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ORgirl - yes it can be all so frustrating. Medicare & SS are meant to be a safety net to keep those elderly with some resources for their later years. If you work, you've paid into both programs via FICA every day you worked. Both are entitlement programs with Medicare being a general entitlement & SS based on what you paid into it. Medicare is available to most (like 80% or so of over 65) and pays for majority of their health care costs. If you look at your statement from CMS carefully, the costs that Medicare pays for your vists, treatments, drugs are astounding. What you do as a copay with Medicare pales to what Medicare pays.

But neither SS or Medicare was never designed to cover or pay for any long term care costs. Medicare was done in the 1960's when the aged living situation and length of living was quite different than now. You died at 78/83 and probably at home or living with a daughter & her family and no real specialized health science centers as done today. but Medicare is IMHO a very good program which has the clout to do cost containment for covered services. If Medicare wasn't there to pay, most of us would be bankrupt from any lengthy hospital stay. SS was meant to provide for just a part of an elderly living costs - what has happened is that for many it is the only source of income.

Medicaid is for those who qualify under whatever rules are in their states program. For NH/LTC they have to be impoverished before medicaid will pay. But cover basically 100% of the basic needed LTC costs once eligible.

Health care costs in the US are astounding. Most first world countries have a system that provides care from birth to death as a part of citizenship for nominal costs. The US model is geared to private sector profitability. Most bankruptcy in the US past decade are due to health care bills.

ACA /obamacare is not about paying for long term care at all. ACA is geared for providing health services coverage for those who have aged out of qualifying for CHiP and too young for Medicare & don't have insurance provided by their employers - that's who ACA is for not the elderly needing LTC.
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Jeannegibbs brings up a very very important point……Medicaid for an individual applicant is very very different than that of a couple in which one applies for Medicaid and the other is the "community spouse" (CS).

CS situations are way more complicated, especially so if the CS is a somewhat younger spouse (or even has kids from a May/December marriage) and will be likely to outlive the other by years or decades. CS needs really good experienced advisors to maximize the CS position and do it so that it is medicaid compliant and in advance of the Medicaid application. To me, it is not a DIY situation.

Medicaid for a elderly widow or widower is much much simpler - they have to basically be impoverished at about 2K in monthly income & 2k in assets and spend-down till that happens. If family want to keep the house, then family has to pay for all on the house from now till after they die and probate finalized.
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Oregongirl, in order for the Federal and State government to have enough money to take care of everyone in assisted living and/or nursing homes, our tax rate would also double. How many of us would pay 40-50% of our income into taxes?

We have only ourselves to blame because how many voters gone to the polls and voted *no* to a tax increase..... thus money budgeted by the Federal and State has to be rearranged to fund new projects that we need.... thus what gets cut is usually education and health care.

As for Obama Care, put into place were new items that will benefit those who are receiving Medicare.... such as free once a year wellness exam. Go to Google and type in "ACA Medicare" to get a list of the positive changes.

Our elective officials in Washington DC are on the same retirement/health plan as every Federal worker. In fact, many are 65 and use the same Medicare as the rest of us use.

As for paying for assisted living and/or nursing home.... we all recall our parents and grandparents saying "save for a rainy day". My parents have done that, and so have I and my sig other. We just lived below our means, thus putting savings into retirement.
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You are talking about Medicaid. With Medicaid, you must spend down until you are left with $2, 000.00 of assets. Also there is a 5 year look back.
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We would need a lot more information to answer the question about protecting a home from Medicaid recovery. It can be done under very limited circumstances.
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Medicare is not what you are thinking about. It is Medicaid. to protect your assets from MEDICAID, you probably will have to talk to a lawyer.
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Protect it in what way?

Easiest is to never apply for Medicaid.
OR do whatever transfer now & wait to apply for Medicaid Fall, 2020.

Otherwise all keeping maw-maws house depends on your states MERP program for exemptions & exclusions; your states probate system;
AND your or other family's ability to be able to pay on all things on the house as the medicaid reciepient will have to do a co-pay of basically all their income to the facility; you will need to keep meticulous documentation on all costs; and do this from day 1 of Medicaid till you finish out probate on your parents estate.

If you keep the house, really look at what the costs are on maw's house are. If you cannot easily pay the required on the property - like at the minimum taxes & insurance- and do this for years & years, then the math flat isn't gonna work.

Keeping their home is to me, kinda like having a 2nd or 3rd home but without secure guarantee of ownership and runs a risk. Most folks can't afford a 2nd home to begin with & most can't bear to do risk, but if you can go for it.
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Wow, freqflyer, my hat is off to you if you've saved enough for the rainy days of your old age. I'm truly impressed.

I look at my young adult grandchildren just starting out. It is going to take them years to pay off their college loans. (My generation mostly didn't have big debts leaving college.) Then they start saving for their own children's college, hoping they can get through with lesser debt load. They are maintaining a house and supporting their children. They may be trying to save for their own old age, but it takes two incomes to live a lifestyle equivalent to what their grandparents managed on one income. Then they may be expected to help out their parents. And, for better or worse, whereas previous generations had to save for perhaps 10 years beyond their retirement and frequently died after relatively short illnesses, they are looking forward to supporting themselves for a quarter of a century or more beyond their retirement, and a high likelihood of a prolonged period of chronic (and expensive) illness.

Those in my grandchildren's generation who choose not to have children might have a better chance of being self-supporting in their old age. Those whose jobs provide a high-value pension might make it.

But the folks with three kids struggling on two or more jobs near the minimum wage? I don't think they have a snowball's chance in h*ll of preparing financially for their own old age.
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I hope my first sentence in my previous post doesn't come across and sarcastic. I am truly sincere.
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While I agree with much of what you said, Jeanne, I do take issue with one part. You said that it now takes two incomes to have the same lifestyle as our grandparents had with one. My grandparents' lifestyles were nothing like what most families have today. My maternal grandparents lived in a two-bedroom, 700 square foot house where they raised three daughters. They never had more than one car. No money was spent on activities for the girls, and I don't think they ever even had a bicycle. My grandmother sewed most of their clothes, they each had two dresses for school, and two pairs of shoes each year. Of course there was no money spent on big screen TVs, computers or cell phones. They had a radio (just one) in the 40s and 50s, and got a TV in the late 50s. They had a big garden and fruit trees, bought pork "on the hoof" and butchered it themselves. Grandma cooked and canned. Meals out were extremely rare, even after the girls were grown and out of the house. They were considered "average" or middle class in their area. I don't see any middle class families living like that today.

They worked hard and saved, even with one income and wage levels of the 40s, 50s, and 60's. Grandma died in her 60s, but grandpa lived to almost 92. He had some health issues in his last years, but still left an estate of over $200,000. When he died 20 years ago, nursing home costs were about $3,000 per month, so he would have been able to pay for six years or more when his social security income was factored in. Average nursing home stays are far less than six years.

While I am glad that Medicaid exists for those who are unfortunately afflicted with devastating long-term illnesses, I am disgusted by those who don't try to live below their means and save for an uncertain future. I see young families take on large car payments, and stand in line to spend hundreds of dollars on the latest tech gadget. Even worse are those who try to hide assets and expect the taxpayers to pick up the tab. Medicaid should be a safety net and not an expected benefit.
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