way that won’t waste your hard-earned assets but will benefit your loved ones for years to come.

We can help you avoid the financial ruin associated with the high cost of long-term care. Contact a Santa Barbara Medi-Cal Planning Attorney today to learn more about the issues surrounding Medi-Cal eligibility requirements and to begin the Medi-Cal planning and application process.

What Government Benefits Are Available to Your Loved Ones?

Many aging seniors in Santa Barbara County may be eligible for Medi-Cal or VA Aid and Attendance benefits. These benefits can provide your loved ones with additional financial resources to help fund the cost of in-home care or long-term care assistance.

Medi-Cal Planning for Long-Term Care

Medi-Cal is a benefit through California’s Medicaid health care program that helps seniors fund their long-term care needs. (It is different from Medicare because Medicare is an entitlement program for those that have paid into the system). You must qualify for the Medi-Cal program, and seniors cannot have excessive financial resources in their name.

Our law firm works with individuals in Santa Barbara County and their caregivers to guide them through the challenging financial and legal decisions that occur as they grow older and require ongoing care. While significant federal and state benefit programs were designed to assist the elderly, far too many people fail to understand how these programs function and what is required for eligibility.

We work closely with our clients to ensure they understand the many legal options to protect assets and qualify for benefits that will help pay for long-term care.

Fortunately, our Medi-Cal planning strategies can help your loved ones preserve their assets but qualify for Medi-Cal. And because your loved ones still have assets, we can use those assets to help supplement the high cost of long-term care to cover what Medi-Cal will not.

Now is the time to use our strategies to qualify your loved one for Medi-Cal. California has adopted the DRA (Deficit Reduction Act of 2006) but has yet to implement it. When it does, it will become much more challenging to obtain Medi-Cal while preserving family assets, leaving your loved one at significant risk

The VA Aid and Attendance Benefits

Another benefit available to your loved ones is the VA Aid and Attendance Benefit. This is a federal benefit available to seniors who served our country during wartime or the Veteran’s surviving spouse.

To qualify, the Veteran needs to require daily assistance with activities. They also need to have served at least three months in the armed services, during which time there was one active day of combat (even if the Veteran did not physically see combat). The other main requirement is that the Veteran (or the surviving spouse) only has limited resources or assets in their name.

Like Medi-Cal planning, we can help Veterans (or the surviving spouse) secure the VA Aid and Attendance Benefit without spending hard-earned money unnecessarily. Now is the time, though, to secure this important benefit before the law makes this benefit extremely difficult to obtain! Thank you, Veterans, for your service to our country.

Medi-Cal Crisis Assistance in California

Full-Service Estate Planning Attorneys for Medi-Cal Planning

Even the families of individuals who carefully planned for their later years and the uncertainty that this time in their lives can bring are often shocked and surprised when a calamity suddenly takes their loved one’s health or well-being. When this happens, the loved ones who must make decisions can panic and feel lost.

This can prove to be detrimental to their loved one or family member:

  • A delay in obtaining the appropriate medical services or treatment can harm the individual’s prognosis.
  • Failing to apply for and obtain benefits can result in a depreciation of the individual’s assets over their lifetime.

Medi-Cal (Medicaid) Eligibility

Medicaid, known as Medi-Cal in California, is the one government program that pays for long-term care in a nursing home. For those who wish to live at home or in assisted living, Medi-Cal will sometimes pay for care in those locations if it can be obtained at a lower cost than in a nursing home.

Unlike Medicare, which is available to almost everyone who reaches age 65, Medi-Cal has eligibility standards based on your medical needs, financial resources, and income.

Due to the income and asset level requirements, many people don’t think they will qualify for Medi-Cal benefits, so they never attempt to apply. This is a big mistake!

At the law firm of Santa Barbara Estate Planning & Elder Law, we use the rules to implement proper, effective, and legal strategies to obtain Medi-Cal benefits for our families while simultaneously protecting their income and assets. Contrary to popular belief, you do not have to “spend down” your life savings to obtain the benefits you’ve earned.

2022 California Medicaid Eligibility

There are several Medi-Cal programs in California available to seniors who qualify:

  1. Assisted Living Waiver Program (AWL)
  2. In-Home Support Services (IHSS)
  3. Skilled Nursing Home Care

Each program has different requirements and benefits, confusing the application process. Further complicating matters is the eligibility criteria which differ between single individuals and married couples.

Monthly Maintenance Needs Allowance: $3,260

  • Applies when: One spouse lives in the nursing home, and the other spouse (the “Community Spouse”) lives outside the nursing home.
  • Definition: Maximum income each month that the Community Spouse may keep. Suppose both spouses’ combined monthly income is lower than the minimum amount. In that case, the Community Spouse keeps all the income (and it may be possible to expand the resource allowance so the Community Spouse can keep more than $130,380).

Maximum Community Spouse Resource Allowance: $130,380

  • Applies when: One spouse lives in the nursing home, and the other spouse (the “Community Spouse”) lives outside the nursing home.
  • Definition: Maximum amount of assets that the Community Spouse may keep in most situations. The Community Spouse may keep $130,380. A court petition may increase this amount.

Monthly Personal Needs Allowance: $60

  • Applies when: A person receives Medi-Cal benefits while living in the nursing home.
  • Definition: A monthly dollar amount that a Medicaid recipient may keep for personal items that Medicaid does not cover (e.g., haircuts). Thirty dollars ($30) more may be available for veterans.

Divestment Penalty Divisor: $10,184

  • Applies when: A potential Medicaid recipient transfers assets.
  • Definition: This figure, based on the statewide average of monthly nursing home costs, determines the length of time an individual or couple is ineligible for Medicaid benefits because of transfers they have made.

No matter how small, every divestment triggers a penalty and denial of benefits.

Resource Allowance for an Individual: $130,000

  • Applies when: A single person living in the nursing home applies for Medicaid benefits.
  • Definition: Maximum amount of assets a single person may own and still qualify for Medicaid benefits (as of July 1, 2022).

Resource Allowance for Each Additional Household Member: $65,000

  • Applies only when BOTH spouses reside in a nursing home.
  • Definition: Increase for each additional household member for the maximum amount of assets the couple may own and still qualify for Medi-Cal benefits (as of July 1, 2022). If one spouse has received Medi-Cal benefits for more than one (1) year and then the other spouse moves to a nursing home and applies for benefits, a different rule may apply.

IMPORTANT: You do not have to spend down your life savings to qualify for Medi-Cal. There are legal and ethical strategies that an expert Elder Law attorney can utilize, to get you the benefits you’ve earned.

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