On April 27, 2017, I attended a roof top event sponsored by HomeTeam for Elder Planning professionals. A group of us spoke about the number one question elder clients ask us, which is, "When do my parents need to begin planning for Long Term Care." Nearly all of us have a family member who is significantly aging, has health issues or needs some assistance with activities of daily living. With advances in medicine, Americans are now living longer than ever before. The statistics show that 1 in 2 Americans will need long term care at some point in their lives. But while living longer can be a blessing, aging also has significant physical and mental challenges that require third party assistance. Furthermore, many older adults live alone, without a support system and face these challenges alone. I am frequently appointed by the Court as a Court Evaluator pursuant to Article 81 of the NY Mental Hygiene Law for proceedings to appoint a Guardian of a person who is unable to manage their personal and financial property. These situations are often dire. If you have loved ones who have not yet engaged in advanced planning, there are three alternatives in New York for them to consider in order for them to maintain their lifestyle in a dignified manner and get care they need.
Long Term Care (LTC) insurance - Almost all LTC policies currently offer an in-home care benefit when the insured is unable to perform two activities of daily living (eating, dressing, bathing, transferring, toileting and continence). However, LTC insurance is only offered to people who qualify both physically and mentally, and typically who are under the age of 79. Additionally, these policies can be expensive, and can become more expensive when the NYS Department of Insurance authorizes the LTC insurance carriers the right to raise traditional LTC insurance policy premiums. An alternative to traditional LTC insurance are hybrid policies, which are life insurance policies with LTC insurance rider. Currently, hybrid policies do not experience premium increases since they are deemed life insurance products. However, hybrid policies pay LTC benefits, if and when needed. Hybrid policies, while marginally are more expensive than traditional policies, provide more flexibility and are a great LTC planning option.
Medicaid planning If LTC insurance is not an option because you can not qualify or it's too expensive, then the next best alternative is Medicaid planning. The biggest concern with Medicaid planning that I come across is that people are afraid, "Medicaid will take my house." Medicaid does not take houses. This is a misconception...Medicaid may place a lien on house, (without proper planning) but it does not take houses. Medicaid is available for people who are medically and financially eligible. Proper planning with an Elder Planning attorney can assist people to become financially eligible for Medicaid so they can receive in-home, assisted living or nursing home care. For in-home care, depending on need, aides are sent to the Medicaid applicant's home by a Management Long Term Care (MLTC) provider after the Medicaid application has been approved. The number of hours for in-home care will be determined at the assessment. It is imperative to have an Elder Advocate at the time the MLTC assessment is conducted to ensure the elder receives the right outcome. If in-home care is not safe, or socialization is a concern, then certain assisted living facilities such as Amber Court, accept Medicaid benefits, as well as most nursing homes.
Private Pay - Spending down personal resources to obtain personal aides for in-home care, companion care, geriatric physician in-home care, in-home concerts, tax and financial planning, daily money managers who assist paying bills and employee payroll resources are available to the older adult who can afford to stay at home and maintain a life style they are accustomed to.
Clearly, there are many solutions for our aging adults. It is imperative that planning begin early so that the best options remain available. The Levy Law Firm can refer you to any of the resources that have been referenced in this article.