Mistakes People Make with Virginia Medicaid for Nursing Homes

Virginia Medicaid may be one important way for you to be able to cover the bills associated with nursing home care, but many people have misconceptions about how this program works and how best to understand it.

This means you need to have an experienced and qualified lawyer to guide you through the process of estate planning as well as Medicaid planning. These common mistakes could block you from getting the benefits that you need from Medicaid support, and they include:

  • Giving away assets too early and putting your security at risk.
  • Failing to take advantage of any benefits for the spouse of a nursing home resident.
  • Ignoring safe harbors created by Congress which allow for certain transfers without jeopardizing Medicaid eligibility.
  • Assuming it’s too late to plan for Medicaid.
  • Applying for Medicaid too early, leading to a longer ineligibility period.
  • Applying for Medicaid too late, which could mean losing many months of eligibility.
  • Not understanding how using Medicaid could affect your home since nursing home residents do not automatically have to put their home on the market in order to qualify for Medicaid.

All of these issues highlight the importance of contacting an experienced and qualified Virginia Beach estate planning attorney to help you with the process of understanding the possibility of Medicaid and how best to plan ahead for it should you need to use Medicaid benefits in the future.

If you have a loved one who needs Medicaid benefits, scheduling a time to talk with an elder lawyer is a great first step to help you with that process. Don’t wait to speak with a professional who can guide you through getting support for your legal claim.



Will Virginia Medicaid Will Pay For My Nursing Home?

The decision to place a loved one in a nursing home can be sudden. The person’s condition may have declined to the point that they immediately need nursing home support, or they may have suffered in a recent accident or injury that leaves them no option but to recover inside a nursing home.

In these difficult circumstances, it can be even more challenging to think about the possibility of qualifying for government funded nursing home assistance. This is handled through the Virginia Medicaid program, but it is important to understand the qualification requirements, such as income limits. Nursing homes can be extremely expensive, with the average daily cost of private rooms inside them being nearly $300 in Virginia.

Even though home health care services and assisted living facilities might be slightly more affordable, they are still expensive. Neither Medicare nor most private health insurance companies will cover stays in nursing homes and very few people purchase long term care insurance policies that would help pay for coverage. Medicaid, therefore, is a very common source for paying for long term care, especially when someone has already exhausted their own assets to pay for care.

Across the country, around 70% of nursing home residents use Medicaid to pay for that coverage. Working with an experienced and qualified Virginia Beach Medicaid planning lawyer can assist you with the process of planning ahead for time in a nursing home. Do not hesitate to consult with a qualified lawyer as soon as you can about your future.


U.S. News Names Best Nursing Homes for 2021-2022

If you’re thinking about placing a loved one in a nursing home in the coming months of year, there’s no doubt you want to do some research first. There’s a difficult emotional aspect of this entire process, but there’s also the peace of mind that can come from knowing that you did all the necessary research to select the right place for your family member. U.S. News has release their top list of nursing homes for 2021-2022.

Nursing homes offer a variety of living options and they are not all created equal when it comes to care, cost, and amenities. Knowing how to make the right choice for your elderly family member often comes down to location, services provided, and costs. It can be a shock to some family members to realize that Medicare will not pay for the vast majority of nursing home services needed and that Medicaid does not automatically kick in.

Since most healthcare issues prompting a stay at a nursing home can develop relatively quickly, it’s important for everyone to consider the possibility of long term care and the plans they have set up to help pay for it.

Without advanced planning, it can be difficult to qualify right away for Medicaid support. That way you know that your loved ones can make an informed decision based on factors beyond cost if you have an immediate need for nursing home care. Your family can visit the facility and get a sense of the healthcare support provided as well as the overall experience you might have while living there when you know that you’ve done your advanced work to qualify for Medicaid in Virginia.

If you need help kickstarting this planning process, schedule a time to meet with a Virginia Beach lawyer to discuss your next steps.

What is the PACE Program in Virginia?

PACE stands for the Program of All Inclusive Care for the Elderly. And this movement has gained a lot of momentum in recent months, particularly as it relates to concerns about care for the elderly and protecting them well into their later years in life. At its simplest definition, PACE is an alternative to nursing homes.

This is a Medicaid and Medicare program that helps to keep people in their own communities. In many cases, the programs are run with the support of in-home care providers at a nexus of community-based centers. This helps to complete an interdisciplinary care team for total comprehensive wellness. According to the national PACE Association, approximately 95% of people enrolled in the program live in the community and only 5% live in nursing homes.

Given that it is required to be eligible for nursing home care before enrolling in PACE, this is a substantial thing to take note of if you have a loved one who is in the process of figuring out the best care solution for them.

Most PACE participants are eligible for Medicaid and Medicare. The operators of these programs will receive specific monthly payments for each participant, meaning that some of it is paid by the payer and some is paid by the provider. COVID-19 played a significant role in increasing attention towards the PACE program. The general death rate in nursing homes across most of the pandemic was 11.8%, where it was only 3.8% in PACE locations.

If you have questions about qualifying for PACE in Virginia or discussing alternative care arrangements, schedule a consultation with an estate planning lawyer in your area to learn more.



What is Medicaid Expansion in Virginia?

Virginia undertook a program called Medicaid Expansion that now provides access to more residents than ever. Medicaid is a crucial program for low income residents, many of whom would not be able to afford things like nursing home care without support. But there are many misconceptions around how to get Medicaid coverage and support in Virginia.

Misunderstanding even just one of these could derail your long term care plans. When you need Medicaid coverage the most, you need to be prepared by understanding the qualification process. That’s where the support of a Virginia Beach VA Medicaid planning lawyer can make a big difference in giving you peace of mind. A 2018 budget bill called for the expansion of the program in Virginia, which now allows people earning up to 138 percent of the poverty level to tap into Medicaid benefits.

As a result of the expansion program, legislators expected a further 400,000 people to become eligible for benefits. But when COVID hit, that number was exceeded. Many people have been affected financially and have also needed recovery care if they were diagnosed with COVID.

Right now, Virginia allows the following groups to apply for and receive Medicaid:

  • Low income elderly residents
  • Disabled residents
  • Pregnant women with households at a maximum of 143 percent of the poverty level
  • Adults under age 65 with income under the 138 percent poverty level
  • Children under 18 where their households earn no more than 138 percent of the poverty level

When planning for the possibility of a nursing home stay in the future, you can’t afford to miscalculate. You need the support of an experienced Virginia Beach Medicaid lawyer to discuss a spenddown strategy that could protect a healthy spouse if you were to need a nursing home stay. Call today to set up a consultation.



When Does Medicaid Pay for My Virginia Nursing Home?

Does your loved one need to stay in a nursing home due to advanced medical care needs? This might raise a lot of questions from a financial perspective as you and other family members scramble to figure out what to do next.

Not every person in Virginia is automatically qualified for Medicaid so the sudden need for long term care or a stay in a nursing home can present significant financial challenges for you and your loved ones. Virginia’s Medicaid program provides payment for nursing home stays for those without appropriate assets or income and when those same people have been diagnosed for needing assistance with activities of daily living.

Since the cost of long-term care and stays in a nursing home are extensive, Virginia Medicaid is something that must be applied for by an applicant in order to receive payment from the government for these important services. Many people make the mistake of thinking that their private health insurance policy or Medicare will cover these stays. Medicaid is a common source of funding for long term care in Virginia, particularly when other assets have already been used up or sold to pay for long term care expenses.

Nearly 70% of residents inside nursing homes around the country use Medicaid to pay for their care. There’s no doubt that you will have many different questions about qualifying for Medicaid and how this financially impacts your spouse and other family members. Schedule a consultation with a Virginia Beach estate planning lawyer to discuss the specifics of your plan.



What Is Medicaid Spend Down in Virginia?

If you are trying to help a loved one apply for Medicaid in Virginia, you’ll discover many different terms and phrases related to this process. One of them is Medicaid spend down.

The term Medicaid spend down refers to families and individuals who would otherwise meet all of the necessary resource eligibility and non-financial requirements to get Medicaid in Virginia, but who have countable income that exceeds the needy income limit for their county or city of residence. It is helpful to think of a spend down as an insurance policy deductible.

For these purposes, you can insert spend down liability in place of the idea of a deductible. Your spend down period could cover you from anywhere from one to as long as six months. After a family or individual owes the amount or incurs the amount of spend down, they can become eligible for Virginia Medicaid services from the date they met the spend down.

If a person who has applied for Medicaid assistance in Virginia has been evaluated but full coverage is denied due to excess income, notification of the denial will be provided to the applicant. Resources will then need to be evaluated with the assistance of a Virginia Medicaid attorney to determine if the family or individual’s countable resources are below the maximum resource limit for their household.

If your countable resources are under the resource limit for your household, you could be considered eligible for a spend down, upon which you will be sent a notice of action regarding the spend down liability amount. These aspects can be confusing for you and your loved ones but having the support of a Virginia Beach Medicaid assistance lawyer can go a long way in answering your questions.



Understanding Virginia’s PACE Program

Seniors in the Commonwealth of Virginia may need support in the form of a health plan. The PACE Program, also known as the Program of All Inclusive Care for the Elderly, allows seniors to have a total health care solution that is separate from a nursing home.

This is especially popular with people who wish to age in place or stay at home and in their own community. Independence is one of the most important aspects for many aging seniors and PACE centers in Virginia allow these participants to still receive the medical care they need but live independently.

A team of doctors, personal care aides, nurses, social workers and rehabilitation therapists can provide coordinated care for each individual PACE participant. Only certain people are eligible to leverage Virginia PACE benefits. First of all, you must live in a PACE service area.

You must also be age 55 or above, able to live safely in the community with the support of PACE, not requiring any outside involvement and be approved for nursing facility care level through the state of Virginia assessment.

A variety of services are offered through this program, including social services, prescription coverage, transportation, speech therapy, physical therapy, meals, activities, and day centers.

Whether you’re looking to prepare for your own future or trying to help a loved one qualify for Medicaid, you’re not in this alone. The support of an estate planning attorney can be extremely helpful during this time.

For more information about planning for Medicaid in Virginia and how to determine the most appropriate estate plan for you, a consultation with a Virginia Beach estate planning lawyer should be your next step.



How Does Virginia Medicaid Evaluate Senior Applicants?

Every state has the responsibility of determining what parameters will allow a person to receive Medicaid payments. Since Medicaid is a government program designed to provide parties who have no other method of paying for their care, it is important to plan ahead with the support of a Virginia Medicaid lawyer.

Simply retitling or transferring all of your assets in the weeks or months before you apply for Medicaid may subject you to a penalty. It is far better to have a long term plan that considers the costs of long term care and your options to reach it. In 2021 the monthly income limit in Virginia is $2,382 for Medicaid home care benefits. There is no set income limit for nursing home care.

The asset limit is $2,000 but this does exclude the applicant’s interest in certain personal effects, household furnishings, a vehicle and equity in the home up to $603,000. Just having asset limits or income above this level does not mean that a person cannot qualify. There are numerous methods to shelter and protect assets and allow a senior to become eligible for Medicaid home care or nursing home care.

As you can see, there are many different complex facets of qualifying for Medicaid, and it is imperative to have the support of a qualified elder law attorney to guide you through. The cost of a nursing home in Virginia can range from $7,500 a month to nearly $12,000 per month. In the Virginia Beach, Norfolk and Newport area, the average cost for nursing home expenses is between $265 to $385 per day.

This could decimate your retirement savings and leave your without the money they need to take care of themselves. Don’t hesitate and don’t wait until a crisis occurs. Schedule a consultation with a Virginia Beach Medicaid planning lawyer.        


Do You Need Medicaid in Virginia for Your Long-Term Care?

At least 50% of healthy Americans above age 65 will need some form of long-term care in the future. This can come in the form of home care, assisted living or nursing home care. This kind of care might be necessary but regardless of the setting it can be very cost prohibitive.

There are five primary ways that you may be able to afford long term care in Virginia. These include:

  • Private pay; in which you write the provider a check directly from your own accounts.
  • Long term care insurance; which requires an active policy with regular premium payments. Only around 8% of Americans have bought LTC insurance.
  • Veterans’ Administration benefits, but these VA programs pays for less than 1% of all long term care services in the US.
  • Medicare; which is a common misconception since most people assume that Medicare would pick up the tab for long term care assistance. Medicare only pays for extremely limited benefits, such as a certain number of days in a nursing home if the person is receiving skilled care.
  • Medicaid; a low-income form of benefits payments that is responsible for more than half of all long term care expenses in the United States.

The Medicaid program is administered at the state level. The primary aspects for Virginia Medicaid eligibility include Virginia residency, membership in a covered group, medical and functional criteria, resource eligibility rules, asset transfer rules, and income eligibility rules.

To learn more about these complex aspects, schedule a consultation with an experienced Virginia elder lawyer today. Planning in advance and thinking through these options before a crisis situation emerges makes it easier for you and your loved ones.