U.S. Department of Labor statistics show that the number of women over 65 in the workforce has increased by 40 percent since 1980. By 2020, older adults will make up more than 25 percent of the U.S. labor force.
The rate of people who continue working after they are 65 is 29.9 percent of the 65-69 age group in the United States as compared with 10.5 percent in Europe.
More employers are recognizing the value of seniors in the workforce. There are multiple programs that can help seniors obtain the technological skills that are mandatory in today’s workforce.
Accessing government benefits quickly can be important for elders. Medicare, Medicaid, and long-term care programs are important.
What Is Medicare:
Medicare is the national health insurance program for the elderly. It consists of:
- A required contributory hospital insurance program (Part A)
- A voluntary program that covers physician services (Part B).
- A voluntary outpatient prescription drug benefit (Part D), administered exclusively by insurance companies.
- There is no long-term care, except in limited circumstances.
Medicare and Home Care
For the most part Medicare shifts long-term care to Medicaid, however, some benefits are covered for home care and long terms care, though they are very limited.
Medicare home care occurs where skilled nursing care is require when the beneficiary is homebound.
Rehab in Skilled Nursing Facility: Medicare covers the first 100 days of rehabilitation in a skilled nursing facility after a three-day hospital stay.
Co-Payment after 20 Days: Co-payments after 20 days of care are paid by Medicare. A Medicare Supplement, or Medigap, policy will cover the co-payments for the twenty day void in payment care by Medicare.
Adult children of aging parents should not confuse Medigap with Medicare Advantage plans (Part C).
Private Insurance Medicare Advantage
Private Insurance Medicare Advantage plans provide an alternative to the traditional federal government program.
Medicaid and Long-term Care
Medicaid is the state-federal health insurance program for the poor. Long-term care costs are covered by Medicaid and not Medicare. A single individual can have only $2,000 in countable resources to qualify for Medicaid nursing home benefits; however, certain resources are excluded, including a home and one car.
The income limit for Medicaid eligibility is $2,130 per month in Social Security, pension, and other income. If income exceeds the limit, the elderly person can create a Miller Trust, or Qualified Income Trust (QIT), to obtain eligibility.
Over 60 percent of nursing home residents are covered by Medicaid, according to “Medicaid: A Primer 2013” by the Kaiser Family Foundation.
In order to have Medicaid cover the expense of a nursing home 24-hour nursing care must be necessary. There is a waiting time of 30 days to qualify to enter a Medicaid facility.
After a stroke or injury a senior may be discharged to a nursing facility for rehabilitation under Medicare where 100 days of benefits are provided.
Each month, the person’s income is deposited in the QIT and the trustee writes certain checks in accordance with Medicaid rules. In many cases, most income deposited in the QIT is paid to the nursing home as a monthly copayment. Any funds remaining in the trust account when the recipient dies are paid to the State of Texas.
Countable resources, such as savings, investments, retirement accounts and real property, cannot be protected in a QIT. For married couples in which one spouse applies for Medicaid nursing home care and the other spouse remains at home, federal spousal impoverishment protections apply.
The “community spouse” can keep one-half of the couple’s countable resources up to $115,920, with a floor of $23,184. If, however, the couple’s combined income is below $2,898, the community spouse may be allowed to keep an expanded “protected resource amount,” up to the total value of the couple’s countable resources.
Elder Law in McKinney Texas
An elder law attorney can provide advice on whether resources exceed the limit and advise on strategies for preserving assets, such as purchasing excluded property, converting assets to income for the community spouse, creating a college education fund for a grandchild, utilizing a testamentary trust for a spouse, or gifting property to a special needs trust for the benefit of a recipient of Supplemental Security Income or Social Security Disability.
Five Year Look Back Period for Medicaid
Medicaid in most circumstances penalizes an applicant who has gifted property during the five year look-back period before applying. The penalty is a period of ineligibility for nursing-home coverage that begins when the applicant has entered a facility and is otherwise eligible for benefits. That period of ineligibility continues for a number of days, calculated by dividing the value of the property transferred by $156.34.
Elder Law In McKinney Enhanced Life Deed Estate
An enhanced life-estate deed will allow the family to avoid probate before applying.
Although the program does not count a beneficiary’s home as a resource, the beneficiary may lose the home to the Medicaid Estate Recovery Program (MERP). MERP can file a claim against a deceased recipient’s probate estate to recover the cost of benefits provided.