When a parent needs care
Medicaid and long-term care
A nursing home can cost more each month than most families earn. Planning changes how long savings last.
Medicaid pays for long-term care once a person's assets are below a limit, but it looks back five years at every gift and transfer. The rules protect more than most families expect: often the house, a car, and a share of the savings for a husband or wife still living at home.
I help families plan ahead, and I help in a crisis, when a parent is already in the hospital and the discharge planner is asking where they'll go. When a parent can no longer make decisions and never signed a power of attorney, I also handle guardianship.
What we look at together
The five-year look-back
Gifts, transfers and sales below value in the last five years, and how each one counts.
What counts and what doesn't
Which accounts, policies and property are counted, and which are left out.
The spouse at home
How much income and savings a husband or wife can keep while the other is in care.
The family home
When it's protected, and how to keep the state from claiming it after a parent dies.
Paying family for care
A written care agreement, so paying a daughter for her time isn't treated as a gift.
When nobody holds a power of attorney
The court process when a parent can't decide for themselves and nobody holds a power of attorney.
Questions about care and Medicaid
Isn't it too late once Mom is already in a nursing home?
Often not. Even after care starts, there are steps the rules allow that can save part of what's left. Call before you sign the admission agreement if you can.
Can't we just give the house to the kids?
A gift of the house starts the five-year look-back and can delay coverage. It can also cost your children capital gains tax later. There are usually better ways.
What does guardianship involve?
A petition to the probate court, a medical evaluation, and a hearing. It takes weeks, not days, which is why a power of attorney signed early is worth so much.
A parent in the hospital right now?
Call me before the discharge meeting if you can. Twenty minutes is enough to know your next step.