Stop Paying The Nursing Home Bill Now

We break down how Medicaid actually works for long-term care, why Medicare ends after short-term rehab, and how singles and married couples can protect assets without sacrificing choice or quality. We share common mistakes, key legal tools, and the steps to stop unnecessary private pay.

• Medicaid built to protect the middle class
• Difference between Medicare rehab and long-term care
• True cost of nursing homes and private pay risk
• Non-countable assets for singles in Arkansas
• Power of attorney gifting authority as a must-have
• Spousal protections that preserve assets and income
• Timing strategies for crisis and pre-planning
• Why nursing homes and agencies don’t guide planning
• How an elder law attorney applies the rules
• Concrete next steps to assess eligibility and apply

“Please get this to anyone you know who is private paying for a nursing home bill so they can stop the bleeding and protect their estate.” 
“We are Generations Legal Group — call 479-601-4119 or visit GenerationsLegalGroup.com.” 
“For more resources and show notes, visit www.answersonagingpodcast.com.”

Information to help you answer all of your questions about aging.

Transcript

Mission And Urgency

SPEAKER_00 0:02

Welcome to Answers on Aging, the podcast dedicated to helping you navigate the complexities of growing older. Your host is Tom Whatley, a certified elder love attorney with a passion for empowering the aging community and their families. From finances and legal matters to health, long-term care, and beyond, we've got you covered. Because every question you have, we aim to answer. Dive into today's episode and let's uncover the truth about aging together.

Medicaid Is Not Only For The Poor

Choosing Good Homes On Medicaid

Costs, Medicare Limits, And Reality

Private Pay Defined And The 80 Percent

Planning Like A CPA

Single Person Rules And Tools

Married Spousal Protections

Biggest Mistakes Families Make

Why You Need An Elder Law Attorney

No One Tells You To Apply

Act Now And Where To Get Help

SPEAKER_01 0:43

Thank you for joining me today. Today's um show is something that I'm extremely passionate about, and it's something that it seems like I do that. I talk about this all the time. Every time I'm out in the public, every time I speak with people, I I tell people this, and it just seems to be getting nowhere, and there's still people calling saying, Oh, I didn't know we had we could not have had to pay for the nursing home. I didn't know that we could have protected some or all of our estate. And it's depressing and it's sad, and I just want to get this information out there. This may not apply to you, but I encourage you if you know someone who is private paying for the nursing home, please get them this information. Send them this video, send them this podcast so that they can listen to this and hopefully protect some of their assets. So let's get into it and let me show you why this is so important. Why this matters. Number one, people are paying privately for the nursing home when they don't have to. When you hear Medicaid, you think, okay, that's just for poor people. People with money have to pay. That is not the case. The Medicaid rules are there. They are created to protect middle class people. There are some income and some asset rules, but those rules are very flexible, and we can work within those rules to make sure that someone doesn't lose everything that they have. And with a married couple, we can actually protect everything that they have up to probably about$1.5 million. And this is strictly following the Medicaid rules and doing exactly what they tell us to do. All right. Now, you you may be thinking, well, Medicaid. I don't want to be on Medicaid because I have to be in one of those nasty Medicaid homes, and I want to be able to choose the home that I want to go to, and I want to be in one of those nicer nursing homes. Congratulations, you can and still be on Medicaid. Every nursing home in Northwest Arkansas takes Medicaid. And pretty much throughout the state, I think there's a few down in Little Rock that don't take Medicaid, but the vast, vast majority, and almost every nursing home takes Medicaid. You get to choose which one that you want to go to. If you don't like it, like it there, you can move. Medicaid does not dictate where you stay, how long you stay there. They don't take away your freedom. They simply pay for the care that you are getting. So the hard truth is nursing homes are expensive. In Northwest Arkansas, and I think pretty much across the state, they are somewhere between$8,500 and$9,000 per month. Okay? That's a lot of money. And that can devastate even substantial estates over time. And the Medicaid rules are there to help people get the care they need. And if you do it appropriately, you don't have to lose everything that you have. Some people may be thinking, well, Medicare pays for the nursing home. It does for a very short length of time. And those rules are if you go to a hospital and you spend at least three days there and then go from the hospital to the nursing home, Medicare will help pay for your care in a nursing home, but they're paying to get you better. They're doing PTOT speech, advanced nursing things that they can do in a nursing home cheaper than they can do back at the hospital. So therefore, they are paying for someone to be in a nursing home, but it's kind of really an extension of the hospital, not long-term care Medicaid. Once the person either goes through their 100 days, that's the most Medicare will pay, or they get to the point where they're not making any more progress, they're as good as they're going to get, Medicare stops paying. And if you stay in the nursing home, you either pay privately or you go to Medicaid. There's also long-term care insurance, but if you don't have long-term care insurance at that point, it's too late. So Medicare does not pay for the long-term care. It'll pay for short term, but not the long term. And absolutely most families are unprepared for this. This is where we get the phone calls from people who don't know that you can protect assets, and they end up paying because they just think that's what they have to do. So, real quick, if this doesn't apply to you, please stick with us through the rest of this. I will show you some very basic rules, touch on that so that you can see how this works. But if it doesn't apply to you, please stick around because you may know someone who is private paying, and therefore they need to know these rules and be able to protect their estate, and they will love you for doing that. So, what is private pay? Private pay is simply paying the bill that comes up every month. And again, it's about$8,500 to$9,000 per month. And they just keep coming every month that you're there until you're broke if you don't do some planning. And at$9,000 a month, this will drain your savings, your entire life savings very quickly. So this is where Medicaid comes in. Medicaid can and does pay for the nursing homes. A common statistic is 80% of everyone in nursing homes, their care is being paid for by Medicaid. 80%. And my thought is the other 20% probably could be on Medicaid. They just don't know that they can. Okay? Now, there are strict rules. You do have to meet income and asset limits, and those limits are there, but the rules around those limits, being able to work within those rules and do things is where we come in. I kind of relate this to a CPA. You can pay all the taxes that you want to pay. The rules say if you make this this much salary, your tax rate is this. You could do that. But most of us go to a CPA to say, hey, the government gives us some deductions, some things that we can deduct from our income so we don't have to pay tax on that, like charitable donations. You give to your church or you give to a church. Our federal government encourages that and says, yes, if you do that, you don't have to pay income tax on that money. And it's just common sense to do some planning with your income tax so that you pay the least amount of tax possible because the government encourages you to do those things and says, if you do these things, if you buy a house and you have mortgage, have a mortgage, then the interest off of that mortgage you don't you don't have to pay income tax on because they want people buying houses. So it's a way to get people to do things, and the same thing with Medicaid. There are rules around that that allow us to plan and make sure that you get the care that you need and not lose everything. Planning matters. Planning definitely matters, and the sooner we can start, the better. We can do some really cool things at the last minute. Okay. That's Medicaid is not welfare. People think of this as just a welfare thing. No. People have paid taxes into the system. This is one of those ways that the system is there to protect people. It is a legal benefit. Medicaid is a legal program with clear rights and rules. And if you follow those rules, you can protect some of your assets. If you don't follow those rules, they will gladly let you just pay for your care as long as you want to. And it's designed absolutely for poor people, but the rules around it allow us to get middle class people, people with hundreds of thousands of dollars, up to probably 1.5 million, especially if you're married. We can get you onto Medicaid pretty quickly following those rules, even if you do have some money. The rules are written in the law. As an attorney, I know the law, I know the rules, I've studied this now for 27 years, and I know what's going on. Okay. So the Medicaid rules for a single person are pretty simple. There are limited countable assets. And so basically, let's talk about the non-countable. And I'm sorry, that that should say non-countable. The things they don't look at is a very short list in Arkansas. Your home, anything that's in your home, one car, and prepaid burial. That's the four big things that we get to not count against you, pretty much regardless of value. Everything else is counted. Okay? Income does go toward care. You're we can't stop that. The person's income does go to pay for their care. Typically, if you're married, there may be some ways, particularly if the spouse in the nursing home has a lot of income and the spouse not in the nursing home has low income. We can use some of the spouse's income to give back to the spouse not in the nursing home. And I'll go over that in just a second. But income generally, the general rule is income goes toward the home. And there are planning options, particularly with a single person. The key here, let me just tell y'all, drop this, and if you have more questions, you can put comments below or call the office and we'll just talk about it. But one of the things you have to do if you're single is you have to have gifting language. Okay. Your power of attorney has to allow the agent to give away assets so that we can protect you. All right? That's just one of many things. So the solution for a single person is we can, in most cases, protect at least half of all of your assets. And with some luck and some a little bit of planning, we can get that 50% up to 60, maybe 70%. And with pre-planning, we can protect much higher percentages. We can get that up to 80, 90, almost 100% protection if we have some time to plan. So planning ahead is always important. Okay? So for the married couple, the spouse not in the nursing home is protected. There are there's a whole section of the Medicaid rules that I call these spousal protection rules. It allows the spouse not in the nursing home to have a home, things in the home, vehicle, burial, assets, and income. And so we take those rules saying, yes, the spouse not in the nursing home gets this this much in assets and this much in income. And then we take those rules and play with them a little bit and get the spouse not in the nursing home where they can protect pretty much everything. Up to there's a limit. Sometimes it's a million, maybe we can get up to about 1.5 million. We can protect everything that a couple has and get one spouse onto Medicaid very quick. And not everything is lost. In fact, with a married couple, almost everything is protected. So what's the biggest mistakes families make? Number one, they they wait too long. If you've waited and you've done nothing, still give us a call, we can do things. But waiting too long puts us in that crisis mode. And yeah, we can do some super cool things, but we can do even better things if we plan ahead and have insurance maybe. We can arrange the assets a little bit. We can do some things to really protect larger sums of money if we have some time. But if we don't, it's fine. We can still do it. People just spend blindly. There's like, I know qualifying for Medicaid, you have to be under$2,000. We are not under$2,000, so therefore we don't qualify, we'll just keep spending. That is not the rule. All right. And you can listen to some bad advice. All right. There's a lot of bad advice out there, and I encourage you, talk to people who know what they're doing. And just because someone's an attorney doesn't mean that they know what they're doing in this area. Okay? We don't want this to happen to you. Okay? We don't want your piggy bank to have X's for I's and be upside down. We want to protect your assets. So Medicaid planning can be done even after nursing home entry. Even after you're in the nursing home, single or married, there are some cool things we can do. Planning isn't limited to before admission. You can start even after you've been there. And even if someone's been there a year or two years, let's stop the bleeding and get this fixed now so that you don't have to continue to do that. And even if you're private paying, give us a call. Let us look at it. We can't help everyone, but we can help almost everyone. And we can help you stop making that out-of-pocket expense every single month. But timing is crucial. Okay? Come to see us as early as possible. If you know someone out there who is paying privately for the nursing home, they should give us a call. Let us talk to them, let us see what's going on and see if we can stop that. And this is why you need an elder law attorney. This is something that they don't teach in law school. It's something that you have to learn elsewhere. And the other job that I have, my other thing that I do is I teach attorneys across the country how to do this. And you know, these are seasoned attorneys who have been practicing typically 5, 10, 15, 20 years, and they're like, I'm tired of doing what I'm doing. I want to do this, but I don't know where to go. I teach them how to do it. And so you really need to have an attorney who knows this area of law and specifically does it. This isn't just natural understanding. This is not something that they teach in law school. And nursing homes don't plan for you. They will tell you you need to pay privately because typically, as a typical rule, they're going to make a little bit more money from private pay residents than they do from Medicaid residents. But again, they will not treat you differently because you go into Medicaid. Nothing will change. DHS, the state Medicaid office, absolutely will not tell you what to do. They will not tell you of the rules that will benefit you. They want you to also pay privately. And even with a married couple, when the person goes into the nursing home, they you can look at the total assets, and once you spend about half of that, typically, they should go into Medicaid. But no one's looking at what they're spending. No one's looking at what they had when they first went into the nursing home, comparing that to where they are now two or three years later to say, hey, you don't have to keep paying. Why don't you apply for Medicaid? You're automatically, under the rules, qualified to get Medicaid. But no one tells them that. Okay, the nursing home's not going to tell them, DHS doesn't know because they don't know. They don't know what you had when you started, and they pretty much don't know where you are now. This is where we come in. We can look at previous balances, current balances, and say, hey, you're ready for Medicaid. But even if you're not ready for Medicaid, we can get you on Medicaid, especially if you're married. Generic advice is dangerous. So I am encouraging you, you take action for your family, pre-plan, do what you can. But if you know someone who is privately paying for the nursing home, please tell them about this. Let them know there are some things we can do. There is no need to wait. The sooner that you understand your options, the more we can save. And you've got to get informed. Thank you for listening to this webinar or this podcast to get the information. Now, take this information and go tell someone. And then we at Generations Legal Group, we work very hard to protect what matters most to you and your family and your loved ones. So again, we are Generations Legal Group. We're at the corner of 28th and J Street here in Bentonville. Phone number is 479-601-49-479-601-4119. Or you can go to Generations Legal Group.com. That's our website. There's a ton of information there that we go through this and pretty much everything else that we cover. I encourage you get the information that you need. And if there's anything we can do for you, please give us a call at Generations Legal Group, and I will see you next time. Thanks.

SPEAKER_00 16:35

And that's a wrap for today's episode of Answers on Aging. Thank you for joining us on this journey of discovery and understanding. For more resources, detailed show notes, and expert advice on the many facets of aging, don't forget to visit our website at www.answersonaging podcast.com. Remember, growing older might be inevitable, but doing it with grace, knowledge, and empowerment is a choice. Until next time, stay informed and keep those questions coming.