The average length of stay in a long-term care facility in Kentucky is 3.8 years. At today’s average cost, that will result in $84,000 a year, or $322,000 per person. And if you are married, that number doubles to $644,000. Who can afford that? If you can, chances are that you would then die penniless.

Government benefits such as Medicaid and Medicare can help offset medical and long-term care costs. But the requirements to qualify are strict, and you may be unable to access those benefits if you own significant assets.

You need Medicaid and Medicare planning to help you get the quality of care you deserve as a senior citizen. This sensitive process would allow you to reorganize your assets to help you remain eligible for the above government benefits.

The process could be complex because there are a lot of laws and regulations to consider. Offending the laws could jeopardize the outcome and lead to legal penalties for you. Hence, it would be wise to consult with a lawyer whose practice focuses on addressing legal concerns for older adults like you.

Elder Law Guidance (The Elder Law Practice of Scott E. Collins, PLLC) offers professional Medicare and Medicaid planning guidance tailored to Kentucky’s regulations and federal law requirements. We can assist you as you reorganize your estate to ensure you get the quality long-term care you deserve without losing your assets.

Below, we explain the basics of Medicaid and Medicare planning in Kentucky to help you understand the process and how it benefits you. We are available to answer any questions you might have afterward. But for now, please keep reading to learn more.

Understanding Medicaid & Medicare

Medicaid and Medicare are two crucial government benefits for senior citizens. One is often mistaken for the other, but they are different. Understanding how each works, what it covers, and what you need is crucial for proper planning, hence the brief explanations below.

What Is Medicare?

 Medicare is a federal health insurance program designed for seniors aged 65 and older and certain younger individuals with disabilities or who require dialysis to address the high medical costs they have to bear in comparison to the rest of the population.

The program has different parts which cover a wide range of health and family services, including

• Inpatient hospital stays
• Hospice care
• Some home healthcare
• Prescription drugs (including many recommended shots or vaccines)
• Outpatient care
• Medical supplies.

Medicare beneficiaries can access these services at a fraction of the actual cost or no cost at all, depending on the type of care required and whether they or their spouse have paid Medicare taxes for at least ten years. That is why access to medicare benefits is crucial to long-term care, as it helps to avoid or minimize out-of-pocket costs.

What Are the Eligibility Requirements for Medicaid in Kentucky?

To qualify for Kentucky Medicaid, residents must meet specific eligibility requirements based on income, age, disability, and family size. Medicaid benefits cover low-income individuals, older adults, pregnant women, and people with disabilities.

Medicaid services include health insurance for children, long-term care, and prescription drugs. Kentucky Medicaid is a federal program managed by the Kentucky Department of Health and Family Services.

For comprehensive health care, both Medicaid and Medicare planning in Kentucky are essential. Medicare beneficiaries may also consider Medicare Advantage plans or Medigap plans to reduce out-of-pocket costs. Contact a licensed insurance agent for more information on eligibility and enrollment.

What Is Medicaid?

Medicaid is a joint state and federal program that provides healthcare coverage to certain low-income earning individuals, including

• Senior citizens
• Pregnant women
• Children
• Individuals with disabilities.

The program generally offers benefits not covered by Medicare, such as nursing home care. The federal government has general regulations that govern the program. However, each state runs its individual Medicaid program, which means that the Medicaid services/ benefits and eligibility requirements may differ in each state.

For example, Medicaid coverage is only available to Kentucky residents who fall within the above categories, need medical assistance, and have an annual household income below the approved state limit. For a single-person household, the limit is $19,392. It increases depending on the family size.

This financial cap is why many people needing help with their medical expenses fail to qualify as Medicaid beneficiaries. If your income exceeds the maximum, you’ll have to use your own money to pay for long-term care before you can receive the benefits you paid into.

You may think, “If I have too many assets to qualify, I’ll just start giving money away to loved ones so that I can qualify.” Please don’t make that mistake. It’s far more complicated than that, and that approach could leave you huge penalties, and you would still not qualify. That’s why proper planning is required. We can help you develop strategies that will allow you to keep your money without sacrificing your benefits.

Can You Qualify for Both Medicare and Medicaid Benefits?

It is possible to be eligible for both Medicaid and Medicare. People who qualify for both programs are known as dual eligibles and usually do not have to pay any out-of-pocket costs for their healthcare since their medical needs are covered by both programs.

If you are over 65, the major impediment to dual qualification is likely your income level or resources (if they are significant. With proper Medicaid and Medicare planning, it might be possible to meet both requirements, which would allow you to get the maximum benefits possible.

One of the key things to remember is that you’ve already paid into Medicare for the duration of your entire career through your payroll deductions. As a taxpayer, a good chunk of your taxes has possibly gone to Medicaid as well. Therefore, these benefits are things you’ve earned, not something you are taking from others.

The Medicaid and Medicare Planning Process

Paying for Long-Term Care with Medicaid and Medicare safeguards your hard-won assets from depletion due to associated healthcare costs.

The planning process enables you to proactively address potential eligibility issues for either program (especially Medicaid) so you can access their benefits whenever needed. 

Some common strategies to achieve this goal include shielding your assets from Medicaid eligibility assessment by creating special irrevocable trusts or Medicaid-compliant annuities. There are also spousal protections in Kentucky that help to ensure that people who need to be admitted to a nursing home for long-term care can access Medicaid even though they have significant resources. This allows the spouse left to be protected from hardship that could come from losing their home or other assets.

In this area of planning, every aspect of your unique situation and the applicable laws must be considered, as that would determine the specific strategy to be adopted.

One mistake can cost thousands of dollars, time, and trouble to repair. Relying on outdated information from the internet or a general practice attorney who does not focus on this unique area of law can cost you the farm, literally!

How Elder Law Guidance Can Help

At our law firm, we know you worked hard over the years to maintain a standard quality of life and provide a softer, better-starting place for your children and grandchildren. You can achieve this dream by planning for your future healthcare costs to preserve everything you have worked for.

Our dedicated and understanding elder law attorneys can help you create a balance to protect your assets to the maximum extent possible while remaining eligible for government healthcare benefits.

 Some of the ways we can help include:

• Thoroughly explaining Medicaid and Medicare benefits and requirements and answering crucial questions such as “What are the Medicare Parts?” to help you understand your rights
• Developing a strategy to protect your assets
• Gathering any required documentation
• Exploring long-term care options
• Preparing for unforeseen events that could de-rail future coverage.

We hope to help bring you peace of mind and certainty about your future through our comprehensive Medicare and Medicaid planning services. Do not hesitate to contact us to get started.

Safeguard Your Future With Help From Elder Law Guidance

Medicaid and Medicare can help you get quality medical treatment when you need long-term care. But, without proper planning, you could lose your right to access crucial health coverage under each program, leading to expensive medical expenses for long-term care in the future.

Of course, the best time to plan for long-term care is long before you suspect you’ll need it. Still, it’s better late than never. Our team at Elder Law Guidance is here to help at any point to safeguard your assets, preserve your legacy, and help you get quality medical care with minimal costs.

Your initial consultation is free, so do not hesitate to contact us and schedule an appointment to start planning today.