Lie #1: “I’m too overwhelmed with expenses already. Hiring a lawyer is just one more expense to add to the list.”

If hiring an attorney were just another added expense, I’d actually tell you not to come into my office.

It’s true.

The reason I’m an elder law attorney is because I want to see seniors leave my office better off than they were before they came to see me.

One of the biggest parts of my job is helping my clients safeguard some of their money from being used up on nursing home care.

But another equally large part of my work is assisting people to get benefits to help pay for their care!

Medicaid, which helps many seniors pay for care, is a complicated system. We’ll help you see how you may be able to qualify for benefits to pay for care. But it’s vital to know how you can use your money to minimize penalties.

It’s similar with Veteran’s benefits for senior vets. If you don’t qualify, the VA will just tell you “no.” By then, you’ve wasted months in the application process.

But if you’re working with a qualified elder law attorney who specializes in these complex areas, we’ll be able to show you which of your current expenses can be figured into your application.

This helps our clients get a “yes” answer much more often than if they file on their own… all while doing honest, legal work.

The difference is, we help you do things right so you have the best possible outcome.

(Plus, if your loved one with Alzheimer’s is a veteran or the widow of a veteran, ask me how you can get help with your application for Veteran’s benefits, absolutely FREE.)

I help my clients find out which benefits they might be able to qualify for.

And whether or not they qualify for a benefit, I help put the right shields in place for my clients to keep the most money.

There are two important things you should do from here:

First, I urge you to seek qualified counsel before filling out any applications for benefits.

Someone who is skilled in the area of Medicaid and VA will be able to help you get the maximum benefit available to you, without wasting months or years on multiple denied applications. You can’t afford to wait.

Second, if you want to learn more, visit my Alzheimer’s Legal Survival Guide at www.AlzheimersResourceKit.com/hammond/resources/legalguide.html.

To hear more about benefits, read items 51-69. There, you’ll find much more information about Medicaid. And with nursing home care ranging from $60,000 to $110,000 per year – or more – you can’t afford to be uninformed!

But if you’re like many of my clients, and you want answers now, you can call my office at (913) 338-5713.

In a short, cost-free phone consultation, one of my staff members will help you find out whether there are benefits you and your loved one with Alzheimer’s might qualify for.

Next time, you’re going to find out about Lie #2 – it just might be one you’ve been telling yourself all along!

Mary noticed her husband Harvey wasn’t as neat and orderly with his mail as he used to be. He scattered it in piles throughout the house. This was unlike Harvey. Lately he seemed confused about when and how to pay the bills.

Harvey also complained that he didn’t have good use of his fingers. They felt stiff he said, and he easily dropped things.

After a fall last spring that kept him in a hospital for six weeks, he was afraid of falling again. He now spent most of his time navigating in the wheelchair instead of walking with his walker. Said he felt safer that way. He knew something was different, but he didn’t know what it was.

One day Mary heard Harvey ask a neighbor the same question six or seven times, which was very unlike him. You see, Harvey had a brilliant mind. He worked as an engineer and could solve the most complex mathematical and scientific problems. He wrote solutions to problems with lightning speed. His mind was fully alert, until recently.

Mary had Harvey tested, and sure enough the results indicated early signs of Alzheimer’s. Not knowing what the future held and realizing Harvey was still capable, they smartly called my office. They wanted to protect their family’s savings. Harvey and Mary needed to find out how they could both maintain a good quality of life, even if Harvey should ever need long-term care.

They’d heard how families were sometimes forced to drain their family’s savings when a member entered into a long-term care facility. And the sad stories of the care-taking partner being left penniless without a means for their own care down the road.

We took a close look at their situation. Their assets, their home, their lifestyle, and the money they want to leave to their children. We helped them develop a plan with the right kind of legal structures in place to help them shield some of their assets should Harvey need to enter a long-term care facility. The plan took Mary’s future into consideration too.

How fast Alzheimer’s will progress is unpredictable. What is important is that a family begins to create the right kinds of protections before a loved one is out of money and out of options.

The earlier the safeguards are put in place, the better the result.

According to the law, to be eligible for Medicaid or other financial assistance for long-term care you must be medically needy of nursing home services AND impoverished; you must have less than $2,000. Now that you are both medically needy and impoverished, the state will conduct an audit of your finances for the previous five years.

If the state discovers recent “gifts” or property transfers of any amount to loved ones or charities, you could be denied care – even though you are now both medically needy and impoverished. This comes as a rude shock to many.

No one really understands how the government expects you to cure this penalty now that you need care and yet have no way to pay for it; nonetheless, you will be denied Medicaid benefits to pay for your nursing home care.

Under 42 U.S.C 1396p(c)(1)(D), the DRA amends the beginning date of the penalty period from the month the transfer occurred to generally the date on which the person is eligible for Medicaid and would otherwise be receiving institutional level of care based on an approved application for such care but for the imposition of the penalty period.

You can find more information on items 51-66 in my “Alzheimer’s Legal Survival Guide” at www.AlzheimersResourceKit.com/hammond/resources/legalguide.html.

After working with Mary and Harvey, Mary said she’ll sleep easier at night, knowing that they’ll both have the protected financial resources available so they can maintain a good quality of life for years to come.

The state laws that govern Medicaid or any financial assistance for long-term care are complicated and constantly changing. To make it easier for you to understand, and to find out how to protect your family’s savings as well as minimize potential penalties, we are offering you a free NO OBLIGATION telephone consultation.

You will be speaking with an expert who can provide insight and advice. The call is about twenty minutes. There is no charge for the call, but please be advised that the call could be extended to 40 minutes.

To secure a time for this free critically important consultation, please call my office at (913) 338-5713.

Over the next 6 weeks, I’m releasing my most valuable gems about how to get help paying for nursing home care. One new secret about where to get help and the kind of dangers you might encounter if you do nothing.

Why?

Because I want to help you know where you can find help, and what mistakes to avoid.

I want to make sure that even if you’ve already unknowingly made a “mistake,” there may be things you can do to keep from experiencing huge penalties.

To get an email with each new installment, go to www.LearnMedicaid.com/hammond to enter your name and email. You don’t want to miss out.

- Day 1: You’ll begin to discover how NOT to go totally broke when you have long term care costs.
- Day 1, part 2: 7 Secrets to Surviving Medicaid Spend Down… and what it means for you
- Day 2: When Medicare no longer cares for you… and it’s sooner than almost all seniors think!

I challenge you to take my e-course, “Don’t Go Broke in a Nursing Home” so that you and your loved one don’t end up unnecessarily out of money and out of options.

On the first day of my series, today, I’m filling you in on how to keep from making 3 Big Money Mistakes that many seniors unknowingly make! Click below to sign up:

www.LearnMedicaid.com/hammond

I got a letter from my client Theresa last week.

She wrote:

As you know, last summer I entered Mom into the nursing home. Her Alzheimer’s progressed. In the home, she’s physically active, social, and of course, her memory is lacking.

As she greets and visits with the other patients, she often takes off her glasses. The nursing home staff keeps a watchful eye for her misplaced glasses.

Unfortunately, she still loses her specs.

Sometimes she takes off her glasses and leaves them on the dinner tray. We lost at least one pair that way. Just a few months into the New Year, I’m now replacing her third pair.

Replacing her eyeglasses with their special prescription requires a bankroll.

With Medicaid limiting Mom’s personal monthly income to $30, I’m so relieved you helped me set up protections so there is money left over to pay for them. Mom’s bifocals cost a mint. With her tiny nose, she requires costly lightweight eyewear, otherwise she suffers with headaches. Her frames would NEVER be covered under Medicaid.

I’m so grateful we have money from the trust available so she can afford to live her remaining days comfortably. Without the planning we’d done with you, she would have to wait until I had funds to cover her expenses.

* * *

Theresa is not alone.

Many of our families face ancillary fees that can add up quickly.

Some of common expenses when your loved one is in the nursing home are hearing aids, dentures, hair appointments, nail manicures and pedicures, and sometimes transportation costs (to your house for dinner, dentists, or doctor appointments). It doesn’t take much for the costs to really add up.

Alzheimer’s patients frequently lose personal items like eyewear and dentures. These items need replacing immediately.

To help ensure quality of life for your loved one, you need money available to cover these expenditures. To save some of your loved one’s money from being spent on care, it’s a complicated process. It’s likely you need some solid advice and a well thought out plan. That’s where we can help.

We work with our clients’ families, so they can legally set money aside for these types of expenditures.

Unfortunately, most families are not aware of the sensitive timelines to set up this type of legal asset protective structure. The sooner planning begins, the more an attorney is likely to be able to save.

Once your family member applies for Medicaid to help cover medical costs, the government conducts the audit on your loved one’s accounts. The government can claim that any gifts an individual made were intended to help them qualify for long term care if it falls within the five-year period.

When you select a legal advisor, it’s important for you to work with someone who understands elder care law. Select an attorney who focuses in this area.

State laws constantly change, especially now with many states managing deep deficits.

State and federal governments are always looking for ways to slash Medicaid coverage.

When you select an attorney to help set up a plan for yourself, it’s important the attorney is intimately knowledgeable about the fine lines of the state laws so your money is protected and spent in a way that will not get you penalized in the future.

Something else to consider: planning is much better for all parties while the person still has the capacity to make their own decisions.

We provide our clients a free phone consultation. If you would like to find out more about how to put legal structure in place to protect and set aside funds so your loved one can maintain a good quality life while in a nursing home, feel free to contact me at (913) 338-5713.

If we cannot help you, we’ll direct you to resources that can. The call is free; don’t miss this opportunity to gain valuable insight.

When someone enters the nursing home, especially someone with Alzheimer’s, they often spend thousands on their care. In fact, some spend all of their money – down to just $2,000 and $30 of monthly income, before they qualify for Medicaid to pay the bills.

To help you find out if your loved one can keep some of their life savings from being spent on long term care, The Elder & Disability Law Firm has developed a Money Saving Strategy Assessment.

My clients have found this Money Saving Strategy Assessment to be extremely valuable.

One of my top team members will conduct this free consultation over the telephone with you, so you can discover what options you have.

My clients want to know right away the methods that can be used to safeguard at least a portion of their hard-earned life savings. They want to know what will work for them in their situation, right now.

For this reason, we created this Money Saving Strategy Assessment. We’ll tell you if there are steps you can take, right now, to protect yourself and your loved ones from needlessly losing everything to pay for long term care.

We’ll also be straightforward with you and let you know if there’s someone else who may be able to help you better than we can. Or, if there are no steps you need to take right now, we’ll tell you that, too.

You’ll discover in this free, no-nonsense consultation session:

-The steps you need to take, right now, to build protections around your loved ones to achieve your goal of never being out of money or out of options
-Benefits that may be available to you to help pay for the cost of in-home, assisted living, or nursing home care for years to come
-Honest, legal strategies that might be right for you and your family to avoid being unnecessarily impoverished
-Some of the valuable resources available to help seniors, right here in our community

The session is conducted by one of the top experts in my firm, who works with many of my clients to help them achieve peace of mind about their legal and financial future.

Please rest assured: this consultation will NOT be a thinly disguised sales presentation; it will consist only of expert information provided by my firm.

To secure a convenient time for this consultation, please call my office at (913) 338-5713. We will provide you with available time slots for your free personalized and confidential consultation.

We look forward to speaking with you soon.

Of all the challenging aspects of the Alzheimer’s journey, often the most confusing part for families is the financial piece of the puzzle. There are so many rules and restrictions, so many bills to pay and documents to draw up; all while trying to protect loved ones and the funds they’ve got. Most of the time, a family will have been doing their best to provide care for their loved one, but in spite of their best efforts they reach a point where they just can’t do it anymore. When this time comes, families/caretakers begin to realize the inevitability of nursing home care. They begin to look into facilities, and into costs. In Kansas City, they’ll find that memory care averages 6 to 6,500 dollars a month. They look at that figure and think, “how are we ever going to afford to pay 60-70,000 dollars a year for nursing home care?” They also come to understand that once their loved one is spent down to the Medicaid limits, they will only be allowed to keep a monthly allowance of $62 in Kansas and $30 in Missouri. They realize this and think, “our entire life savings is going away, and my loved one isn’t going to have anything extra left over to care for him/herself.” Inevitably, as this realization hits, they come to us at the Elder and Disability Law Firm and ask the question they think holds the most potential for easing their worries—“Can I give my money away?”

The answer to this question used to be pretty simple, but not anymore. This is because on February 8th, 2006, a new law called the Deficit Reduction Act or DRA was signed into effect. Everything that happened before that date follows the old rules, but everything that happened on or after it is subject to the new ones.

Let’s consider how this would have worked before the DRA came into being—because once you understand how it used to work, you can understand how it works now.

Under the old laws, pre-DRA, the state would say that nursing home care cost a certain amount of money, say $3,000 a month. The state would then say that if someone makes a gift, chooses to give their money away, for every one month’s cost of care that they give away they can’t apply for Medicaid for a month. So let’s say that a family chooses to gift $30,000. If the state has set nursing home cost at $3,000/month, the state would instruct us to divide that gift by the average cost of care—in this case $30,000 divided by $3,000, equaling ten. That ten would mean a ten month penalty period in which that person could not apply for Medicaid, and that ten month period would begin immediately from the date of the gift. So say that the family still had $50,000 left after the gift, they would simply use those funds to private pay for care until the penalty period was up and Medicaid could be applied for. It was a great way to set aside funds and protect some of the life savings of the Alzheimer’s patient.

But on February 8th 2006, the game changed considerably. President Bush signed the DRA, and the rules were rewritten. Under the new laws, the state now asks if any gifts have been made, either money or property, in the last five years. They then go a step further and say that if anything has been gifted in that time, unless you are already in a nursing home and spent down to the Medicaid limits, and unless Medicaid application has already been made, then that gift still creates a penalty period, but the penalty hangs around for that five year period. Before the DRA the penalty that gifting created began right away. Now, the gift would still create the penalty, but the period would not start to count down until you were in a nursing home, spent down to almost nothing, and applied for Medicaid. Additionally, the states have raised what they consider the average cost of nursing home care is; in Kansas and Missouri the cost can generally be considered around $4,000 a month, so gifts are now divided by that larger number, but the problem is that the penalty will still hang around for five years.

It’s at this point in the explanation the people are generally shaking their heads—it does sound awfully confusing. So what’s the bottom line?

The bottom line is this: in lots of cases there are still ways to protect moneys, even if you already have a loved one in a nursing home, but you certainly need the help of an Elder Law attorney to walk you through the process; because even though it used to be fairly simple, now there are some major hoops that need to be jumped through. With good legal advice and an Elder Law attorney who knows the ropes, you can save—as a rule of thumb—45-50 cents on the dollar. You never want to be out of money or out of options, and by properly setting things up you will have arranged it so that even if your loved one does need care, they will never be out of either thing, money or options, because you will have taken the proper steps.

For an unmarried person attempting to pay for care, there are a few options:

1) You can write a check, but few families can do this for any extended period of time.
2) If you’re lucky enough to have purchased long term care insurance that will pay your cost of care, or at least help in doing so.

But what about when those options are no longer available? If the insurance isn’t enough, or my loved one doesn’t have insurance and paying out of pocket is too much? What other options exist?
3) Medicaid. But you’ve got to qualify your loved one for it, and it is not necessarily a simple task. Rather, it’s not a difficult task as long as you know the rules of qualification, and play by them. It is for this reason that we at the Elder and Disability Law Firm have provided this article, with an overview of each step of the process, and retain staff whose sole purpose it is to help any family who enters our office in Kansas City needing to qualify for Medicaid to do so.

If the person whose care needs to be paid for, who needs to qualify for Medicaid is a single person, the state says that certain assets are exempt from what is considered “countable” and that everything else counts. These exemptions are: a house, a car, a prepaid funeral plan , $1500 cash value life insurance or term insurance, and household goods: furniture, clothing, appliances. All these things are exempt, but nothing else is—that means that checking accounts, bank accounts, IRA’s, bonds, stocks, mutual funds; anything else, counts in what is referred to as your “countable assets,” and the state says that once we’ve exempted what we can, the person looking to qualify must then spend the rest of their assets down. The number they have to spend down to depends on the state in which they live—for example, in Kansas assets must be spent down to $2,000 whereas in Missouri they must be spent down to less than $1,000.

Say there’s a single person with Alzheimer’s who needs nursing home care, and their countable assets amount to $100,000. Until they have spent their assets down to whatever the state has deemed the proper number, they will be considered to be using “private pay” for their nursing home costs, meaning that they must write a check/pay out of pocket. With something like $70,000 a year for care, it won’t take long to get that money spent down. Once they’re there, they file an application showing the state where the money was spent and what they have left. If everything is in order, the state will say that that person has qualified for Medicaid. Once the assets are down to those limits, the individual will then have to turn over their income, say social security or pension, and keep an amount as a “personal needs allowance” (which also varies by state; $30 in Missouri and $62 in Kansas) and also retain enough to pay their health insurance. Any funds that remain after these allocations are paid to the nursing home as a continuous copay. Rather than for married couples, specifically when only one person requires care, qualifying for Medicaid is fairly easy if you just know how to do it. Namely:

1) figure out what’s exempt
2) spend countable assets down to the limits set by your state
3) turn over income
4) keep whatever the state deems the amount to be for “personal needs allowance” and to cover the cost of your health insurance
5) the remaining funds go as a co-pay to the care facility

Veterans?
If the person served during a period of wartime, for at least 90 days, and were honorably discharged, and if they have very heavy costs of care, they may be eligible for an “improved pension” which might be a check every month from the VA, the amount will vary— but can be anywhere from just under $1,000 a month to 15 or 1600 dollars a month, and in that case those funds would also go towards cost of care.

We know that Alzheimer’s can be a debilitating disease, and when it takes hold, often it becomes necessary to seek nursing home care. Yet in married couples it is common that one spouse remains perfectly healthy while their partner declines; and in that case, only one of them needs that care. How can half of a married couple qualify for Medicaid? In short, they must go through a process called Division of the Assets.

Consider this: a couple is married, and the husband has Alzheimer’s. The wife has been his care giver, but it has gotten to the point that she can no longer adequately care for him and for herself, for any of multiple reasons. So she places her husband in a care facility, but then must figure out how to pay for it. In Kansas City, that cost, especially for memory care, can be anywhere from $6,000-$6,500 a month—sometimes more, and few families can afford to just outright pay upwards of $60,000 dollars a year. For a while, the couple can choose to “private pay” by simply writing a check to the facility with money they’ve already got. If the couple was fortunate enough to secure long term care insurance, that will go towards that cost of care for a while, but for most clients of the Elder and Disability Law Firm and others like them, what ultimately happens is that they come to a point that they can no longer pay that fee out of pocket. In those cases, they then go through a process to qualify one partner for Medicaid, through a process called Division of Assets.

Say our couple has $100,000 in the bank. The state would review the assets and would say certain things are exempt from what are called the “countable assets”, meaning that the monetary value of those things does not count against the ultimate amount that the state dictates an individual or couple can have. Namely these exemptions include a house, a car, a prepaid funeral plan for both spouses, $1500 cash value life insurance or term insurance, and household goods: furniture, clothing, appliances. All of these items are exempt, but everything else would count in the state’s review of the assets. The next step then is to put half of those total banked assets (in our case, half of $100,000) on the side of the spouse who needs care, the husband, and the other half on the side of the one who’s remaining at home, the wife. So the husband has, in this example, $50,000 of assets. He would have to spend that money down until it went (in Kansas) to $2,000 or (in Missouri) less than $1000. Once that money had been spent down, he would then be eligible for Medicaid and his wife would be allowed to keep her half of the assets and a certain amount of income.

Spend down? What is it okay to spend that money on?
Certain things are clear; the couple could always elect to pay the cost of the nursing home; that is definitely an acceptable expense to spend down with. But they might also consider, if the wife is still driving, trading in her car for a new or newer car. As long as this purchase or trade was made after the husband had already been placed in the nursing home and they/their legal assistance had already set that snapshot where the couple has started to spend down, everything they spend on the new car would come from the husband’s side and be a perfectly legal and viable part of that spend down. Another approved way to spend down is to complete any home improvement that can be done; fixing up the roof, new heating and air, new carpet or furniture—as far as the spend down rules go, it is absolutely okay to replace those things with new ones, and all of those costs would come from the husband’s side of the assets. Our couple should also determine if there is any debt to be paid off; is there a mortgage? Credit card? They can use the husband’s assets to do settle those debts. Have they pre-paid their funeral plans? If this was done before the division of the assets, then it was exempt. If it is done after the husband is placed and the division occurs, the funds would fall under the spend down guidelines. There are all types of things to consider when facing the prospect of spending down money in both a logical and legal way.

Once that money is spent down to the limit dictated by the individual’s state, for example $2,000 in Kansas or < $1,000 in Missouri, the wife is now considered the “community spouse” and she will be entitled to what the law calls a Minimum Monthly Maintenance Needs allowance of at least $1,750 a month. She’ll keep her income—whether that be social security checks, pension, whatever. And if that figure is greater than $1,750, she’ll just get to keep it. If her income is less than the $1,750 mark, she’ll get to keep enough of her husband’s incomes so as to be at the $1,750 per month level. If there’s anything left of his income after that, minus $62 in Kansas and $30 in Missouri and minus the cost of his healthcare, the surplus will be an ongoing copay to the nursing home.

Something else that should be considered—in our example, the countable assets for our couple totaled $100,000. But what if the assets in question amount to $200,000? or $300,000? $500,000? Would the healthy spouse always just get half that figure? Or in other words: What’s the most the community spouse can have?

Currently, the maximum amount that that person could retain would be $109,560—a number mandated by the federal government that changes year to year. So if the couple began with 300,000, it would have to spent down until it would split so that the at-home spouse would get their $109,560, and only at that time would the spend down of the other half of the assets begin. There are many planning steps that can be take in a situation like this one.

The bottom line is to consistently make sure of two things, and every step taken should be rooted in these:
1) Make sure that your loved one gets the care they need.
2) And make sure that as a family, you are never out of money or out of options

A frequently asked question of the Elder & Disability Law Firm is this one:

“Can I care for my mother, who has Alzheimer’s? Can she pay me?” It seems like a straightforward query, but it’s actually a fairly complex legal question, because there are so many different ramifications. First, if you’re intending to care for an Alzheimer’s patient yourself, it is important to know how. There is a resource center on our website, www.kcelderlaw.com, that can teach you how.

But as far as the initial question of parent care/child payment, we have to know how the state treats this situation from a Medicaid perspective. To understand what makes it so complicated, we must know a little bit about Medicaid. Prior to February 8th 2006, if someone made a gift (gave assets away), there were penalties, but they expired on a monthly basis. Then “The Deficit Reduction Act” was signed. Under that act, when someone gives money away, they are creating penalty periods which can last up to five years. You may be wondering, “how is this related to the question? I just want to know if I can care for my mother.”

It’s related because the state says that if you don’t have a care contract in place, then anything your mother/father/whoever pays you for care is considered a gift. As we just described, any gift can create Medicaid penalties for up to five years—which is why you need good legal advice if you are in a situation in which a parent is planning to pay you for your care.

First, you have to get a care contract the meets the provisions of the laws of your state. Once that is in place, the contract will spell out all the services you’ll provide, how much your parents can pay you—and there are some very detailed rules about this—but a rule of thumb is $10-15/hr, though this is an estimate that should be taken with a grain of salt because those rates can be more, less, and are even dependent upon the county in which you live.

The steps are easy: Get a care contract, good advice from someone who knows about the things you’ll be dealing with in drawing up a care contract, look into worker’s compensation insurance, and make sure everything is handled from a federal tax standpoint. These steps are required because if you examine the situation, what’s truly going on is that the parent is the employer, making the child the employee, and that means that the child must declare that income on their taxes, insurance, etc.

If the question is, “Can my bother pay me to take care of her?” The bottom line answer is, “yes,” but you have to jump through some serious legal hoops to make sure that it is set up just right. If you don’t, you run the risk of having the state Medicaid agency, in the even that down the road your parent needs care you can’t provide, say that “even though you work very hard for the money you were given, you didn’t set things up properly so these are considered gifts” and your parent won’t be eligible for Medicaid again for a good long while.

This is one of the questions most frequently asked of the attorneys of the Elder & Disability Law Firm. If a father’s got Alzheimer’s and his daughter wants to care for him, can she? It is possible, as long as they follow all the legal steps that are required. But what if it goes beyond that? If she moves in with her parents to provide care, are there any benefits for the caregiver? The answer is also yes—and it’s an exception to the Medicaid rule. If a person makes gifts (giving money or property away) they are usually setting up a five year penalty period, in which they would not be allowed to apply for Medicaid. But if a child moves in with a parent, and that child’s care keeps a parent out of a care facility for at least two years, under federal law that house can then be given to the child without any penalty.

What about tax consequences? The parents will have a cost-basis in the house, which is, by and large, the amount they paid for the residence. If the parents make a gift of the house to the child, whatever the cost-basis was will travel to the child. Whether or not there are things you can do with that are questions more for an accountant than an Elder Law attorney. The bottom line is that if a child’s care keeps mom or dad out of a care facility for two years, from a Medicaid perspective, their house can be gifted with no penalty. It is crucial to have very good documents in place before putting a plan like this into motion, because if the child has become eligible but either parent no longer has the legal capacity to transfer title, they would be stuck—it is another instance in which a powerful Power of Attorney can make all the difference.

But what if the child of an Alzheimer’s patient is disabled? Are there special provisions?

Consider the same situation from the previous example; a father has Alzheimer’s, but in this case there is no caretaker child, so the father needs Nursing Home care. Say that Dad’s got $100,000 in countable assets—the state says that he would have to spend that down to one or two thousand dollars before he’d be Medicaid eligible. In that case, if there is a disabled child in the picture, the parent could gift them their entire estate with no penalty whatsoever, which could be a very important planning technique. How that gift should be structured—whether it goes to the child outright, or is put in different trusts, etc—is beyond the scope of our practice specifically, but suffice it to say that it is possible to make an entire gift of the spend down to the child, protect the assets for the child, and qualify for Medicaid immediately. The key is to have good Powers of Attorney set so that if the parents lose the ability to make those decisions, the documents still allow for decisions to be made.