Wealth and Honor

Helping Families Navigate the Financial Challenges of Age Transitions

Tag: medicaid

Free Lunch and ‘Free’ Care Likely Too Good to be True!

October 23, 2024 /

I take care of my 88 year old mother. Last month I attended a free lunch seminar offered by a company I'd never heard of, about Medicaid planning. It sounded like they could make arrangements so that all of mom's assets would be protected for me and my brother, and that Medicaid would pay for all of her nursing home expenses should we decide to move her to one. It sounded too good to be true. The company is not a law firm but they said they had lawyers working for them. They charge $5,000 to file all the paperwork for Mom to get qualified. Is this a fair price to pay and should I even get Mom on Medicaid?

Meredith B.

There’s an old saying that if you take your problem to a carpenter whose only tool is a hammer, don’t be surprised if the solution requires a nail. As the caregiver for your 88-year-old mother, it’s completely understandable that you’re seeking the best options to protect her assets while also considering her healthcare needs. Unfortunately, some believe there is only one solution to the problem of paying for care. The situation becomes more complex, especially with the maze of options surrounding Medicaid and long-term care.

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Four Ways to Pay for Long Term Care with Home Equity

August 15, 2024 /

My wife and I are in our mid-seventies and concerned with how we will pay for care as we age. We do not have long term care insurance and likely could not qualify due to health reasons. We own our $700,000 home debt-free but have modest liquid assets. Can we use our home equity to pay for care without having to sell it or go into debt? We would like to stay in our home as long as possible.

Frank W

As we age, the need for long-term care becomes a critical consideration for many families. For older adults who have not purchased long-term care insurance or do not have sufficient liquid assets to cover extensive care costs, their primary asset—the family home—often becomes a focal point for financial planning. Many individuals feel that their home is the one asset they’ll be able to leave to family members. However, most polls show that children don’t really want mom and dad’s home. Inheriting the home also means inheriting taxes, maintenance, insurance, and squabbles over division. Most homes are sold at a discount with the cash divided among heirs.

It makes sense then that the home should be an available resource for long term care expenses. Your wishes to stay in your home as you age and move from independence to dependence is also typical. Most people would prefer to “age in place.”

Let’s look at four less-traditional ways to use your home equity to pay for long-term care.

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Too much trustee discretion prevents elderly beneficiary from Medicaid eligibility.

October 21, 2019 /

A New York Appeals court recently affirmed the State’s Medicaid division’s decision to deny Medicaid eligibility to the beneficiary of a trust, arguing that the trust gave the trustee too much discretionary authority. The case underscores the need to have an experienced attorney familiar with local Medicaid rules, draft trust documents where protecting Medicaid eligibility is a major concern.

In this instance, the applicant’s son was trustee of a living trust established for the benefit of the applicant. As trustee, the son took out a home equity loan using trust assets as collateral, and used the loan proceeds to pay for his father’s living and caregiving expenses. Once the trust assets were depleted, the father applied for Medicaid benefits but was denied because the State ruled that the trust assets were available to the applicant, and imposed the required “look-back rule” in denying eligibility.

In upholding the State’s determination, the Appeals Court stated:

Because the trust instrument gave the trustees broad discretion in the distribution of the trust principal, including for petitioner’s benefit, the agency did not err in concluding that the principal is an available resource for purposes of petitioner’s Medicaid eligibility determination

For the full text of the ruling, click here.

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