Home and Community Care: Offers much-needed peace of mind for family members concerned about leaving their loved one alone

by Procino-Wells & Woodland, LLC

May is National Elder Law Month!

Medicaid Planning: Home-Based & Community Services

By: Michele Procino-Wells, Esquire

Maintaining one’s independence and personal autonomy is one of the most foundational principles of freedom. However, living with a debilitating illness or disability can place great limitations on these personal freedoms, which in turn has caused many to experience depression, anxiety, and withdraw.

Historically, recipients of Medicaid long term care benefits who were diagnosed with a condition like dementia (even if mild) or other cognitive disorders were automatically institutionalized in a long-term care facility, even if their needs did not yet require round-the-clock supervision and monitoring. Seeing this as a problem, the Medicaid guidelines were amended in 1981 to allow for the inclusion of home-based and community services within the breadth of coverage – thereby preserving an individual’s comfort and integrity by allowing for in-home nursing care or adult day services.

In Delaware, individuals who are elderly or disabled may be eligible for coverage for any of the following home-based or community services:

  • Adult day services
  • Alzheimer’s day services & family respite
  • Assisted living
  • Assistive devices
  • Attendant services in the home
  • Congregate meals
  • Case management
  • Emergency response
  • Personal care

Qualifying for Medicaid coverage of home-based and community services

Home and/or community care can offer much-needed peace of mind for family members concerned about leaving their loved one alone – even for a brief period of time. For a spouse accompanying his or her companion through the throes of dementia, adult day services or in-home caregivers can become a vital component to the overall wellness of the entire family unit. Oftentimes, a primary caregiver is required to forego employment, social activities, and most hobbies in order to engage in round-the-clock monitoring of their spouse.

Many families put off receiving help with the care of an ill loved one because they mistakenly believe their only option is nursing home care or that home care would be too expensive for them.  However, with appropriate planning many families can qualify for home based services paid for entirely by Medicaid.  This planning may involve converting some of the Medicaid applicant’s assets to income or strategically spending down some assets but generally a single person can usually shelter at least 50% of their assets and a married person can usually shelter at least 80% of their assets.

Medicaid planning strategies may include purchasing irrevocable funeral arrangements, paying for home improvements, paying off debt, entering into Caregiver Agreements with family members, gifting assets and purchasing certain types of annuities authorized by Medicaid.  All such strategies are permitted by state and federal law and are all fully disclosed to the Medicaid office upon application for benefits.  It is critical though that these strategies be part of a comprehensive asset protection plan created by an elder law attorney who specializes in long term care asset protection planning.

If you are facing a difficult situation with a loved one who could benefit from a home or community based service provider, contact Procino-Wells & Woodland, LLC by calling 302-628-4140.

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