Sitting bedside with her husband after his stroke, Jane is talking with the discharge planner for the local hospital. After discussing the level of care John will need, Jane and the planner have decided that the nursing home connected with the hospital is the only viable option for John’s needs. Now Jane needs to visit the nursing home and discuss how she will pay for John’s care.
The following day, Jane stops by the nursing home hoping to get a tour of the facility. Upon walking in, she is immediately impressed by the comfort, care, and especially the staff. The facility is bright and welcoming and the staff is both highly attentive and respectful. After her tour, Jane is absolutely certain that John should be admitted to the nursing home when he is discharged in two days.
After the tour, Jane sits down with the social worker and business office manager for the nursing home in order to fill out the admissions paperwork. Jane fills out the paperwork while the manager explains the billing process, including the facility’s $200 per day rate. Jane immediately stops writing and looks at the employees in shock.
You see, Jane can’t afford $200 a day with just the Social Security she and John receive. The social worker reassures Jane that, according to the discharge planner, Medicare will pay for John’s care for immediately after he moves from the hospital to the nursing home. Unfortunately, though, Medicare doesn’t pay for all nursing home care. Eventually, John will stop improving or Medicare’s 90-day limit will run out, and Jane will need to pay the bill somehow.
The social worker helps Jane fill out a financial statement identifying what Jane believes their assets to be. Looking at their joint checking account, John’s IRA, the value of the home they own together, and the 40-acre farm Jane inherited with her three other siblings, the social worker believes Jane will be able to pay for John’s care for about 56 months if she sells the farm and liquidates John’s IRA.
Jane immediately sees the problem with the calculation the social worker did: it assumes she is spending all their money on John and using nothing to care for herself! For every dollar she spends on food, fuel, utilities, or repairs, that number shrinks. The business manager responds that John can apply for Medicaid once Jane has spent all the money.
Jane is dumbfounded. Until John’s stroke, she had never considered that nursing home expenses could wipe out everything they have worked their whole lives to earn, and now her mind is spinning out of control: “Why doesn’t all the money they contributed to Medicare over their combined 85 working years get them health insurance coverage for the nursing home? They’re not that old! I can’t afford to support myself for the next 15 or 20 years if I have to spend everything on John’s care. I can’t sell my farm! My siblings will never go along with that, and it wouldn’t be fair to them.”
Fortunately for Jane and John – and you, if you find yourself in this situation! – there is a solution to the problem. When she gets home, Jane does a Google search for “how to pay for a nursing home” and discovers an elder law attorney in her area who specializes in planning for nursing home stays. After a quick phone conversation with the staff at the law office, Jane already feels like someone is going to fight for John and for her. After first meeting with the lawyer just two days later, Jane knows there’s a solution that fits their needs.
Jane leaves the lawyer’s office and heads straight to the hospital with a spring in her step. Even though John is moving to the nursing home that same day, Jane has virtually no stress. She knows John will get the best care he can get, and she knows exactly where the money will come from to pay his bills. Even the discharge planner at the hospital notices how relaxed Jane is.
When they arrive at the nursing home, Jane sits down with the social worker and the billing coordinator to discuss Jane and John’s ability to pay the nursing home bill. When Jane informs them that she hired a long-term care planning expert to help make sure John’s care is completely paid for, the social worker tells her they have everything they need to admit John to the nursing home: “We’ll contact your lawyer to make sure everything is sorted out. You focus on taking care of John and spending time with him.”
—–
This is a true story. Okay, it’s really a combination of many stories: our clients often have too much money to apply for Medicaid immediately but not enough money to support a spouse who doesn’t need nursing care. Like Jane, they might have an inheritance that they can’t sell because it’s owned jointly or a life’s savings that they believe should be preserved.
If this is you or if your parents are like John and Jane, you need a long-term care planning expert to help you navigate the difficult waters of Medicare, Medicaid, VA benefits, and long-term care insurance. Contact our office at (712) 737-3885 to start building your long-term care planning solution today.
