Paying for long term care - NBC Right Now/KNDO/KNDU Tri-Cities, Yakima, WA |

Privately purchased long-term care insurance is a potential resource for nursing home or other long term benefits since Medicare does not pay for long term nursing home care.

The cost of Long-term Insurance depends on what coverage options you choose, such as in-home care, the waiting period before coverage begins, your age at the time of application, the maximum amount paid per day, the length of benefit period, and inflation protection.  Washington law requires sales agents to provide a full disclosure of all policy options before you purchase a policy.  Washington also permits" partnership policies" hereby you are allowed to keep additional resources if you need to qualify for Medicaid after the policy benefits are exhausted, through none are currently offered. Some Long term care policies also allow you to qualify for federal income tax advantages.

Medicaid is a state-administered, needs-based federal assistance program that provides many types of medical benefits, including nursing home care.  Generally, most of a Medicaid recipient's income goes to pay the nursing home and Medicaid pays the balance of the nursing home costs.  (The COPES program is also a state-administered, needs-based program for providing in-home care.)

If you are unmarried, you may qualify for Medicaid if your resources are limited to less that $2,000, plus exempt resources such as a car, a burial plot, a $1,500 face value life insurance policy, and your home if you intend to return there.

If you are married, you and your spouse can own $87,000 (as of January 2001), plus the exempt resources described above for an unmarried person.

Other factors in determining eligibility for Medicaid for nursing home costs include income and level of skilled care needed.

A person usually applies for Medicaid when already receiving nursing home care.  Application is made through the Washington Department of Social and Health Services.  Nursing home social workers can often help fill out the forms, but an elder law attorney or agency such as Columbia Legal Services should be consulted for information regarding updated eligibility criteria before an application is submitted. 

If you give away resource that cold have been used to pay for care, the state will impose a "period of ineligibility" based on the amount given away.  If more than 5 years have passed since the gift was made, no period of ineligibility will apply (although more restrictive rules apply to transfers in trust.)

Following a Medicaid recipient's death, the state may file a lien against the recipient's estate to recover payments made, but will not collect on the lien until the spouse's death if the recipient has a surviving spouse.

source: Washington State Bar Association