When should I engage in elder law planning?
The sooner, the better. We don’t have a crystal ball so we never know when illness will strike. While many of us think of nursing home residents as people who are elderly, a significant number of people who need long-term care are middle age or younger. Thus, it is never too early to plan. Moreover, the government has imposed stringent rules penalizing transfers of your assets prior to entering a nursing home. You may be disqualified from receiving Medicaid if you have made asset transfers during the five-year look-back period prior to applying for Medicaid. An elder law attorney can explain the Medicaid look back and penalty period rules to you so that inappropriate, disqualifying transfers are not made.
Does Medicare cover the cost of long-term care?
No. This is one of the most common misconceptions of seniors. Medicare covers short-term rehabilitation but does not cover custodial care at home or in a nursing home. Medicare will cover acute illnesses such as heart surgery or strokes, but not chronic illnesses such as Alzheimer’s disease or Parkinson’s disease. If you meet strict requirements, you may receive up to 100 days of Medicare coverage for skilled nursing care in a nursing home; however, there are significant co-payments that will be due. Some people have Medigap insurance policies which cover these co-payments. If you need help with activities of daily living such as eating, bathing, toileting, or transferring in and out of bed, these are considered custodial needs and are not covered by Medicare.
Why might I need an elder law attorney?
If you or a loved one is concerned about cost of long-term care and how you will pay for it, then you should speak to an elder law attorney. The elder law attorney will be able to explain to you the various methods of paying for long-term care, including the government benefit programs that are available and how to qualify for them. If you are concerned about planning for a time when you might not be able to make decisions on your own, then an elder law attorney can explain to you the various options that are available to you to make sure your wishes are carried out in the event you become incapacitated. These are just a few of the many ways an elder law attorney can assist you. There are many more types of situations where an elder law attorney can be helpful. That is why it is so important for you to speak with one so your individual concerns can be addressed.
What is elder law?
Elder law is a practice area devoted to the needs of a particular type of client as opposed to a particular area of law. While not all elder law clients perceive themselves as elderly, many of them have similar needs. Elder law attorneys must be knowledgeable in many areas of the law, including guardianship, long-term care planning, advance health care directives, powers of attorney, estate planning, probate and trust administration, asset protection, special needs trusts and planning, and elder abuse. Elder law attorneys take a holistic approach to addressing clients’ concerns by focusing on the problem to be solved and not one particular area of law.
My parents gave me $50,000 a year ago to buy a home. Do they have to wait 5 years to apply for Medicaid due to a “Look Back”?
This is the most frequently asked question and the most misunderstood aspect of Medicaid planning. We find that CPA's and Financial Planners are also giving families wrong information. Nursing home business offices also misunderstand this rule. The Federal Government forces the State of Wisconsin to ask an individual if they have transferred any assets or given any gifts to anyone within five years (60 months) of the date of application. Any gifts or any tranferring of assets within the 5 years are subject to penalties. Any gifts or any transferring of assets made greater than 5 years of the date of application are not subject to penalties. For example, you gave your daughter $150,000 to buy a home in October of 2010 and applied to Medicaid in November of 2015, there would be no penalty. In the same example if you applied for Medicaid in November of 2014, you would be denied Medicaid and have a penalty period of approximately 20.5 months and would be denied until mid July 2016. Please call for a free consultation with our Benefit Specialist to understand your unique situation.
Can you help me complete an application for Medicaid/T-19?
Medicaid laws are complex and are forever changing. Too many families rely on either the care facility or self educate to complete the application. Unfortunately, this process isn't simple and costly mistakes are made. Gathering financial documents and filling out paperwork can require anywhere from 20-40 hours of your time and more. If you are missing a single item, you may lose a month or more of benefits. Knowing how to lock in a higher amount of assets for the community spouse is not something that a care facility or the government is going to assist you with. Senior Planning Group is recognized as experts at processing Medicaid applications for the past 17 years. We have successfully processed over 2,000 applications throughout Wisconsin. Our Benefit Specialists work closely with the Elder Law Center of Wisconsin and Attorney Ryan Zenk. So why use us to process your application? We guide you from start to finish. We save you time by contacting your financial institutions for you and collating all the paperwork needed. Our turn around time is fast which saves you money, and our fee is a fraction of the cost of one more month of private care.
I heard we should provide a snapshot of assets when my parents move into a CBRF. Why is this important?
After 17 years of working with CBRF's, owners and admissions rarely explain to married couples that they need to create a "snapshot" of their resources to lock in the higher CSAS (Community Spouse Asset Share). Otherwise the community spouse has to spend down to $50,000. Please call for your complimentary consultation which will save you money.
When can I apply for Medicaid/Family Care/T-19?
For a single individual, a Medicaid application can be filed when you have entered a nursing home, assisted living facility, or when receiving home care and your countable resources have been reduced to below $2,000 and after all periods of ineligibility have expired. For a married couple, a Medicaid application can be filed when the institutionalized spouse's countable resources have been reduced to below $2,000 and the Community spouse's (the one not requiring services) assets have been reduced to the appropriate CSAS limit. The amount that the Community Spouse can shelter varies depending on many variables. Please call for a complimentary consultation with our Benefit Specialist and or Elder Law Attorney.
Can a care facility ask my parents to leave when they run out of money?
The painful answer is yes, however it depends on what type of facility your parents live in. Skilled Nursing Homes (SNF) in Wisconsin that accept Federal funding (90%) cannot ask you or force you to move. You have the right to stay and apply for Medicaid/ T-19 if you otherwise qualify. You may be asked to share a room with another resident once Medicaid is approved. Many Assisted Living Facilities, Residential Care Facilities (RCAC) and Community Based Residential Facilities (CBRF) in Wisconsin can and do ask residents to move once their assets are depleted. Senior Planning Group knows which facilities NEVER ask families to move based on financial ability to pay. Families must be very careful and have to listen carefully when discussing Family Care which is a Medicaid waiver program in Wisconsin with an assisted living facility upon admission. Many providers are very vague and skirt around the question. Many facilities put their own limitations on the number of residents that are allowed to stay after funds are depleted. It is imperative that you understand in detail the history of their participation.
What is benefits planning?
Benefits planning is just another term for "How do we pay for this?" Senior Planning Group's Benefit Specialist will evaluate your individual financial situation. We screen for Public Benefits which are funds provided by the government based on a person's financial assets and income. These benefits may include Medicaid, Family Care, Social Security Income (SSI), Social Security Disability Income (SSDI), food stamps, subsidized housing and other public benefits. We focus on the benefits that are most relevant to the elderly such as Social Security, Veterans Benefits, Medicaid, Family Care and Medicare.
Can you help me with home care?
Most seniors wish to remain in their homes as they age. We can help you by bringing in the right care to assist you when needed. We act as your private consultant to find you the best care for your unique situation. We help by assessing your needs, explaining the costs, knowing who provides the best care, arranging services, training caregivers, monitoring care and troubleshooting issues.
My parents are not safe at home and need to move. How can you help me?
This is one of the most difficult decisions for you and your family to make and it's overwhelming to even know where to start. Our Geriatric Care Managers help you assess the options and determine the right type of care facility. There are many different levels of care offered in retirement communities today and more options than ever before. Please note that we are not a 'PLACEMENT AGENCY" and do not get paid for referrals. The State of Wisconsin offers different types of licenses which allow assisted living facilities to provide varying services, and the individual facilities may also limit what services they wish to provide. You will benefit from our expertise in carefully assessing your parents needs and knowing which facilities will provide the appropriate care. We have in-depth knowledge of what disability level each facility is willing to accept and which facilities will ask you to leave when your parents money runs out. We also review key aspects such as activities, personal preferences and location that are important to you and help you prioritize. Finances, costs and understanding the contracts and expectations play into our discussions so you are fully informed. Not only do we help with all of this, but we can be there for you through the entire process. In other words,we make sure you make the right housing decision the first time!
Will our insurance cover care management services?
Medicare does not cover private Geriatric Care Management. Most Long Term Care Insurance plans cover Care Management services by Master Level Social Workers or Registered Nurses with their BSN. Please refer to your outline of coverage or schedule a consultation to speak with our Benefit Specialist to review your policy and pre-authorize coverage.
What are your hours?
Our physical office is open Monday through Friday, 8:00 am to 4:30 pm. Our Geriatric Care Managers are available 24/7 for all care management clients. Each family is given a 24 hour on-call number which is answered by one of our staff, not a contracted on-call agency.
What is the cost of benefits planning (how to pay for care)?
We custom tailor our services for each client and family's specific needs and situation. Prices for services vary based on the individual financial situation. Please give us a call for a complimentary meeting with one of our Benefit Specialists.
What is the cost of your care management services?
We custom tailor our services for each client and family's specific needs and situation. Prices for services vary based on the level of geriatric care necessary. Please give us a call for a complimentary meeting with any one of our staff.
How do I know what level of service my parents need?
Our Geriatric Care Manager will provide a thorough assessment of your family member's needs whether it be their medical and psychological condition, physical environment, need for more life enrichment, mobility and life skills, safety at home or financial situation to help you determine what support or services would be most beneficial. We will work with you on an ongoing basis to re-evaluate needs and make any necessary adjustments to their care plan.
What can a Care Manager do for me?
A Care Manager can conduct assessments to address potential gaps in a senior’s life. They can formulate care plans, provide solutions, screen, arrange, and monitor in-home help or other services. Our Care Managers can provide your family with assistance in hiring a qualified caregiver for home care, review medical issues and offer referrals to case specific specialists, provide crisis intervention, act as a liaison to families at a distance, oversee care and quickly alert families to problems. This is especially important when families are engaged in long-distance care-giving for a loved one. In addition to offering eldercare counseling and support, Care Managers can assist with moving an older person to or from a retirement complex, assisted care home, or nursing home.
My mother is getting out of the nursing home as her Medicare days are done. She won’t be able to take care of herself the way she used to. What do I do now?
Our Geriatric Care Managers start discharge planning the day someone enters either a hospital or nursing home for sub-acute rehabilitation. Your mother's care needs and abilities may have changed, so this should be factored into both short term and long term care plans. A Geriatric Care Manager can help you with this transition from nursing home to either their home with care givers or into an assisted living facility. Our Care Managers will attend all the care plan meetings that the nursing home will hold for family members. We will be an integral part of your mother's transition by providing education, guidance and support and identifying, assessing and coordinating all the support services that are needed to meet all care needs and ensure a safe living arrangement. In addition, our Care Managers will ensure that arrangements are in line with a person's ability to pay/health insurance options.
My parents live in Florida and my father can no longer care for my mother. Can you assist me in moving my parents back to Wisconsin?
Moving is always stressful, but even more so when moving elderly parents. Senior Planning Group has experience moving parents back to Wisconsin from Florida, Arizona and California. After collecting medical information, we partner with a Geriatric Care Manager in their respective city and ask for an assessment of their care needs, strengths and weaknesses. Our benefit specialist will provide a comprehensive financial statement that ensures it is in alignment with their financial resources. We also review their health insurance policies and legal documents to make sure they are compliant in Wisconsin.
I work full time and cannot always be there when mom needs me. Can you help?
The most effective way to find the elder health care and support that is right for your mother is to have an assessment done by our Geriatric Care Manager who will carefully match your mothers medical, household and social needs with an array of senior care resources as well as other specialty senior service providers. Our Care Managers will monitor the care providers so you have peace of mind that she is being cared for.
I have seen a decline in my father’s health and ability to care for himself since my mother died. Now, every time I go there I see more and more dirt, spoiled food in the refrigerator, and dirty carpets. I am not sure how to help him as he is resistant to my suggestions or for you to visit. Can you help me?
Nothing is more difficult for a family caregiver than an elder loved one who refuses help. This is one of the most common and difficult challenges that adult children face. Professional Geriatric Care Managers are skilled in their approach when visiting your father. First, we listen and ask him if he would like help. We share with him that the family is concerned about his ability to live alone. We quickly reassure him that we work for him and that he is the client. We discuss ways to remain safe in the home with support for as long as he is able to live alone. During the visit, our Care Managers will assess the living conditions, walk through the home and just visit. We usually have a short visit and re-schedule an in-depth assessment the following week. Please review our Care Management assessment section of this web site for more information.