CarenSLaw: HOW WILL I EVER PAY FOR NURSING HOME CARE?

CarenSLaw: HOW WILL I EVER PAY FOR NURSING HOME CARE?:      Have you ever wondered how you will pay for a nursing home should the need arise?  All of us have thought about this subject briefly ...

HOW WILL I EVER PAY FOR NURSING HOME CARE?

     Have you ever wondered how you will pay for a nursing home should the need arise?  All of us have thought about this subject briefly at some point.  Some people believe the government will pay.  Many people believe Medicare will pay the cost.  Other people believe their health insurance will pay.  And others believe they will pay for nursing home care from their own pocket.  I will summarize the options and the advantage and disadvantages of each.

      First, it is important to know that Medicare will not pay for custodial long term, nursing home care.  If you or a loved one is discharged from a hospital to a nursing home, Medicare will pay for up to 90 days of care as long as the nursing home is providing essential services and your condition is improving.  Once you cease to improve or the 90 day period expires, Medicare will no longer pay the bill.  As important as it is to have health insurance is, your health insurer will not pay for care at a nursing home.  Once your Medicare benefit has expired you must examine other options.

      One option is to pay for the nursing home yourself.  There are some advantages to this alternative.  Certain nursing homes do not accept residents whose stay is being paid by the government.  The government pays the nursing home much less than an individual pays the nursing home, so in some instances the nursing home does not want to accept a reduced payment and will not accept government pay residents.  This is legal as a nursing home is a private entity.  The advantage of being a private pay is an increased availability of nursing home placements.  In certain situations, a private pay resident might receive better care than a government pay resident.  The disadvantage is the cost.  It costs approximately $100.000.00 per year to be a nursing home resident.  For a married couple, the cost is approximately $200,000.00 per year.  Residents needing more than basic nursing home care can pay as much as $180,000.00 per year per person.  If your total estate is $3,000,000.00 or higher you will probably be a private pay unless you do some sophisticated planning at least 5 years before you are admitted to a nursing home.

    The second option is to have your long term care insurer pay.  Depending on the level of benefit you purchase your long term care insurer can pay a significant if not all of the cost of the nursing home.  The advantage of this option is that you keep your assets and you can pass them along to your hiers when you die.   Another advantage is that if you have long term care insurance at a certain minimum level, the government will not force you to sell your home in the event government benefits are provided.  Additionally, if you have long term care insurance the government will not try to collect from your probate estate any balance due for government benefits provided.  And finally, any long term care premiums you pay will be tax deductible.  The disadvantage of having long term care insurance is that it can be expensive. And of course, like any insurance product, you may never need it.

     The final option is to qualify for government benefits  In Massachusetts this joint federal state program is called Mass Health.  Mass Health provides medical care for low-income aged, blind and disabled persons.   If you own assets worth $2,000.00 or less you qualify.  Your social security or other income will be paid to the nursing home and you will be left with a very small needs allowance.  If the value of your assets total more than $2,000.00 your can gift them and/or put them in a trust, but you must do this at least 5 years before you enter a nursing home.  If you are close to needing nursing home care and your assets exceed $2,000.00 in value, you can convert them from countable assets to non-countable assets.  For example, you can take $10,000.00 in cash and put it into a burial plan or your spouses's home.  If you are married, your spouse can keep at least $115,920.00 of assets.  Excess assets can be put into a special private annuity.  Qualifying for Mass Health can be complicated so you should seek professional advice.  The rules are complicated, they change often and intrepration is not consistent among Mass Health employees.

      I hope my summary helps you or a loved one decide which option is best in his or her unique situation.

    TEN MISCONCEPTIONS ABOUT CHILD SUPPORT AND ALIMONY

1. Your expenses are relevant in a determiantion of the appropriate level of child support.
   Truth:  In general, expenses are not relevant.

2.  Child support must be used on the children, and the receipient must account to the payor.
     Truth:  The recipient can use child support for family expenses and expenses of the recipient.

3.  If the payor loses his or her job, the obligation to pay support ceases.
      Truth:  If the payor loses his or her job that party must file a modification action.

4.  You can't get blood from a stone.
      Truth;  The Court has ways of making deliquent parents pay.  Ask me.

5.  If a party gives up a career to raise the children that party is entitled to alimony.
     Truth:  Only if other factors apply.

6.  If the payor has no realionship with the children there is no obligation to pay support.
      Truth:  The amount and/or duration of support is not related to the quality of the payor's relation-
                  ship with the children

7.  Child support can be determined by a simple mathematcial calculation
      Truth: There are many factors that go into the calculation and often times the calcuation is not
                  simple.

8.  Once the parties agree on a child support amount it cannot be changed.
     Truth: Child support may be increased or deceased upon a change or circumstance.

9.  When one child is emancipated, child support is dramatically changed.
      Truth:  The change is not automatic, you must go to court, and the percentage of the change
                   is not large.

10.  If you are entitled to an alimony termination under the new Alimony Reform Act, you can just
        go into court and terminate alimony.
        Truth:  There are dates before which an alimony termination case may not be filed and the dates
                     are based upon the length of the marriage and the age of the payor.