Medicaid in Connecticut

Many clients come to us searching for the secrets of navigating Medicaid for long term care. Others believe they want to avoid it at all costs. I feel that Medicaid is a misunderstood tool, which if wielded correctly can be very useful to many people. Nothing is appropriate for everyone, but this program is much more versatile than you may think.

Rumor: The government is going to take everything. Or I have to spend everything first (half if I’m married). Reality: Absolutely not! If a person has nothing left but their income, they are unlikely to be able to afford their groceries, rent or house taxes, and other living expenses. If that is true, then they might be forced to live in a nursing home where Medicaid can pay all costs. But that is much more expensive for the government, so they don’t prefer it either. While the program does require that you are not otherwise able to pay for your own care, that does not mean you are left with nothing. The top level of Medicaid does require that the applicant “spend down” to $1,600.00 or less in savings. Certain assets such as your house and car do not count. Certain assets are inaccessible, and others can be moved into different places, like a pooled trust, and used in future years. If there is a healthy spouse, then there are even more options to save assets under their name. A Medicaid “spend down” does not really mean spend the money. It means rearranging it.

Rumor: I have to go live in a nursing home. Reality: A skilled care setting is important if the need for skilled care exists, but many people can age in place. Medicaid simply provides funding for caregivers based on your care needs (one exception is Assisted Livings that are not on the pilot program). Caregivers can provide assistance with bathing, dressing, cooking, companionship and medication reminders to name a few which can make all the difference from you having to be in a nursing home because you are now safe at home. Your family also has peace of mind that you are getting the care you need, and they can be your family rather than a care giver.

Rumor: The quality of care is terrible. Reality: There are many agencies that accept Medicaid funding. You are given a choice of these agencies and then an aide is assigned to provide you with care. If for some reason this aide is not a good fit, then you can change aides and or agencies. Family members other than the spouse can also be paid by Medicaid with a tax- free stipend. If your care needs change, home care can be increased or decreased as needed. If it isn’t feasible to stay at home because you may need two people to care for you then skilled care in a facility may be warranted. If you can rehab to go home again safely with care rest assured the goal is to have you go back home with Medicaid paying for your home care.

The Medicaid Home care Waiver Program, which is also called the Connecticut Home Care Program for Elders (CHCPE), provides many benefits to assist you to age in place safely. Home health aides provide assistance with your activities of daily living, incontinence supplies, meals on wheels, transportation, adult day care or paying for a family member who lives with you to provide care. While applying for Medicaid is much work and requires rearranging your finances, it also means having someone else pay for the caregivers so that your money only needs to be spent on your living costs. That means your money lasts longer. There might even be something left for the family, although inheritance is never the goal - only the byproduct. So while you think you may want to avoid Medicaid at all costs, the cost may just be your life savings, and your ability to stay in your home.

Attorney Halley C. Allaire is principal in the law firm of Allaire Elder Law, a member of the National Academy of Elder Law Attorneys, Inc., with an office at 271 Farmington Avenue, Bristol, (860) 259-1500, or on the web at www.allaireelderlaw.com. If you have a question, send a note to Attorney Halley C. Allaire and your question may be discussed in a future column.