Many people know that Medicare will pay for rehabilitation services in a nursing home if the patient has had a three day inpatient admission to a hospital. A physician must order the care in a nursing home and it must be related to the condition that resulted in the hospital services. Practically speaking, the care must only be available on an inpatient basis. The person must need to receive seven days a week of nursing home care, or skilled therapy five days a week or some combination seven days a week. This is the normal rehabilitation families know about.
People are scared to travel, scared of getting sick, and scared of dying. Families needing home care or nursing home care for loved ones are especially affected by the COVID-19 restrictions and risks. Nursing homes will not allow visits unless the relative is dying. This is agonizing for families. One idea to keep in touch with a loved one in a nursing home is to buy an “ALEXA SHOW.” The children activate it from their home and can see and talk with mom or dad without the parent doing anything.
Last week the wife of a man who applied for Medicaid (Title 19), called and said that a bank manager refused to honor the Power of Attorney, from her husband to her. She needs the bank records to get her husband eligible. The manager claimed that the notary signing the acknowledgment at the end of the power of attorney did not put a notary “number” next to his name, and the power of attorney was not valid. This is completely wrong. A certain percentage of people working in banks, insurance companies or other financial institutions are completely uninformed on the laws governing powers of attorney.
In March my office is making a presentation to the Connecticut Chapter of the Alzheimer’s Association. It will provide professionals with information on programs to provide care for those with Alzheimer’s, but everyone with a loved one suffering from the disease can benefit from this summary. Medicaid has the most comprehensive program for in home care. The applicant must miss three activities of daily living (bathing, dressing, toileting, transferring, or eating), or have a need for daily supervision to prevent harm or need medication supports. A company hired by the Connecticut Department of Social Services evaluates the needs and a determination is made on functional eligibility, and how much the state will pay for care. At the high end, Medicaid can pay up to $5945 per month. In some cases, that could be 24-hour care.
For retirees who move to Florida or other warmer climes, planning ahead in case long-term care is needed is just as important as for those who stay. Even though it is my experience that if retirees need significant homecare help or a nursing home, they usually return to where their children live, as that is their support group. There are additional matters to consider as a result, because planning must take account of differences in the laws of both states.
Want to avoid probate? Want it to protect assets? Want to make things easier for your family should you pass away? Everyone’s answer is yes, so here is a comparison of revocable and irrevocable trusts. The obvious difference is that “revocable” means you can change it or terminate it at any time, as long as you are still alive and capable. You cannot revoke an irrevocable trust. The most critical difference is that a revocable trust does not protect your assets if you or your spouse need Medicaid or VA or Connecticut programs to pay for long term care, at home, or in a nursing home. That’s because if you can revoke it, and take the assets back, the state quite logically says that asset is still yours. So if the goal is to protect assets in case of long term sickness, a revocable trust does not help. For that, you need an irrevocable trust.