Elder Law

Did you know that rising long-term care costs in Colorado can exceed $9,000 a month and run, on average in the Denver metro area, over $100,000 per year?

Unless you have millions of dollars or can afford and qualify for long-term care insurance, this poses a great risk to you, your spouse and your loved ones if long-term care is needed.

What’s the real risk of needing Long-Term Care?

The reality is we are living longer and needing more long-term care.  More than 2/3 people will require fairly significant long-term care services at some point in their life.  According to National Care Planning Counsel the majority of people who need assisted living will eventually move to a skilled nursing facility.  The average amount of time spent receiving care is 1,705 days or 4.6 years.

Decades of hard work, diligent financial planning for retirement and providing for loved ones are all things that can be squandered by the cost of long-term care.  Without careful planning, particularly a strategy ensuring eligibility for Medicaid benefits, the assets you have set aside over an era could be consumed by these astronomical costs over a relatively short period of time.

MYTH # 1

You have to be broke to qualify for Medicaid

This is not true.  With proper planning, a family can preserve a great portion, possibly ALL of their assets and still get Medicaid assistance to help pay the incredibly high cost of long-term care.  Medicaid is for those hard-working Americans who have prided themselves on strong work ethic and saving who have vital resources that need to be protected. The government’s own rules and policies sanction and encourage activity to qualify for this program.

Myth # 2

I am taken care of because I have Medicare

This is not true.  Medicare will only cover a portion of long-term care expenses in the first 100 days out of the hospital – but it does not pay for nursing homes.  Medicaid does!

If you are interested in being proactive about this potential risk to your hard-earned assets OR if you or a loved one is facing long-term care expenses suddenly, Peter L Durante LLC has the experience, knowledge and insight to help navigate you through the complex process of finding and affording quality care.  We can help you determine the best options for care and how to structure your assets and liabilities in such a way to help you qualify for Medicaid.

At Peter L Durante LLC we understand that you may be overloaded by the emotional struggle of dealing with an elderly infirmed spouse or family member who is no longer self-sufficient.  Most families find themselves completely unprepared when a health crisis strikes.  Because the average applicant is unrepresented by counsel, their position of vulnerability often forces them to accept an unfavorable determination when applying for Medicaid.

Contact us for Elder Law support today so that we can take that burden off your shoulders with our comprehensive services and provide you the peace of mind you deserve.

CRISIS PLANNING

If you are currently in a state of medical need – either in a nursing home or will be potentially placed in a nursing home (or need long-term Home Care Based Services) in the near future – it cannot be stressed enough how critical timing and logistics are in order to avoid another month of high costs.  The sooner we can take control of the timeline the better off you will be.

Because crisis-planning cases are so time sensitive, Peter L Durante LLC is flexible and has processes in place to triage your case based on the criticality of competing deadlines.

PROACTIVE PLANNING

If you are proactively planning to avoid future nursing home bills of $9,000 + a month you can do it without buying long-term care insurance and you don’t have to give everything away to your children now.

Proactive planning is the process of reviewing a client’s personal finances and making recommendations on appropriate estate planning techniques and a proper financial posture that will preserve more choices for the client and cause necessary eligibility-achieving maneuvers to be less dramatic and less costly when a patient has a crisis health problem than they would if they waited to do crisis-only planning.

GOVERNMENT DOES NOT ACTIVELY HELP THE APPLICANT

Like with most government programs, the government does not actively help the applicant take advantage of the rules. The onus or responsibility for using the rules that allow a patient to protect resources is on the patient or the patient’s family to be proactive, similar, in essence, to the tax code which places the burden on the taxpayer to proactively take advantage of credits and deductions in order to reduce the taxpayer’s tax burden.
Also, like the tax code, the Medicaid rules are complex, and this gives rise to the comprehensive services Peter L Durante LLC offers.

Because of increased longevity, we are seeing a larger need for long-term care services, nursing homes, and hospice. The cost of these services continues to increase. An annual bill for nursing home care can run, on average, over $100,000 a year. Did you know that when there is a potential risk of this nature there is usually insurance designed around the risk? Did you know that in this area insurance has not been an option for the majority because insurance companies have found it increasingly unprofitable and are forced to charge high premiums and implement complex underwriting which puts the price out of reach or people simply do not qualify?

So how are people to protect themselves from such a huge risk?

Medicaid has a whole separate program that provides medical assistance for long-term care and skilled nursing care. This is not a program for the indigent or the poorest of the poor, but for those who have vital resources that need protection. The needs of a patient’s spouse have created statutory safeguards for assets that the government – as a matter of public policy – deems are in need of protection. The government’s own rules and policies sanction and encourage activity to qualify for this program.

OUR ROLE

The role of Peter L Durante LLC is one of architect, contractor, and tour guide- guiding an applicant through the difficult maze of eligibility rules and government bureaucracy. Once the facts are gathered, we must design a plan that reconstructs the nature and position of the client’s assets and income streams to be in full compliance with the Medicaid rules and, simultaneously, take maximum advantage of those rules to protect as much as possible, because the government would agree it does no good to impoverish a family with long term-care costs. Public policy encourages both the protection of certain assets as well as certain financial transactions.

MEDICARE vs. MEDICAID CONFUSION

There is often confusion between Medicare and Medicaid especially considering there is overlap of coverage and purposes. Medicare is a primary health insurance program for people age 65 and older. Medicare is not designed to cover the full cost of all necessary medical expenses but is considered to be the primary insurer determining the scope of its overage and payment before any secondary insurer is required to pay.
Medicare may pick up the cost of some nursing home stay – up to 100 days – but it will not pay for the full cost of any long-term stays over that amount of time. Even though it may pick up bills for the first 100 days it is also not a full ride for the whole 100 days. Medicare may pick up the full cost for the first 20 days, and the patient is responsible for co-insurance over the next 80 days.
Medicaid is a federal-state partnership. Funding comes from both the state and the federal government, but is run by state social service agencies. There is essentially three ways to pay for long-term care expenses:
 Long-term care insurance
 Self Pay; and
 Medicaid
Most people think of Medicaid as the health insurance program for the poorest of the poor; but it is less understood that Medicaid has a whole separate program that provides medical assistance for long-term care and skilled nursing care. Medicaid carries a stigma from its earlier origins as part of a “welfare” program. There tends to be a huge amount of psychological resistance to planning to use the Medicaid system by hard-working Americans who pride themselves on their strong work ethic and on never taking a government handout. But the practical reality is that everyone who enters a nursing home who is not super rich or does not have unlimited insurance automatically enters a new financial world where resources will deplete rapidly. Medicaid is far more complex and sophisticated than being a welfare program for the extremely poor. Contrary to popular belief, a patient or his spouse need not be completely indigent to qualify. This program is for those who have vital resources that need to be protected.
Rules create what is in essence, a public-private partnership. Certain assets and the needs of the patient’s spouse have created statutory safeguards for assets that the government -as a matter of public policy – deems are in need of protection.