Skilled Care vs Custodial Care - Trust and Estate Planning Law Office

When it comes to certain aspects of Elder Law, such as Medicaid or Long Term Care Planning and Asset Protection, laws are constantly changing. For that reason, it’s important to stay updated on any recent elder laws, as they may impact you. Read about 3 important elder law updates in 2021 that could impact you.

3 Important Elder Law Updates in 2021:

Medicaid Lookback Period: Lookback periods vary from state to state. In New York, the law requires a 5 year lookback period on Medicaid Nursing Home Benefits. This means that transfers that were done during this period are reviewed by Medicaid and a penalty is measured if the asset transfer (or “gifts”) in that period was for less than the full consideration. The transfer rate in New York is $13,037, so you should consider this if you are planning on applying for Medicaid or if you already have Medicaid and are making asset transfers. The Governor has also redesigned the program to implement a 30-month look-back period on any uncompensated transfers for home care or community Medicaid that was supposed to go into effect on April 1, 2021, but has been pushed back to July 1, 2021. Once in effect, those who plan to apply for Medicaid and who already have Medicaid after July 1, 2021, must disclose all transfers going back to October 1, 2020. There are exemptions to this update though. If the transfer is or was made to a spouse or a disabled or blind child, Medicaid does not impose a penalty. Additionally, real estate transfers to a spouse, disabled or blind child, a family caretaker that resides in the home and cares for the loved one for at least 2 years, and a sibling with an equity interest in the estate that resides at the elderly’s home for at least 1 year have been expanded to be exempt from receiving a penalty under the new Elder Laws in New York. When considering applying for Medicaid Nursing Home benefits you should take into account that your transfers prior to and after you apply for coverage matter in regards to your eligibility.
Stimulus Check doesn’t impact Medicaid Eligibility: When assessing your eligibility for Medicaid, the COVID-19 pandemic may cross your mind and specifically the stimulus checks that were given out by the federal government. The three rounds of stimulus payments that were issued from March 2020-April 2021 have been considered to be exempt from Medicaid, SSI, and other need-based benefits. This means that the payments received from the stimulus checks do not count as countable income, and will not compromise your eligibility for any of the benefits named above. This new update gives those who plan to apply for Medicaid or who have Medicaid peace of mind that these payments will not affect their eligibility for their healthcare plan and their loved ones will continue to receive benefits without any issues.
The New Power of Attorney Form: A Power of Attorney (POA) is an important document you should have especially if you are a senior. This document allows you to appoint an individual to make decisions for you when you are unable to do so yourself. The Healthcare Power of Attorney deals with any and all medical decisions that will be made on your behalf by a representative of your choosing in the case that you become incapacitated. This form that was put into effect in 2010 in New York, was known to be complicated and long. Governor Cuomo has recently issued a new form of this Power of Attorney that is simpler and shorter. This new form will go into effect in June 2021 and will not impact those who already signed a power of attorney. This new POA document is different from the one currently in effect. The difference in the new Power of Attorney form is that it’s shorter in length and is simpler in the language that it uses, making it easier for people to understand. An individual who is physically incapable of signing, but is mentally in the right state of mind can appoint a trusted individual to sign the Power of Attorney on their behalf. Banks and Financial institutions that refuse to accept this new version of the Power of Attorney can face penalties and could be subject to legal fees. This new law is great for those who are looking to make decisions on behalf of their loved ones and provide them with the best care possible. If your concerned that your Healthcare Power of Attorney is not up to date, speak with an Elder Law Attorney.

What is Elder Law?

Elder Law is an area of law that relates to issues relevant to older people and their family members and loved ones. Elder law attorneys act as advocates for their elderly clients and can handle a variety of legal matters that affect elderly or disabled people. Some of these issues are related to long-term care planning, guardianship, retirement, estate planning, and Medicaid Planning, along with other important matters. Additionally, an experienced New York City Elder Care Attorney will be able to handle the sensitive and emotional needs of an elderly person, and therefore address complicated situations that concern their clients.

How Can an Elder Law Attorney Help?

An Elder Law attorney is informed of all current updates to the laws on Medicaid eligibility and other aspects of Elder Law. Unfortunately, Medicaid laws constantly change as well as the requirements of your state so it makes the process of finding the best plan for your loved one even harder. An Elder Law attorney will help simplify this process for you and advise you of all updates to the law creating less problems on this journey of Medicaid planning. Hiring an Elder Law attorney will ensure that you're planning for your loved one’s care in a way that corresponds with the laws imposed by the state in which you reside, while also satisfying their wishes.

For further important updates on the Elder Laws in 2021 please contact the Law Office of Inna Fershteyn at 718-333-2395 to obtain aid in receiving medical coverage to cover the cost of nursing home care and help with any of your Elder law needs.

There comes a point in time when you may begin to consider placing your loved one into a nursing home to ensure that they receive the best care possible. When making such a decision it is important to be well informed and aware of all of the aspects that attribute towards nursing home care. One such attribute pertains to the cost of care and how it will be covered. Usually the cost will either be covered using Medicare or Medicaid. However, there are specific qualifications that outline which coverage plan may be utilized based on your personal situation. Additionally, it is important that you are able to differentiate between the types of care offered, such as skilled care and custodial care. In order to best be informed of all the details concerning enrolling your loved one in the care of a nursing home, you should contact an Elder Care Attorney to guide you in your decision making process. With proper counsel you will be sure to place your loved one in the hands of the best nursing home possible, while still being able to cover all of the costs such care will require.

Qualifications for Medicare Coverage of Nursing Homes

There are specific statements that discuss if an individual qualifies for Medicare coverage when it comes to nursing home care. The first statement pertains to the period of time the individual stayed at the hospital out of medical necessity. In order to qualify for Medicare coverage an individual must have spent at least three consecutive days in inpatient care for a medical necessity. After being discharged from the hospital the individual must then be admitted to a nursing home within the 30 day period that begins the moment the patient is discharged. The individual must be in need of skilled nursing or rehab care on a daily basis for the specific condition they endured while hospitalized in inpatient care. Lastly, in order to receive Medicare coverage for nursing home care, an individual must have a letter from a physician ordering and proving the necessity of this care. If the individual falls within the category that aligns with all of these statements, then they may be eligible for receiving Medicare coverage when it comes to nursing home care.

Skilled Care vs Custodial Care

The greatest difference between skilled care and custodial care pertains to the manner in which the care is provided and who is responsible for providing such care. Skilled care refers to care that is specifically administered by a professional who is responsible for ensuring that the individual does not further deteriorate from the condition they are currently in. This care is administered when direct medical care becomes a necessity as a result of a short-term medical condition that they will recover from. On the contrary, custodial care can be performed within the home setting, meaning the one administering this care does not have to be a medical professional. This type of care provides aid for activities related to daily living. These activities usually pertain to eating, bathing, and similar skills. In most cases, patients that receive custodial care have a chronic condition, meaning they are not expected to improve in the manner that those who receive skilled care are. If custodial care is the only type of care necessary, then it is possible that Medicare will not cover the costs. However, Medicaid will cover the costs of custodial care, so you will be able to provide your loved ones with the care they require to continue thriving.

Medicaid Rules for Skilled Nursing Payments

Receiving Medicaid coverage can be quite complex, as there is a very specific list of qualifications necessary to obtain coverage. Medicaid is based on “needs only” policies, meaning there are strict regulations pertaining to the amounts of assets you are allowed to hold. Medicaid is income based, while Medicare does not depend on your assets or income. An esteemed Elder Care attorney will assist you in qualifying for the type of coverage you need, as the attorney has much experience in the field and knows the specific rules of state pertaining to the amount of money an individual can have while still qualifying for Medicaid coverage. A Medicaid applicant over the age of 65 can possess up to $2,000 in NY in order to qualify for coverage. Asset limits for married couples vary in relation to whether both spouses require Medicaid coverage or only one spouse. One automobile regardless of the quantitative value is referred to as a “non-countable” asset as long as the car is used to transport the Medicaid applicant or other members of the family. The attorney will assist you in preparing for the five year Medicaid lookback period and will provide guidance on the Medicaid spend-down process.

Is Dual-Eligibility a Possibility?

Dual-Eligibility refers to an individual who is qualified to receive both Medicaid and Medicare coverage. In this case, Medicaid will cover all of the costs that Medicare did not cover. Usually, individuals qualify for Medicare based on their age and qualify for Medicaid based on the income bracket they fall into. Additionally, Medicare beneficiaries below the age of 65 who live on Social Security Disability Insurance may be eligible to receive Medicaid benefits. The benefits of being dual-eligible is that you may receive greater medical coverage and lower out-of-pocket costs. For medical issues Medicare is the primary payer, Medicaid will serve as the secondary payer to cover any Medicaid costs leftover. Medicaid assists in covering the cost of the Medicare premiums, deductibles, and copays. An Elder Care Attorney can assist you in becoming dual-eligible and receiving the benefits that result from this eligibility.

For further Medicaid eligibility information please contact the Law Office of Inna Fershteyn at 718-333-2395 to obtain aid in receiving medical coverage to cover the cost of nursing home care.