Nursing Home and Medicaid Planning in New York

Serving Clients in the Five Boroughs and New Jersey

A long-term care plan is essential for every individual entering the retirement years. It will provide orderly management of financial and medical decisions in the event of disability or incapacity. We offer a clear three-point plan which will:

1. Help you maintain the highest degree of independence in the face aging, illness or incapacity.
2. Document your wishes and needs.
3. Assemble the right combination of financial options and legal tools to meet your current, ongoing and future needs.

Maintaining Independence

Most people want to continue living in the environment they know best — their homes. We work with our clients —and their families — to help determine how much independence is possible. We usually begin with these steps:

• We start with an assessment to determine what assistance is needed.
• We connect our clients to community support organizations, at-home caregivers and other resources.
• We help document your wishes through advance directives such as a Durable Power of Attorney or Health Care Proxy.

Planning Ahead: Documenting Wishes and Needs

Self-determination and control is the goal, but they may not always be possible. Planning ahead can ensure that your wishes are carried out by your appointed agent.

Options For Financial Security

Living longer means that you may have to plan more carefully for financial security. We can create a plan to better cover extraordinary medical and living expenses, such as home care services, assisted living facilities, nursing homes or other long-term care arrangements. These expenses may be paid for in various ways, including:

• Private payment/family savings
• Medicare
• Private long-term care insurance
• Medicaid
• Prescription drug coverage

With the high cost of care, insurance and government benefits are paying a larger and larger share. In spite of this, unprotected private savings are still expected to be fully used before most types of public funds become available. The right mix of resources will ensure that your care is covered. Some key things to consider in forming your long-term health care plan:

Planning for incapacity

As the number of birthday candles increase on your birthday cake, so do the odds of becoming incapacitated due to an injury or illness. Whether incapacity strikes suddenly or over time, the consequence is the same. Either you will have properly appointed decision-makers of your own choosing through legal planning in advance, or a judge (who likely does not know you or your loved one) will appoint someone for you under the ongoing supervision of the court. The pre-planning alternative is less expensive, easier on your loved ones and protects your privacy from the public record.

Planning for Long-Term Care

According to commonly cited statistics, if you are age 65 and single, then the odds are about 50 percent that you will need long-term care at some point. For married couples, odds are about 75 percent that one spouse will need such care. For how long? The average stay runs about two and a half years.

Long-term care is expensive 

According to commonly cited statistics, if you are age 65 and single, then the odds are about 50 percent that you will need long-term care at  some point. For married couples, odds are about 75 percent that one spouse will need such care. For how long? The average stay runs about  two and a half years.

Paying for Long-Term Care

You may be thinking, “I have Medicare, so I don’t have to worry about long-term care, right?” Wrong. Medicare only pays for acute nursing home care, not chronic care. Think of acute care as rehabilitation after hip surgery. You will be going home to care for your own daily needs.

Think of chronic care as needing help with “activities of daily living” like bathing, eating, dressing, continence, toileting or transferring, not to mention dementia or Alzheimer’s. Even for acute care in a skilled nursing home, Medicare is limited to paying for up to 100 days with strict eligibility requirements and full payments limited to the first 20 days and co-payments thereafter. By the way, your Medigap (i.e., Medicare Supplement) policy will not pay for your long-term care, but may pay the Medicare co-payments for days 21 through 100. Medicare does not fully cover long-term care, but Medicaid can. Establishing Medicaid eligibility is complicated, so start early and work with a professional – such as a Grimaldi Yeung Law Group attorney – who understands the rules and the process to increase your chances of success.
∙ Private payment of catastrophic medical and care expenses will reduce your savings to fund your daily needs and leave less to pass to your heirs.
∙ No matter how you fund your health care, there are tax implications. Careful planning with a skilled professional will integrate tax savings.

For resources on aging services and benefits click here.