Answers to Questions about Medicare and Medicaid

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One adult son talks about his mother-in-law's well-being: She is elderly, lives alone, experiences symptoms of dementia, and doesn't accept help easily. She refuses to have strangers in the house. She has lost all effort to cook, but she will not have someone come in to help her with cooking. We tried a couple of house cleaners, but they don't clean the way she does. She refuses to even look at any of these assisted living places. If she knows my wife is taking her there, she refuses to get in the car. She's stubborn. What do you do, call the cops?


The recent Hometown Life article, titled "Plan ahead to assure secure future for aging parents," stressed the importance of planning ahead for elderly parents are or may become physically or mentally unable to care for themselves. This process should include two important documents: a power of attorney—which can give an adult child legal authority to act on behalf of elderly parents with financial matters—and a patient advocate designation—to help them in medical matters. By starting early, children and their parents can work together to create these documents.


The article also answers questions on a few other topics:


What about putting your name on your parents' bank accounts?

Children should not be joint owners, because you’ll be subjecting your parents' assets to all of your liabilities, causing issues for future benefits. The government is more likely to scrutinize a joint account if the parent applies for Medicaid when transitioning to a skilled nursing facility. Instead, a signed financial power of attorney allows an adult child to pay bills, sign checks, and help the parent with other financial matters—without the need for joint bank accounts.


Who pays when an elderly parent, on Medicare, needs rehab in a skilled nursing center?

Medicare may pay 100 percent of the first 20 days. After that, Medicare may pay 80 percent, and supplemental insurance may pay the other 20 percent of the bill. There is a 100-day Medicare benefit, but not everyone qualifies. You also need to have a 30-day wellness period outside the hospital or a skilled nursing center for that benefit to reset. For example, if the parent leaves the facility on Day 20—but returns the next week—they start where they left off at Day 21 because they didn't have a 30-day wellness period.


Should I give any money away if considering entering a skilled nursing home (with Medicaid)?

No, Medicaid will examine the past five years of your finances when you apply for coverage. If you have given money away, you could be severely penalized with long periods of ineligibility and you may not get Medicaid even if you have zero dollars.

Reference: Hometown Life (January 23, 2015) "Plan ahead to assure secure future for aging parents"

For more information on Long Term Care and Medicaid Planning, please visit our website.