If a person has long term care insurance, it can become activated when personal care assistance is needed, usually in the home which is where most people want to stay.  If there is none, then the “rainy day” is here and the cost of care can be very expensive; people can become pauperized.  Most people would like to stay in the familiar of their own homes.  However, there are now more Assisted Living Facilities that will accept Medicaid reimbursement or are “Medicaid funded Assisted Living Programs” for those who qualify.  So, one can enter one of these as a private pay person and then pursue Medicaid.

For those at home in need of care, they can private pay or apply for Community Medicaid with Home Care (and a pooled-income trust if needed).  Still others may need the Chronic Care/Nursing Home Medicaid if their care needs exceed what can be provided at home and require 24×7 supervision and the skill a Nursing Home can provide.  This type of Medicaid does have a five year look back period and/or a transfer penalty period.  When planning in the event of further illness or incapacity and considering the need for either type of Medicaid, I very strongly recommend a consultation with an Elder Care Attorney. I would also make sure the lawyer or law firm is certified in Elder Law since the laws are changing.  There are some lower-cost options for those who cannot afford the fees such as the Nassau-Suffolk Law Service and Touro Senior Citizen’s Law Program.

If the person is very eligible for Medicaid and has little/no assets and property (would be considered a simple Medicaid application), community based case management agencies such as JASA and Catholic Charities are qualified and equipped to help.  Either way, being faced with the need for care can be a complicated and overwhelming process requiring the gathering of important documentation.  Being well-informed of the documents needed and care planning options can be provided through the counseling experience and help to alleviate normal and appropriate anxiety.

The Veteran’s Administration can also provide certain benefits and is worth exploring when there is a Veteran or Surviving Spouse in need of care (eg.-Aid and Attendance benefit which can help offset the cost of home care or an assisted living facility).