By: Justin Johnson
Back in 2012 my mom and I took my grandma to family in Texas to spend the winter there. She had been having physical limitations for several years prior but for the most part she remained active on her dairy goat farm. Around the time we made the trip to Texas we noticed her limitations were increasing and thought it best that she spend the winter in a warmer climate.
As the winter progressed, my family noticed her limitations became mental ones. By the time we came to pick her up the following spring, it was very apparent that her mental capacity had decreased significantly. Over the next several months, I watched as my mother struggled to care for my grandma while balancing a work schedule and managing a farm of her own. Eventually, when EMS had to be called because my grandma had forgotten to eat and slipped into a diabetic coma, it became clear that she would need to be placed in a nursing facility to better serve her medical needs. After learning of the high cost of nursing facilities, my mom began navigating the difficult terrain of qualifying an individual for Medicaid eligibility
In Kentucky, the average monthly cost of a nursing home can range from around $5,000 to $9,000 per month1. Such a cost is burdensome for nearly every Kentuckian and could likely wipe out all assets you have accumulated. This is where Long Term Care planning and/or qualifying an individual for Medicaid can be extremely helpful for individuals and more personally is the route my mom had to take for my grandma.
To qualify for Medicaid, an individual must meet certain criteria in order to qualify. Medicaid, is a Federal/State run program designed to provide health insurance coverage for low income individuals. Unlike Medicare, Medicaid also provides coverage for nursing home care, given such individual qualifies. In order to qualify, an individual must have assets below a certain level. However, certain assets such as a vehicle, personal property items, and potentially a home (depending upon the circumstances) are not counted when determining eligibility.
Generally speaking, there are two situations individuals will encounter when it comes to Medicaid; those being “Pre-planning” and “Crisis Planning”. When it comes to pre-planning, this occurs at least 5 years in advance of an individual needing Long term care. Additionally, pre-planning provides more assurances that an individual’s assets can be protected should they require Long Term Care. Conversely, crisis planning occurs when an individual has already entered a nursing facility and certain measures will need to be taken to get an individual qualified for Medicaid. Either circumstance presents its own set of challenges and it is important to consult with an attorney that is knowledgeable and passionate about this area of law.
If you or a loved one would like more information regarding Long Term Care planning, please call our firm at 859-236-8888 to learn more.