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Medicaid and VA planning

Protect Your Assets with Medicaid and VA Planning in Florida

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You and/or your loved one wish to grow old without financial worry. OK, right off the bat, let’s rephrase that. You and/or your loved one wish to cover any necessary medical needs without surrendering your hard-earned money and assets for yourselves and future generations. This is where Medicaid and VA Planning must be an essential part of any well-made life-care plan.

Wise choice. Whether you’re seeking such services here in Florida — or any other U.S. state or territory — the astronomical costs of health care can drain bank accounts more quickly than you imagine. 

How Much Could Nursing Home Care Cost Without Medicaid and VA Planning?

Did you know that Medicare and most other insurances don’t cover a stay in a Florida nursing home beyond 100 days? So costs could come out of pocket, from savings, or from property or other financial assets for a longer-term stay due to illness or even a moderate injury from an unexpected fall. 

So let’s have a look at some average long-term nursing facility costs, according to the Genworth Cost of Care Survey. In 2020, a semi-private nursing home room in Florida cost $8,669 PER MONTH! The United States average was $7,756 per month. Not that they were much cheaper, but our neighbors in Alabama and Georgia paid $6,540 and $6,722 monthly, respectively, for equivalent nursing home rooms, according to those most recent statistics.

But let’s analyze the numbers even more deeply, city by city and region by region. Here in the Tampa Bay, FL area, an average semi-private room in 2020 cost $9,946 per month. Meanwhile, a four-hour drive south in Miami, FL, it was $9,095 per month and far north on the Panhandle in Tallahassee, FL it was much less costly at $7,543. (Again, we say “much less costly” recognizing how outlandishly expensive a legitimate stay in a nursing facility can be.)

And make no mistake, if you haven’t the Medicaid or VA eligibility or an actual fortune in savings to cover the cost in cash, the health system has zero sympathy. THEY WILL TARGET ASSETS.

But Medicaid and VA Planning Isn’t Only for Nursing Care

Most are typically concerned about eligibility for long-term and end-of-life care mentioned above. But some more routine types of care and assistance typically covered earlier in life for healthier individuals can still be astronomically expensive. 

These might include:

  • Homemaker services
  • Adult day care/respite care
  • Home health care
  • Assisted living facilities

Let’s again break down some Florida averages (also dependent upon specific location). A home health aide in 2020 cost $4,290 monthly. Adult day care (some may know this as respite care, a type of community care common for persons living with dementia and others who can no longer safely stay home alone) cost $1,408 per month. Homemaker services and assisted-living facilities cost $4,195 and $3,700, respectively.

Again, they will target assets, if you are not prepared financially or eligible for Medicaid or VA benefits and attendance.

Navigating Eligibility for Medicaid and VA Planning in Florida

Good news is, many individuals and couples could be eligible for Medicaid or VA assistance to protect net worth and assets with some planning. It’s actually one of the most critical elements to life-care plans I build every day. Financial eligibility planning is just as important as figuring out final wishes for end-of-life care (like power of attorney, living wills, and hospice or palliative care) or preparing for everything else (the good and bad) that goes along with our loved ones’ golden years.

Medicaid and VA coverage is primarily a financial tool — fair or unfair — that first determines if an individual or couple is financially able to cover all or some of necessary health costs. Applying people and households must come in under certain income and asset limits. 

But in general, legal Florida residents (we’ll discuss citizenship and legal residency rules, as well) seeking long-term care Medicaid must meet income limits. For Floridians to be eligible for Medicaid, they must be a Florida resident, a U.S. citizen, a permanent resident or a legal alien and require a nursing home level of care. Applicants for Long-Term Care Medicaid must also meet the state’s income limits, which in 2021 is approximately $2,382 per month for a single household and an asset limit of $2,000.

Are You Financially Ready for a the Life-Care Planning Process?

Medicaid planning legally protects an individual’s assets to care for you and yours, in addition to Medicaid and VA benefits. Caregiver Support & Resources, LLC works with elder-law attorneys, and we can legally and ethically protect people’s assets to help them qualify for Medicaid and VA attendance.  Medicaid, unlike Medicare, will cover most long-term care costs. Once we obtain Medicaid eligibility for an individual, if they remain within the Medicaid guidelines, they will have eligibility for the rest of their lives. Likewise for VA aid and attendance.

There’s no reason an elder or their spouse should live in poverty for transitioning to higher levels of care. Our clients, their families and future generations may still live in comfort and dignity.

power of attorney

What is Power of Attorney?

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Your dad has struggled these last few months. His health on the decline — quicker than anyone anticipated — has sewn confusion, aggravation and dismay throughout the family. Who has power of attorney? What can they do? What can’t they do?

His memory began taking the biggest blows several months back. Creutzfeldt-Jakob Disease, the doctors said, noting that while he’s only 63, it’s a particularly aggressive form of dementia. There’s little “hoping for the best,” they noted, but it would be best to get his affairs in order. Your heart sinks remembering how hard your sister cried that day.

Now your family is stuck in a dilemma that extends uncomfortably beyond doing the most obvious thing first: caring for dad. 

But who makes the decisions? Who carries that weight? He has assets that may not have been accounted for when he drafted his will at 55. When his time has come, who tells the doctors it’s time to say goodbye?

Power of Attorney Gives Control in Uncertainty

Thankfully, Dad did expect the unexpected. He allowed for power of attorney (POA) in various aspects of his life, should he be unable to make such decisions for himself.

While Creutzfeldt-Jakob Disease described in this fictional account may be exceptionally rare, rapid incapacitation of an elder due to dementia or terminal illness happens often. Every day, people receive a diagnosis of Alzheimer’s or other forms of dementia. Seemingly in the blink of an eye, their ability to make important decisions becomes not only questionable, but impossible.

A good life care and end-of-life plan must account for the unexpected and empower care partners in uncertainty. Above all, it should explicitly prioritize your loved one’s wishes in the end.

End of Life Care

We’re sincerely sorry if it sounds insensitive, but “pulling the plug” is discussed daily in end-of-life care scenarios. The doctors say there’s no bouncing back. Inevitably, conflicts arise as one family member says, “Dad would’ve wanted to fight” and another says, “Dad wanted to go with dignity.” 

Medical power of attorney, or a health care proxy, assigns a person (or persons) to make that choice. It’s tough, of course, but a decision has to be made when a person can no longer speak for themselves — legally, mentally and physically. That’s why it’s important to have conversations early about end-of-life care, while the individual can coherently and emotionally express their final wishes. 

Financial & Legal Decisions

Sometimes your dying loved one has assets to distribute or protect, especially when planning for Medicaid. They may be considerable (stocks and trusts) or slight (family heirlooms and trinkets), but they’re all of equal importance. Power of attorney ensures someone is empowered to execute decisions regarding finances and property.

But it’s more than executing a will. Before and even after a loved one’s death, financial and legal documents require verification. Financial power of attorney allows a designated person to:

  • Pay bills
  • Cash checks and withdraw funds
  • Sign documents
  • Trade stocks and bonds
  • Buy and sell property
  • Manage bank accounts

The chosen agent has power to execute financial and legal decisions in accordance with the individual’s wishes or best interest. If funeral and burial ceremonies have yet to be determined and paid for, power of attorney also allows an agent to decide the necessary processes for dignified services.

Power of Attorney: Execute Final Wishes with Confidence

Your loved one’s final wishes may be difficult to execute. A variety of obstacles — from uncertainty to legal squabbles — can confuse and stall important decisions. You may struggle with balancing what seemingly remains of their autonomy, dignity and independence with what needs to be done.

Power of attorney prioritizes your elder’s final wishes. It establishes authority of someone (or multiple people) to make decisions when it may be hardest to do so. Failure to act may result in legal conservatorship and guardianship battles that can stress families for years beyond the last breath.

If you need help, Caregiver Support and Resources, LLC has over 25 years of experience with all aspects of life care planning including hospice care and legal referrals. We’re happy to help you contact an elder law attorney and guide the process in a caring and compassionate way. 

(Editor’s Note: Caregiver Support and Resources, LLC is not a law office. Maureen Rulison is not an attorney. The information contained in this blog is not to be construed as legal counsel or advice or substituted as such in any U.S. state, territory, locale or foreign state where it can be accessed. Rather, this blog is meant only to educate elders, care partners and families as to legal processes around life care planning.)