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Senior Living Options When Care is Needed

Senior Living Options When Care is Needed

As Americans age, living options can become a concern. Available options are tied to the resources a senior has to cover living costs, and vary widely in cost, assistance, and care provided. In addition to budget considerations, seniors must also realistically consider the needs they have and what senior living option best fits those needs.

Nursing Homes

Nursing homes, or skilled nursing facilities, are one option for senior living. These facilities are for seniors who can no longer live independently. They provide care for seniors with illnesses or mental conditions that cause them to require monitoring and medical care on a full-time basis. For example, many nursing home patients have dementia, are confined to a wheelchair, or spend most of their time in bed. Their conditions require that medical attention be available around the clock.

Nursing homes also provide the option for short term care, where patients come and stay for a limited time after major medical events such as strokes or heart attacks. In these facilities, the residents generally live in semi-private rooms and all meals are provided. Medicare may help cover the cost of skilled nursing facilities, assuming the resident meets certain financial requirements. Long term care insurance may also pay for nursing home care. Otherwise, a nursing home resident pays privately, which can often bring financial hardship upon the family. As a result, many families work with an elder law attorney to discuss care options as well as payment options for that care.

Assisted Living Facilities

Another option for senior living is assisted living facilities. These facilities are ideal for seniors who are still independent but may need some assistance with activities of daily living, as well as meals, cleaning, or other daily self-care tasks. These facilities usually offer a more private living conditions. Since residents may be fairly independent, assisted living facilities are an appealing option because they often offer a variety of activities and opportunities for seniors to interact with one another and to stay active. Assisted living facilities are generally paid for privately with a few exceptions, including long term care insurance or partial assistance from Medicaid.

Independent Living Communities

An independent living community is another viable option for senior living. These communities are for independent, active seniors who enjoy the idea of living in a community. Independent living communities are much like living in a condo or as a part of a community with an HOA. Often maintenance, housekeeping, and landscaping are part of what is included with living in these retirement communities.  Many seniors choose this type of community when they are no longer able or no longer wish to maintain a home. The housing options for independent living communities range from detached homes to apartments. Another benefit of retirement communities is the wide range of amenities and activities available. Seniors are often lonely and living among other seniors can provide friendship and companionship. Residents in independent living communities pay privately, and the cost varies from one community to another.

Memory Care

Memory care facilities provide a more specialized senior living option for seniors who have serious cognitive impairments, such as Alzheimer’s or dementia. These facilities are much like assisted living facilities, but cater to cognitive impairments. They may even be a specialized part of an existing assisted living facility. The staff at memory care facilities have specialized training that helps them better assist residents with cognitive impairments. They are often planned intuitively to help patients who may become easily disoriented. These facilities also give extra consideration to security for residents who may wander due to their cognitive impairment. If a senior needs this kind of care, it is important to plan and look for facilities that provide it ahead of time.

Senior living options vary greatly in care and cost. It is important that seniors have conversations with their families about the needs they have or may have in the future, as well as the cost of the type of care they wish to have. The earlier the planning begins, the better off the senior and the family will be when the time comes to seek alternative living options. This planning should be a part of the overall legal and financial plan of the senior.  If you have any questions, please contact us at 1.800.660.7564 or visit our website: www.covertlaw.com.

Creative Financial Approaches to Long Term Care Services

Creative Financial Approaches to Long Term Care Services

Long term care insurance was sold aggressively in the 1980s, 90s and thereafter to offset the costs of seniors needing to live in a nursing home, assisted living or needing at home health care. Now, however, the business of long term care insurance has dramatically changed. What was once over 100 insurers providing LTC policy for sale has shrunk to a pool of less than twenty insurers who continue to sell the health care product. The big financial problem was that the majority of insurers had badly underestimated the longevity of these long term care policy holders and how many claims would be filed during their lifetime. The model became unsustainable from a business perspective. 

As reported by the Wall Street Journal (https://www.wsj.com/articles/millions-bought-insurance-to-cover-retirement-health-costs-now-they-face-an-awful-choice-1516206708) the industry is now in financial turmoil and has turned to the old adage of privatize the gains and socialize the losses; the translation being that millions of people age sixty-five or older with long term care policies are facing steep rate increases. It is not uncommon for a policy holder to face a fifty percent increase in their premium while some of the worst cases are upwards of ninety percent. Because the industry itself used such poor benchmarks and miscalculated projections, policy holders are seemingly left with two choices: Pay the money or leave your coverage after paying into it for years, and sometimes decades.

What if you want a different choice? Everyone would agree that being priced gouged for premiums as you age is inherently unconscionable but if the policy is discontinued what then will happen to the peace of mind long term care brings? What was once the safety net of senior aging care (without becoming a burden to family members) is rapidly disappearing.

CNBC has recently reported about this very issue and suggests getting financially creative for long term care. (https://www.cnbc.com/2018/02/27/heres-a-surprise-source-you-can-tap-for-long-term-care-services.html) There is a surprising source that you can tap in order to maintain protection for yourself but it requires planning, professional help and time. Do not delay. 

The financially creative premise is to become asset poor, impoverished, and qualify for Medicaid which pays for nursing home care and services. This does not mean the legacy you built during your lifetime will not go to your selected inheritors. On the contrary the assets you own must move out of your name to qualify for Medicaid. The assets will then shift to your designated beneficiary since to qualify you as an individual cannot have over $2,000 in assets.

To begin you will need to retain the services of a qualified elder law attorney, who may also bring in an accountant and a financial advisor. Ideally, you will be able to wait five years before needing long term care and the help of Medicaid. If there are assets transferred during the “five year lookback” it may be subject to penalties or make the applicant ineligible for some period of time requiring them to pay out of pocket.

Now with time on your side it becomes critical to select the right vehicle for transfer. These can be annuities but more often tend to be irrevocable trusts. The assets in the irrevocable trust are no longer under the control of the older person and can provide protection from certain creditors. The vehicle chosen for transfer of assets is very important not only for the older individual but the recipient as well. In the case of an outright gift of appreciated assets (i.e. stocks or real property) there would be no stepped up cost basis which could lead to crushing capital gains taxes when it is time to sell. An elder law attorney with input from your accountant and financial planner can help you choose the right transfer of wealth plan.

Elder law attorneys are closely watching changes in Medicaid,, as Congress is often proposing legislation to change the program.. Be certain your elder law attorney is up to speed on the current requirements, as the eligibility requirements can change very quickly in each state, and sometimes each county.

Though you may never have thought you would find yourself creatively trying to qualify for Medicaid while protecting assets, the current long term care premium prices preclude a large portion of seniors from being able to pay the cost of the policy. Genworth Financial reports the national median cost of a private nursing home room to be $97,455 a year. It doesn’t take long to be wiped out at that cost without long term care. Medicaid may be your solution and time is of the essence for planning. 

Contact our office today and schedule an appointment to discuss how we can help you with your planning.

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NEIL R. COVERT, Attorney at Law

Clearwater - Sarasota - Fort Myers - Naples

1.800.660.7564

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