Last week, Joanne Lynn, M.D, a noted geriatrician, warned members of Congress that enormous misery is coming. It will come within the next 10 years, if the country fails to improve support programs for the elderly.
Many baby boomers believe that long-term care is free of charge from the government and have failed to plan for it. Most have completely ignored this topic, as it is not fun to think about or discuss.
Some are still thinking that families like those portrayed in old TV shows like Ozzie and Harriet or Leave it to Beaver are common. They think they will move in with their adult children like people did in the 1950s. Others recall the days when the nursing home said not to worry about paying for care for the first three months, because Medicare recovery care will pay for this. (This used to be accurate, but the provision was easily abused when no documentation that patients were making progress in their rehabilitation was required.)
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Others tell stories of how easy it is to qualify for Medicaid — a welfare program for the impoverished. All you need to do, they think, is to sign your house over to your children, or put your money into an irrevocable trust, and then care is all free from the government.
Well, Ozzie and Harriet are long gone, Medicare only pays for recovery care after three days in a hospital (which is becoming more and more infrequent), and then only while the beneficiary is actively recovering, and most of the care you want won’t accept Medicaid.
The reason more and more of the beautiful assisted living facilities won’t accept Medicaid is that it doesn’t pay enough to cover the facility’s actual costs. Only nursing homes — the one place nobody wants to end up in — must accept Medicaid, because they also accept Medicare, their cash cow for providing Medicare-paid recovery (rehab) care.
Medicaid-covered home care is also difficult to arrange, leaving you the choice of paying for care (money or insurance) or choosing a nursing home that will accept you.
And yet many people continue to participate in a practice of planning to end up on Medicaid (welfare). While the rules seem to make this impossible, many professionals are happy to help you hide your money in irrevocable trusts and other strategies so that you are stuck in the welfare system — and will complain about being forced to end up in a nursing home instead of nicer accommodations.