CFP

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Long-Term Care Insurance - Medicaid

Medicaid is a State and Federal Government program that pays for certain health services and nursing home care for older people with low incomes and limited assets. In most states, Medicaid also pays for some long-term care services at home and in the community. Who is eligible and what services are covered vary from state to state. Most often, eligibility is based on your income and personal resources.

"Medicaid Planning" was previously used by some financial planners to help their clients transfer assets to other family members, sheltered investments, etc... in order to give the appearance that the client was financially insolvent. The Balanced Budget Act of 1997 made it a misdemeanor for planners to assist clients in participating in so-called "Medicaid Planning". The Act also contains a provision that allows a 36 to 60 month look-back period for assets transferred for less than fair market value.

Practice Question:
Which of the following statements are correct concerning Medicare and long-term care?

I. Medicare does not pay for "Skilled Care"
II. Medicare covers short-term nursing home care only
III. Medicare pays for up to 120 days
IV. Nursing home admission requires 3 days of prior hospitalization

A. I and II
B. II and III
C. II and IV
D. IV only

Answer: C
Medicare covers only short-term nursing home care in a Medicare-certified nursing facility. The only care Medicare will pay for is "skilled" care, such as ongoing nursing visits. Medicare also requires recipients to have been hospitalized for at least 3 days prior to admission in a nursing home in order to be covered for their skilled care.

Benefit Periods

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