Because individuals are living longer, it’s likely that most will require some form of long-term care (LTC). LTC includes a range of services and support, such as in-home care, care in an assisted living facility, respite care, and skilled nursing care (SNC). The rising cost of care leaves individuals concerned that they’ll be unable to afford necessary care or be required to deplete all their assets for only a few years of care. In North Carolina, the average monthly cost of an assisted living facility is approximately $3,000, while the average monthly cost of SNC is between $8,000 and $12,000. Beyond paying for care out-of-pocket, there are alternative LTC payment options.
LTC insurance is one payment option, which reimburses policyholders a daily amount for LTC services and support in a variety of settings. Many policies have limits on how long or how much they’ll pay. Some policies function as hybrids – they’re available to pay for LTC if needed; however, if the insured dies before utilizing it for LTC, it pays out a death benefit like life insurance.
Another option is State-County Special Assistance, which offers two programs: one for individuals able to remain in-home; and one for those in residential facilities, including adult care homes, family care homes, and group homes. Specific eligibility requirements for this program include income and resource limits.
NC Waiver programs provide funding for support and services to help older individuals or individuals with disabilities continue to live in their homes and communities, rather than in institutional settings. An individual must meet the income and resource limits for these programs, and require SNC, the cost of which must be less in the home or community versus at a facility. Unlike Medicaid, Waiver programs aren’t an entitlement; with limited capacity and funding, there’s a waitlist.
In NC, Medicaid is a common source of LTC funding. Eligibility for Medicaid requires an individual to need SNC and to meet income, resource, and other requirements. Medicaid provides financial protections for the spouse in the community. If eligible, the institutionalized individual uses his income first to pay for care, and Medicaid pays the difference.
Proper elder law planning uses certain techniques to preserve your resources and maintain eligibility for the Special Assistance, Waiver or Medicaid programs. Contact the experienced elder law attorneys at Weaver, Bennett & Bland, P.A. to discuss your specific LTC planning needs.
Crystal L. Welton is an estate planning, estate administration, elder law, and special needs planning attorney at Weaver, Bennett & Bland, P.A. Contact Crystal at Weaver, Bennett & Bland, P.A. at (704) 844-1400. The information contained in this article is general in nature and not to be taken as legal advice, nor to establish an attorney-client relationship between the reader and Crystal L. Welton or the law firm of Weaver, Bennett & Bland, P.A.
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