October 27, 2025 • 43 mins
Listen in as host Steve Kuker, President of Senior Care Consulting, has a thorough review of Medicaid including what it is, how to qualify for it, what it pays for, some limitations, and how to use State-specific regulations to your advantage. IF there is a possibility you could run out of assets and need senior care, THIS very informative program is for you! #SeniorCare #SeniorCareLive #SeniorCareConsulting #SeniorLiving #KansasCitySeniorCare #SeniorCarePlacement #SeniorCareAdvisor #Franchise #SeniorCareFranchise (800) 331-6445
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:01):
Are you caring for an aging loved one? Are you
a senior searching for answers? Welcome to Senior Care Live,
a program dedicated to you, providing information, education and resources
for seniors and their caregivers. And now America's Senior care consultant,
Steve Kecker.
Speaker 2 (00:23):
Hello, and welcome to Senior Care Live. I'm Steve Keeker,
your senior care consultant, and I really appreciate you tuning
in today. This might be a little bit of a
fire hose type of a program because I'm going to
cover a lot of information and we're going to kick
it off with something called Medicaid. I think most people
(00:44):
have heard of Medicaid. I like to just say that
Medicaid is that safety net that says, if you have
outlived your assets, which by the way, is kind of
easy to do these days, if you've outlived your assets
and you need care in a senior care community, the
(01:05):
Medicaid program will pay for the majority of that cost.
All right. The Medicaid program will pay for a lot
of other things as well, But for the purposes of
this overview and discussion, we're going to focus on Medicaid
paying for your stay in a long term care, and
(01:25):
I'm going to talk about what is it, what does
it pay for, how do you qualify for it, and
then maybe review some limitations. And that's a lot. So
let's jump in here. So what is medicaid. Let me
just start off by say, don't confuse that with medicare.
A lot of people will interchange. Oh, that is that
(01:47):
medicare thing or that medicaid or no, no, those are
two separate things. So medicaid is financial assistance for healthcare
and prescription call. It is a federal program, so it's
offered through the federal government, but it is administered by
(02:11):
the state. That's a really key key point there because
each state could have slightly different rules, and depending on
what state you live in and what you're needing, you
may be able to use some of those rules in
(02:32):
your favor. I'll give you an example of that here
in a little bit. And again, do not confuse Medicare
and medicaid. These are not interchangeable. Again, I've already just
briefly touched on what medicaid is. Medicare is your health insurance.
That's just as simple as that Medicare is your health insurance.
(02:55):
It'll pay for your major medical your hospital stays, and
then your part B is going to pay for a
lot all the other things like your doctor's office visits
and MRIs and X rays and labs and maybe some
equipment it supplies that sort of thing. So medicare is
your health insurance, not the same, okay, And then you
(03:18):
have to meet certain income and asset criteria. So let's
take one step further, and again we're talking about medicaid
for the purpose of depending on Medicaid to help us
pay for our stay in a long term care community
(03:38):
and for a shared room. Just as a reminder, in
long term care community, the average is a solid This
is a shared room, the semi private room. You have
a roommate. Okay, that's what medicaid will pay for. And
we're talking, you know, nine to ten thousand dollars or
(03:58):
so every month, So it does pay out a lot
for this. So taking that next step, how does medicaid work.
First of all, let's keep it simple or a little
more simple, and let's look at a single person, an
individual person. So you're not a married couple. So if
(04:23):
you're not a married couple with a spouse and a spouse,
and you're on your own, whether your spouse has passed away,
or whether you're divorced or you've never married, you're for
Medicaid purposes, you're considered a single person. So this is
very simply an asset test. And so you have to
(04:45):
divide your assets into a couple of different categories. So
an exempt asset meaning it's off the table for now,
maybe forever. An exempt asset is your house. Well, way
do you missed, Eve? Don't you have to like sign
(05:07):
the deed over to the nursing home. No, And if
I've heard that so many times, if I had a
nickel for every time I've heard, oh, Steve, we can't
move down in there until we signed the deed of
our house over to the nursing home. They want his
nursing they want his house before they'll they'll take Medicaid. No,
they don't. It doesn't work that way. If I didn't
nickel every time I heard that, I'd have a big
(05:29):
pile of nickels. I wouldn't be ready, quite ready to
retire yet, but I have, I'd have a whole pile
of nickels. So your house is considered an exempt asset.
And then here's the caveat for now, So your house
is exempt. One vehicle is considered an exempt asset. One vehicle,
(05:53):
a prepaid funeral plan. Prepaid funeral plan, by the way,
that's a really smart thing to do. Just get it
out of the way. Do your family a huge favor,
have that all set up and all paid for so
they don't have to stress about all of that while
they're mourning the loss of you. Do your family a
(06:15):
favor and get that done. And there's some financial advantages
of that too. So an exempt asset your house for now,
one vehicle, a prepaid funeral plan, a small amount of
cash value, and a life insurance policy up to fifteen
hundred dollars, so not not much a little bit, and
(06:37):
I'm not talking about the face value or the death benefit.
I'm talking about if it's a cash value life insurance
policy that has a little bit of a savings on
the side, you can keep up to fifteen hundred dollars
of that. And then all the stuff in your house,
your household goods, all of those things are considered exempt assets.
(07:00):
On the other side of the ledgers, so to speak,
you have your countable assets, and that's it's almost everything
else and I like to say, think liquid assets, so
countable assets. I'll explain this in a second. Checking savings
(07:20):
money market mutual fund CDs in certain states four oh
one k's iras, actually in all states four oh one
k's and iras. I just skipped ahead mentally. We'll get
there when we're talking about a couple. Okay, checking savings
money market mutual fund CDs four o one k's, iras, annuities,
(07:47):
think liquid assets. Those are your countable assets. So now
we've taken that next step and we say, okay, we
look at everything. This is the exempt asset list, this
is the countable asset lists. So now what do you do?
So then we have to look at the countable asset
list again, the liquid assets, and we have to spend
(08:12):
down those assets. So if you ever hear the term,
if you're anywhere close to working with medicaid or just
exploring that learning about it, if you hear the term
spend down, spend down, that's what that means. You have
X dollars of liquid assets, countable assets, and you're going
(08:34):
to spend down the assets to the trigger point. So
this program is broadcast from the Kansas City metropolitan area.
So we have two different numbers in our area. Remember
it's a federal program, but it's administered state by state,
(08:55):
and the states could have slightly different numbers, slightly different
rules and so forth. So in the state of Missouri,
you would spend down the assets to five thousand, nine
hundred and nine dollars, so you're almost broke. Okay, once
(09:16):
you spend down those liquid assets, the accountable assets down
to fifive I was gonna say, fifty nine on nine,
nine hundred nine dollars in the state of Missouri. Boom,
you're in. That's it. This is a simple asset test,
is how I like to describe that. In the state
of Kansas, you have to spend down your liquid assets
(09:39):
to two thousand dollars. Two thousand dollars in the state
of Kansas, and again you're almost broke. And at that
point you have outlived your assets, and then the Medicaid
program will come in and pay for the majority of
the cost of your stay in the long term care community.
(10:03):
And I have a whole lot more I'm gonna get
into coming up next. But look, with my firm, with
Senior Care Consulting, we go through all of this in detail.
Every single time we work with our clients. If you're
interested in looking at this interested in discussing our services,
it's nine one, three, five, twenty eight hundred or online
(10:26):
at Seniorcare Consulting dot com. And now the Senior Care
Live Question of the Week. Medicaid considers your income as
a factor when qualifying from Medicaid to pay for long
term care? Does that stay a true or false? What
do you think?
Speaker 1 (10:43):
You're listening to Senior Care Live on the Senior Care
Broadcasting Network. For more information, visit seniorcare Live dot com.
We'll have more with Steve coming up next.
Speaker 2 (11:05):
Welcome back. You're listening to Senior Care Live on the
Senior Care Broadcasting Network. For more information, go to Senior
care Live dot com. All right, back to the Senior
Care Live Question of the Week. Medicaid considers your income
as a factor when qualifying for Medicaid to pay for
(11:28):
long term care? Is that statement true or false? And
the answer is.
Speaker 3 (11:38):
True?
Speaker 2 (11:39):
Oh wait a minute, Steve, you just said it's an
asset test. Okay, so it's a little bit of a
trick question. So it is ninety nine percent of an
asset test. Actually, it is an asset test, but they
also look at your income. Your income is rare, rarely
(12:00):
a factor, rarely, rarely a factor when qualifying for long
term care. So here's an example. So let's say that
a long term care community charges Let's use you some
nice round little numbers here. They charge ten thousand dollars
a month for their long term care community, and that
(12:26):
would be a shared room, a semi private room, one
bed in a rooms you have a roommate. That's what
Medicaid will pay for. So let's say they charged ten
thousand dollars. If the long term care community is Medicaid certified,
(12:46):
and let's say that they accept from Medicaid nine thousand
dollars per month as their payment in full, they say, okay, yeah,
if anyone comes in on Medicaid, we agreed to bill
medicare Aid. We will accept nine thousand dollars as our
payment in full. We'll write off the other thousand. Okay,
So their Medicaid reimbursement rate to that particular community is
(13:12):
nine thousand dollars per month. If your income is over
nine thousand dollars per month, then you can pay for
your own care. You don't need MEDICAIDS help. But how
many people do you know trying to qualify for long
(13:37):
term care and have it paid for by medicaid? How
many of those folks do you know that have over
a nine thousand dollars per month income? And I would
say very very very very few, very few. Now, I've
had a few clients over the year, and let's say
(13:59):
they had a large military pension, they had a high
Social Security pension every every month, social Security payment income
every month, and uh and and and it. It was
a pretty high number. And I've had just a very few,
like I could count them on one hand over all
(14:20):
these years. And I thought, you know what, that's that's
getting pretty close. So I had to actually go to
the places that I was considering as part of our
top or list of our top options, and then I
calculated their Medicaid reimbursement rate and I made sure that
his income was under what they're paid by Medicaid, and
(14:44):
he was just under a couple of them and pretty
far under another one. And so it all worked out.
But it is a factor, although it's usually not much
of a factor, it's very rare, all right. So so
let's jump back into medicaid, how it works, what it
(15:04):
pays for all the things. So we just talked about
a person with and let's just say this person has
fifty thousand dollars accountable assets, liquid assets, checking saving money
market mutual fund CD four one KIRA, all the stuff.
Then he spends that down to nine hundred dollars in
(15:27):
Missouri or two thousand dollars in Kansas. And let me
say most of the states around the country are very
similar numbers to this. And once you spend that down,
then boom you qualify. Most of the clients that I
work with through Senior Care consulting, their income is fifteen
hundred dollars a month, two thousand dollars a month. I'm
(15:49):
working with someone right now. They do have a military
pension and a solid Holt Security number. Their income is
about five to six thousand dollars a month. But all
of those numbers are less than the Medicaid reimbursement to
these facilities, and so we're in good shape there, all right,
that is exactly how it works for a single person. Well, Steve,
(16:15):
what about a married couple. My husband and I were
together and we have joint income, joint assets, all of
that stuff. So what you would do in the case
of a married couple is you would again the exempt assets.
(16:36):
They're the same, Okay, your house for now, one vehicle,
prepaid funeral plan, up to fifteen hundred dollars of cash
value to a small life insurance policy. And all the
stuff in your house, all the liquid assets, checking savings,
(16:56):
money market mutual fund, CDs for O one ksras, annuities,
all the stuff. Add them up, and then you would
do what's called a division of assets. Now let me
stop right here just for a second. Do not do
this on your own period. You're gonna screw it up.
I'm just telling you this is a little too complex,
(17:18):
and you don't want to mess this up. Okay. And
most individuals in these long term care communities, most of them,
I would say, they're more than willing to help an
individual file the medicaid application on a simple spend down.
The vast majority that I've ever worked with, they don't
(17:41):
want anything to do with this division of assets. It
gets too complicated. And if you make a mistake, first
of all, you could screw up the medicaid application and
maybe that individual wouldn't qualify, or you might leave a
lot of money on the table that could have gone
to the Unity spouse. So work with a qualified, very
(18:07):
experienced elder law attorney. Well, Steve, I don't know if
I want to pay money for that elder law attorney.
It's some of the best money that you're ever going
to spend. Ever. Go to NALA dot org n a
e LA dot org National Academy of Elder Law Attorneys
(18:32):
n A e LA dot org. You can type in
your city or your zip code and it'll do a
search out so many miles. You have some variables there
you can set and you'll get a list of elder
law attorneys in your area, and that's where you can
begin your research. Strut your research there. Make sure they
(18:55):
practice one hundred percent elder law. You have a lot
of of law firms saying, oh, hey, everybody's getting old
and we need to jump on the train, and okay,
hey look at us, we do elder law too, And
they may do okay with that, But I personally would
go with an elder law firm that that is their specialty,
(19:16):
and it's so specialized that many times a lot of
other attorneys will refer their clients to an elder law specialist.
Na ELA dot org. Find your attorney to help you
with this division of assets, and coming up next, I
will continue to discuss all of the details that are
(19:38):
involved in the Medicaid division of assets.
Speaker 1 (19:42):
You're listening to Senior Care Live on the Senior Care
Broadcasting Network. Have a question, this is Seniorcare Live dot Com.
Stick around. We'll have more with Steve coming up next.
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Speaker 2 (21:06):
Welcome back. You're listening to Senior Care Live on the
Senior Care Broadcasting Network. For podcasts to the program, visit
Seniorcare Live dot com or wherever you get your podcasts.
All right, So we're talking about medicaid today, what it is,
how it works, how you qualify, what does it pay for?
(21:27):
All of the stuff. And I started to get into
what if what happens if you have a married couple
and you know before before there is a legal opportunity
to do what's called the division of assets, where you're
dividing assets on paper. Guess what people used to do. Well,
(21:51):
if I'm going into the nursing home, then all of
all of our money is going to be gone because
the nursing home is so expensive. Honey, let's get a divorce,
just on paper. But let's get a divorce. I'll give
you as much as I can so that at least
(22:11):
you have something to live on and you have somewhere
to stay. Now, in the United States of America, people
getting divorced to pay for medical care and long term care.
How horrible is that? So Congress agreed with that statement
and said, wait a minute, why can't we just do
(22:32):
divide assets on paper? Don't get divorced. We'll just do
this division of assets on paper. So let's say, and
again go to an elder law attorney to do this properly.
Let's say a couple has just make up nice round
(22:53):
little numbers here, two hundred thousand dollars in liquid assets,
checking savings, money market mutual funds, four O one k's, iras, annuities,
all the things they have two hundred thousand dollars. So
let's put one hundred thousand dollars on his side, one
(23:13):
hundred thousand dollars on her site. Boom, on paper, we
protected half of the liquid assets for her. She is
the community spouse, she does not need care, she's perfectly healthy,
(23:35):
and she still lives in the house. There's still taxes
due home insurance, homeowners insurance coverage. The water heater still
breaks down, we have electric bills, gas bills, all the
costs of living independently. Personal property tax in many states
(23:58):
cost a lot to live. So at least we've protected
half of the assets for her the community spouse. In
this example, he goes to the nursing home and in
this example he takes one hundred he has one hundred
thousand dollars, and he's going to spend that down to
(24:21):
at least in my area, nine hundred and nine dollars
in Missouri, two thousand dollars in the state of Kansas,
and again all the other states in the country they're
very similar. So the question is, well, what can you
use that money to pay for? And you can obviously
(24:43):
pay for your care. It's going to go out at
the rate of nine to ten thousand dollars a month
for a shared room in long term care. You can
pay off some of your debts. Let's say you've got
you know, eight thousand on a visa over here, and
another four thousand on a master card over there, and
we have a small home equity loan because we had
a new roof put on and a new HVAC system
(25:06):
installed there as twenty thousand dollars. You can pay off
some of your debts, your joint debts from his side
of the ledger, so to speak. You can make some
home improvements. Again, the house is an exempt asset. She
needs somewhere to live, so it's an exempt asset for now.
(25:29):
So maybe you use some of that money to maybe
put in some new carpet, maybe make a few home improvements,
invest into the house. Here's one that I'm just adamant about.
Take some of his money that when it's gone, when
it's down to fifty nine oh nine or two thousand
(25:50):
dollars or whatever the number is in your state, Medicaid
will start paying for the majority of the cost of
his stay in long term care. So while you have
to spend invest eight or ten thousand dollars into a
pre paid funeral plan. Now, this is just a good
financial move on your part. You've taken accountable asset that
(26:14):
you have to spend and you have converted it to
an exempt asset, a pre paid funeral plan. The only
way to look at that is, let's say you're living
in long term care, you're in Kansas, you're down to
two thousand dollars, and at some point you pass away.
(26:37):
Now it's time to arrange the funeral and all of
the things. Average funeral I haven't looked up the number
here recently. It's got to be at least ten thousand
dollars now might be more than that on average. So
let's say your funeral, in your burial, and you know
all of the things that go along with that. We
(27:00):
your final expenses, final arrangements. Let's say ten thousand dollars. Well,
he has two thousand dollars in his account. Who's going
to pay for the other eight thousand dollars? Does she
have it? Can the family pitch in and everybody kind
of chip in and make up that eight thousand dollars difference?
(27:22):
Why would you put that burden on your spouse or
your family when you could take eight or ten thousand
dollars of your spend down and pay for it yourself,
perfectly legal, perfectly great idea. You could even take some
(27:42):
of that spend down and invest it in a new
car or a better car for your spouse who will
be coming, you know, every day to see you or
every other day. So let's say let's say the vehicle
that you have isn't as dependable as you'd like, trade
it in get a better vehicle. You can spend some
(28:03):
of the money of that spend down on that vehicle.
Does that make sense? So pay for your care, pay
off some debts, make some home improvements, take cash, which
is accountable asset, invest some of it into a prepaid
(28:24):
funeral plan which is an exempt asset. Maybe even upgrade
or buy a new car. But once he is down
to nine and nine dollars in Missouri, two thousand dollars
in the state of Kansas, boom he is in. He
is in. Now if you see and this this gets
(28:48):
a little too complicated for me, but I can tell
you in general, if you go to see an elder
law attorney to look at that, and they're going to say, well,
wait a minute. Instead of him spending one hundred thousand
dollars all the way down to fifty nine oh nine
(29:10):
or two thousand dollars, we have a legal, perfectly legal
opportunity to take most of that one hundred thousand, maybe
let's say eighty thousand, ninety thousand, whatever the number is,
invest that into a single premium immediate annuity for the spouse,
(29:35):
which will then pay her an income of whatever the
number is. So what you've done is you have protected
some of the liquid assets on his side, invested it
into a vehicle that will increase the monthly income for her. Now,
(29:55):
why is that important coming up next, I'm going to
talk about what happens to the income. But when your
spouse goes to the nursing home, so does their income. Okay,
most people don't understand that. So if his income is
too I'm just going to use overly simplified numbers. If
(30:16):
his income is two thousand a months, her income is
two thousand a month, they have a household income of
four thousand dollars a month, and that's what they've based
kind of everything on. Now he goes to the nursing home,
his income of two thousand goes with him, and now
the household income is two thousand dollars. It took a
(30:37):
fifty percent reduction for her to live on and she
has half the assets. By the way, so how many
of us could survive on a fifty percent per month
decrease in our income? And I would say none of
us could do that. I don't care how much money
(30:58):
you have, you can't do it. So again, working with
an elder law attorney, they may be able to take
a big chunk of his spend down and legally convert
that perfectly perfectly okay, to do it, convert that into
a financial vehicle. A single premium immediate annuity that would
(31:23):
increase her monthly income for a period of time and boom,
get him qualified for Medicaid fairly quickly. Again, reach out
to Equality Local Elder Law Attorney n A e LA
dot org and I will have more coming right up.
Speaker 1 (31:41):
You're listening to Senior Care Live on the Senior Care
Broadcasting Network. To contact Steve or a guest of his show,
this is Seniorcare Live dot com. We'll have more coming up.
Speaker 2 (32:00):
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dot com. Welcome back. You're listening to Senior Care Live
(33:11):
on the Senior Care Broadcasting Network. Have a question, visit
Seniorcare Live dot com. All right, today it's all about medicaid,
how it works, how you qualify for it, what does
it pay for, all all of the things. So I've
talked about to spend down what you can use some
of that money for. If you work with a qualified
(33:32):
elder law attorney na e LA dot org. Put in
your zip code you'll get a list of local elderlaw attorneys. Yeah, Steve,
but I don't know. You know, they might charge you know,
eight thousand dollars to help me or tenth five whatever
the number is. Well, here's how I look at it.
(33:53):
If they charge you eight thousand dollars to protect one
hundred thousand dollars, probably ought to do it, because if
you don't do it, there goes one hundred thousand dollars.
It's silly to not do it. Frankly. Just make sure
that you get with a solid elder law attorney that can.
Speaker 1 (34:11):
Help you do that.
Speaker 2 (34:13):
And again, this is all the stuff that we go
through when we have a consulting review with our clients
at Senior Care Consulting. See, when we work with our clients,
we need to conduct and we do conduct a comprehensive
(34:34):
geriatric care assessment. Part of that assessment has to do
with the financial piece of all of this. Is there
a chance you might outlive your assets? If the answer
is yes, and usually it is yeah, there's a chance,
or no, we're definitely outliving our assets, or it's a
long shot, but we want to let's go ahead and
(34:55):
just have that safety net in place just in case. Okay,
then we have a though discussion of medicaid and how
it all works and when that might come into play
given their specific situation. So we talked about all of that. Well,
what about your income, Steve, So if you have to
(35:17):
spend it down to two thousand dollars and get qualified
in Kansas and then I have two thousand dollars coming
in next month, does that kick me out? No, it doesn't.
So let's talk about your income. This is very straightforward.
So whatever your income is here's the calculation. Your income
(35:38):
minus the cost of your Medicare premiums. So let's say
you have a Plan F or a G or whatever
it is, and you're spending three hundred dollars a month.
Your Medicare is your healthcare, remember that. So you want
to keep that up. So whatever your income is your
(36:01):
Medicare premiums, and then you're going to keep a couple
of bucks your personal needs allowance. In the state of Kansas,
you get to keep sixty two dollars a month. Don't
spend it all in one place. In the state of Kansas,
you get to keep fifty dollars a month. And that's
(36:24):
just a little bit of just a little petty cash,
a little slush fund to get a diet coke and
a Snickers bar now. And then okay, So your income
minus whatever you're paying for your Medicare premium minus a
couple of bucks whatever is left over, whether it's two
hundred dollars, whether it's two thousand dollars, whatever the number is,
(36:45):
that goes back to the nursing home. As a copay
now I speak in English, I call it a copay.
Happens every single month. They call it a patient liability
is a patient liability. What's a copay? You see how
I do that? So that's your copay. That's the individual's
(37:07):
contribution towards the cost of their care, and then Medicaid
pays the nursing home the difference. But there's even a
little bit of a catch to that. Let's say the
nursing home normally charges three to fifty a day, three
hundred fifty dollars a day, but Medicaid says, we'll only
pay you three hundred dollars a day. They'll say, yeah,
we'll take that, So the nursing home might ride off
(37:29):
fifty dollars a day. Okay. The individual pays what they
can after they've kept up their Medicare and kept a
couple of bucks, and Medicaid pays them the difference up
to that Medicaid allowable, which in this example is three
hundred dollars a day. So that happens every single every
(37:50):
single month, like clockwork. That's exactly what happens. Now. I
talked about some loopholes earlier in the program. Loopholes are
or maybe just some opportunities to take advantage of some
of the rules in some of the different rules for
different states. Here's one that we do pretty frequently, so
(38:15):
senior care consulting. We help our clients find the right
senior care community that would include assistant living, of course,
long term care. Many times it involves memory care. Sometimes
it's a continuing care retirement community with all of the above.
I have worked with several, several many clients over the years,
(38:37):
and they live in Missouri. And listen to this very closely.
In the state of Kansas, the community's spouse. So this
is the spouse that's doing well living independently. Let's say
it's Missus Jones. Mister Jones needs long term care, mister
Jones needs a nursing home. Even though they're a resident
(39:00):
living in Missouri. If mister Jones moves to the Kansas
side of the state line, the Kansas rules apply. In
the Kansas rules say that the at home community spouse,
Missus Jones, her four to oh one K and her
ira are exempt. Take them off the table. You don't
(39:24):
have to split them in half. They do not calculate
into the division of assets. So I'll never forget this lady.
She was a pistol. I just love her to pieces.
She said. Steve I'm no spring chicken, but I'll gladly
drive to Kansas to save my three hundred thousand dollars
(39:46):
of a four oh one k that I received when
I retired from Sprint. If we would have chosen a
place on the Missouri side of the state line, that
would have to be divided and spent down, yes they could.
They could an elder law attorney be be able to
take part of his spend down and turn it into
(40:06):
an annuity. She didn't want anything to do with that.
She just wanted to hang on to it and have
her financial advisor continue to invest that for her. So
we found an excellent long term care community for her
husband on the Kansas side of the state line. Kansas
rules apply period. That's how you take advantage of some
(40:26):
of the differences in the rules and the laws, and
then just a quick limitation. Medicaid will pay for long
term care, that nursing home level of care, the medical
model all day every day because it's medical. They will
pay very little for the assisted living level of care
because it's not a medical model. So for example, on
(40:46):
this on this Kansas side of the state line, there's
a program. Again, it's all these buckets of money. Under
these different programs HCBS Home and community based services. They'll
pay for part of the cost of assisted living, but
not all of it. It gets very complicated again, and
on the Missouri side, they'll spend a whopping two hundred
(41:07):
and ninety two dollars a month that has no impact. Hey,
why it sounds great, but it doesn't deliver. So look,
if you're looking for any level of senior care and
you need help, and this is a big part of
the equation, give us a call. We'll walk you through this.
It would be our honor to serve you and your family.
Senior Care Consulting nine one three, nine four five twenty
(41:31):
eight hundred or online at Seniorcareconsulting dot com. All right,
I'm Steve Keeker, and I wish you grace and peace.
May God bless you and your family on this day
and always join me next week right here on Senior
Care Life.
Speaker 3 (41:49):
Does your business serve the elderly and their caregivers in
our area? There are hundreds of thousands of people either
receiving or providing senior care, and they need to know
about you. A nique and successful radio program called Senior
Care Live is the perfect opportunity to let your target
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(42:10):
Live is currently adding a limited number of partner sponsors,
and if you're aligned with their mission, they want to
talk to you. They're interested in partnering with hospital organizations,
physician groups, home care providers, a state planning and older
law practices, financial advisors, insurance companies, real estate brokers, home
health agencies, and other providers serving the elderly and their caregivers.
(42:33):
Senior Care Live has a limited number of partner sponsor opportunities,
so call now at nine one three nine four five
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eight hundred or visit seniorcare live dot com seniorcare live
dot com.
Speaker 2 (42:49):
Quid pro quo a Latin phrase that means an exchange
of goods or services where one transfer is contingent upon
the other. Here's an example. I'll recommend your senior community
if you'll pay me a huge kickback from my referral.
The free referral services have a vested interest in you
choosing one of their business partners. That's how they make
(43:11):
their money. Does this paid recommendation sound objective or credible,
of course not. I'm Steve Keeker with Senior Care Consulting.
I'm so proud to say we have never received a
single penny from any provider ever. We offer replacement service
with integrity for help finding the right senior care community,
without conflict of interest and without the quid pro quo
(43:35):
called nine one three, nine four five twenty eight hundred
nine one three, nine four five twenty eight hundred Replacement
service with integrity at Seniorcareconsulting dot com
Are you caring for an aging loved one? Are you
a senior searching for answers? Welcome to Senior Care Live,
a program dedicated to you, providing information, education and resources
for seniors and their caregivers. And now America's Senior care consultant,
Steve Kecker.
Speaker 2 (00:23):
Hello, and welcome to Senior Care Live. I'm Steve Keeker,
your senior care consultant, and I really appreciate you tuning
in today. This might be a little bit of a
fire hose type of a program because I'm going to
cover a lot of information and we're going to kick
it off with something called Medicaid. I think most people
(00:44):
have heard of Medicaid. I like to just say that
Medicaid is that safety net that says, if you have
outlived your assets, which by the way, is kind of
easy to do these days, if you've outlived your assets
and you need care in a senior care community, the
(01:05):
Medicaid program will pay for the majority of that cost.
All right. The Medicaid program will pay for a lot
of other things as well, But for the purposes of
this overview and discussion, we're going to focus on Medicaid
paying for your stay in a long term care, and
(01:25):
I'm going to talk about what is it, what does
it pay for, how do you qualify for it, and
then maybe review some limitations. And that's a lot. So
let's jump in here. So what is medicaid. Let me
just start off by say, don't confuse that with medicare.
A lot of people will interchange. Oh, that is that
(01:47):
medicare thing or that medicaid or no, no, those are
two separate things. So medicaid is financial assistance for healthcare
and prescription call. It is a federal program, so it's
offered through the federal government, but it is administered by
(02:11):
the state. That's a really key key point there because
each state could have slightly different rules, and depending on
what state you live in and what you're needing, you
may be able to use some of those rules in
(02:32):
your favor. I'll give you an example of that here
in a little bit. And again, do not confuse Medicare
and medicaid. These are not interchangeable. Again, I've already just
briefly touched on what medicaid is. Medicare is your health insurance.
That's just as simple as that Medicare is your health insurance.
(02:55):
It'll pay for your major medical your hospital stays, and
then your part B is going to pay for a
lot all the other things like your doctor's office visits
and MRIs and X rays and labs and maybe some
equipment it supplies that sort of thing. So medicare is
your health insurance, not the same, okay, And then you
(03:18):
have to meet certain income and asset criteria. So let's
take one step further, and again we're talking about medicaid
for the purpose of depending on Medicaid to help us
pay for our stay in a long term care community
(03:38):
and for a shared room. Just as a reminder, in
long term care community, the average is a solid This
is a shared room, the semi private room. You have
a roommate. Okay, that's what medicaid will pay for. And
we're talking, you know, nine to ten thousand dollars or
(03:58):
so every month, So it does pay out a lot
for this. So taking that next step, how does medicaid work.
First of all, let's keep it simple or a little
more simple, and let's look at a single person, an
individual person. So you're not a married couple. So if
(04:23):
you're not a married couple with a spouse and a spouse,
and you're on your own, whether your spouse has passed away,
or whether you're divorced or you've never married, you're for
Medicaid purposes, you're considered a single person. So this is
very simply an asset test. And so you have to
(04:45):
divide your assets into a couple of different categories. So
an exempt asset meaning it's off the table for now,
maybe forever. An exempt asset is your house. Well, way
do you missed, Eve? Don't you have to like sign
(05:07):
the deed over to the nursing home. No, And if
I've heard that so many times, if I had a
nickel for every time I've heard, oh, Steve, we can't
move down in there until we signed the deed of
our house over to the nursing home. They want his
nursing they want his house before they'll they'll take Medicaid. No,
they don't. It doesn't work that way. If I didn't
nickel every time I heard that, I'd have a big
(05:29):
pile of nickels. I wouldn't be ready, quite ready to
retire yet, but I have, I'd have a whole pile
of nickels. So your house is considered an exempt asset.
And then here's the caveat for now, So your house
is exempt. One vehicle is considered an exempt asset. One vehicle,
(05:53):
a prepaid funeral plan. Prepaid funeral plan, by the way,
that's a really smart thing to do. Just get it
out of the way. Do your family a huge favor,
have that all set up and all paid for so
they don't have to stress about all of that while
they're mourning the loss of you. Do your family a
(06:15):
favor and get that done. And there's some financial advantages
of that too. So an exempt asset your house for now,
one vehicle, a prepaid funeral plan, a small amount of
cash value, and a life insurance policy up to fifteen
hundred dollars, so not not much a little bit, and
(06:37):
I'm not talking about the face value or the death benefit.
I'm talking about if it's a cash value life insurance
policy that has a little bit of a savings on
the side, you can keep up to fifteen hundred dollars
of that. And then all the stuff in your house,
your household goods, all of those things are considered exempt assets.
(07:00):
On the other side of the ledgers, so to speak,
you have your countable assets, and that's it's almost everything
else and I like to say, think liquid assets, so
countable assets. I'll explain this in a second. Checking savings
(07:20):
money market mutual fund CDs in certain states four oh
one k's iras, actually in all states four oh one
k's and iras. I just skipped ahead mentally. We'll get
there when we're talking about a couple. Okay, checking savings
money market mutual fund CDs four o one k's, iras, annuities,
(07:47):
think liquid assets. Those are your countable assets. So now
we've taken that next step and we say, okay, we
look at everything. This is the exempt asset list, this
is the countable asset lists. So now what do you do?
So then we have to look at the countable asset
list again, the liquid assets, and we have to spend
(08:12):
down those assets. So if you ever hear the term,
if you're anywhere close to working with medicaid or just
exploring that learning about it, if you hear the term
spend down, spend down, that's what that means. You have
X dollars of liquid assets, countable assets, and you're going
(08:34):
to spend down the assets to the trigger point. So
this program is broadcast from the Kansas City metropolitan area.
So we have two different numbers in our area. Remember
it's a federal program, but it's administered state by state,
(08:55):
and the states could have slightly different numbers, slightly different
rules and so forth. So in the state of Missouri,
you would spend down the assets to five thousand, nine
hundred and nine dollars, so you're almost broke. Okay, once
(09:16):
you spend down those liquid assets, the accountable assets down
to fifive I was gonna say, fifty nine on nine,
nine hundred nine dollars in the state of Missouri. Boom,
you're in. That's it. This is a simple asset test,
is how I like to describe that. In the state
of Kansas, you have to spend down your liquid assets
(09:39):
to two thousand dollars. Two thousand dollars in the state
of Kansas, and again you're almost broke. And at that
point you have outlived your assets, and then the Medicaid
program will come in and pay for the majority of
the cost of your stay in the long term care community.
(10:03):
And I have a whole lot more I'm gonna get
into coming up next. But look, with my firm, with
Senior Care Consulting, we go through all of this in detail.
Every single time we work with our clients. If you're
interested in looking at this interested in discussing our services,
it's nine one, three, five, twenty eight hundred or online
(10:26):
at Seniorcare Consulting dot com. And now the Senior Care
Live Question of the Week. Medicaid considers your income as
a factor when qualifying from Medicaid to pay for long
term care? Does that stay a true or false? What
do you think?
Speaker 1 (10:43):
You're listening to Senior Care Live on the Senior Care
Broadcasting Network. For more information, visit seniorcare Live dot com.
We'll have more with Steve coming up next.
Speaker 2 (11:05):
Welcome back. You're listening to Senior Care Live on the
Senior Care Broadcasting Network. For more information, go to Senior
care Live dot com. All right, back to the Senior
Care Live Question of the Week. Medicaid considers your income
as a factor when qualifying for Medicaid to pay for
(11:28):
long term care? Is that statement true or false? And
the answer is.
Speaker 3 (11:38):
True?
Speaker 2 (11:39):
Oh wait a minute, Steve, you just said it's an
asset test. Okay, so it's a little bit of a
trick question. So it is ninety nine percent of an
asset test. Actually, it is an asset test, but they
also look at your income. Your income is rare, rarely
(12:00):
a factor, rarely, rarely a factor when qualifying for long
term care. So here's an example. So let's say that
a long term care community charges Let's use you some
nice round little numbers here. They charge ten thousand dollars
a month for their long term care community, and that
(12:26):
would be a shared room, a semi private room, one
bed in a rooms you have a roommate. That's what
Medicaid will pay for. So let's say they charged ten
thousand dollars. If the long term care community is Medicaid certified,
(12:46):
and let's say that they accept from Medicaid nine thousand
dollars per month as their payment in full, they say, okay, yeah,
if anyone comes in on Medicaid, we agreed to bill
medicare Aid. We will accept nine thousand dollars as our
payment in full. We'll write off the other thousand. Okay,
So their Medicaid reimbursement rate to that particular community is
(13:12):
nine thousand dollars per month. If your income is over
nine thousand dollars per month, then you can pay for
your own care. You don't need MEDICAIDS help. But how
many people do you know trying to qualify for long
(13:37):
term care and have it paid for by medicaid? How
many of those folks do you know that have over
a nine thousand dollars per month income? And I would
say very very very very few, very few. Now, I've
had a few clients over the year, and let's say
(13:59):
they had a large military pension, they had a high
Social Security pension every every month, social Security payment income
every month, and uh and and and it. It was
a pretty high number. And I've had just a very few,
like I could count them on one hand over all
(14:20):
these years. And I thought, you know what, that's that's
getting pretty close. So I had to actually go to
the places that I was considering as part of our
top or list of our top options, and then I
calculated their Medicaid reimbursement rate and I made sure that
his income was under what they're paid by Medicaid, and
(14:44):
he was just under a couple of them and pretty
far under another one. And so it all worked out.
But it is a factor, although it's usually not much
of a factor, it's very rare, all right. So so
let's jump back into medicaid, how it works, what it
(15:04):
pays for all the things. So we just talked about
a person with and let's just say this person has
fifty thousand dollars accountable assets, liquid assets, checking saving money
market mutual fund CD four one KIRA, all the stuff.
Then he spends that down to nine hundred dollars in
(15:27):
Missouri or two thousand dollars in Kansas. And let me
say most of the states around the country are very
similar numbers to this. And once you spend that down,
then boom you qualify. Most of the clients that I
work with through Senior Care consulting, their income is fifteen
hundred dollars a month, two thousand dollars a month. I'm
(15:49):
working with someone right now. They do have a military
pension and a solid Holt Security number. Their income is
about five to six thousand dollars a month. But all
of those numbers are less than the Medicaid reimbursement to
these facilities, and so we're in good shape there, all right,
that is exactly how it works for a single person. Well, Steve,
(16:15):
what about a married couple. My husband and I were
together and we have joint income, joint assets, all of
that stuff. So what you would do in the case
of a married couple is you would again the exempt assets.
(16:36):
They're the same, Okay, your house for now, one vehicle,
prepaid funeral plan, up to fifteen hundred dollars of cash
value to a small life insurance policy. And all the
stuff in your house, all the liquid assets, checking savings,
(16:56):
money market mutual fund, CDs for O one ksras, annuities,
all the stuff. Add them up, and then you would
do what's called a division of assets. Now let me
stop right here just for a second. Do not do
this on your own period. You're gonna screw it up.
I'm just telling you this is a little too complex,
(17:18):
and you don't want to mess this up. Okay. And
most individuals in these long term care communities, most of them,
I would say, they're more than willing to help an
individual file the medicaid application on a simple spend down.
The vast majority that I've ever worked with, they don't
(17:41):
want anything to do with this division of assets. It
gets too complicated. And if you make a mistake, first
of all, you could screw up the medicaid application and
maybe that individual wouldn't qualify, or you might leave a
lot of money on the table that could have gone
to the Unity spouse. So work with a qualified, very
(18:07):
experienced elder law attorney. Well, Steve, I don't know if
I want to pay money for that elder law attorney.
It's some of the best money that you're ever going
to spend. Ever. Go to NALA dot org n a
e LA dot org National Academy of Elder Law Attorneys
(18:32):
n A e LA dot org. You can type in
your city or your zip code and it'll do a
search out so many miles. You have some variables there
you can set and you'll get a list of elder
law attorneys in your area, and that's where you can
begin your research. Strut your research there. Make sure they
(18:55):
practice one hundred percent elder law. You have a lot
of of law firms saying, oh, hey, everybody's getting old
and we need to jump on the train, and okay,
hey look at us, we do elder law too, And
they may do okay with that, But I personally would
go with an elder law firm that that is their specialty,
(19:16):
and it's so specialized that many times a lot of
other attorneys will refer their clients to an elder law specialist.
Na ELA dot org. Find your attorney to help you
with this division of assets, and coming up next, I
will continue to discuss all of the details that are
(19:38):
involved in the Medicaid division of assets.
Speaker 1 (19:42):
You're listening to Senior Care Live on the Senior Care
Broadcasting Network. Have a question, this is Seniorcare Live dot Com.
Stick around. We'll have more with Steve coming up next.
A recent Internet search for nursing homes in Kansas City
(20:03):
provided thirty two million results. It's daunting to think that
there are over three hundred fifty senior care communities to
choose from in the Kansas City metro and on average
you'll spend fifty to one hundred hours trying to find
a place for your loved one. If this sounds overwhelming,
that's because it is. I invite you to reach out
to Senior Care Consulting. We've been serving family since two
(20:26):
thousand and two. With our premium service, we do most
of the work for you. You'll spend just a few
hours of your time finding the best place available, and
you can trust us to be objective because we don't
receive reimbursement from any provider. We work for you. To
learn more, call Senior Care Consulting at nine three, nine
(20:47):
four five twenty eight hundred nine nine four five twenty
eight hundred a placement service with integrity at Seniorcareconsulting dot com.
Speaker 2 (21:06):
Welcome back. You're listening to Senior Care Live on the
Senior Care Broadcasting Network. For podcasts to the program, visit
Seniorcare Live dot com or wherever you get your podcasts.
All right, So we're talking about medicaid today, what it is,
how it works, how you qualify, what does it pay for?
(21:27):
All of the stuff. And I started to get into
what if what happens if you have a married couple
and you know before before there is a legal opportunity
to do what's called the division of assets, where you're
dividing assets on paper. Guess what people used to do. Well,
(21:51):
if I'm going into the nursing home, then all of
all of our money is going to be gone because
the nursing home is so expensive. Honey, let's get a divorce,
just on paper. But let's get a divorce. I'll give
you as much as I can so that at least
(22:11):
you have something to live on and you have somewhere
to stay. Now, in the United States of America, people
getting divorced to pay for medical care and long term care.
How horrible is that? So Congress agreed with that statement
and said, wait a minute, why can't we just do
(22:32):
divide assets on paper? Don't get divorced. We'll just do
this division of assets on paper. So let's say, and
again go to an elder law attorney to do this properly.
Let's say a couple has just make up nice round
(22:53):
little numbers here, two hundred thousand dollars in liquid assets,
checking savings, money market mutual funds, four O one k's, iras, annuities,
all the things they have two hundred thousand dollars. So
let's put one hundred thousand dollars on his side, one
(23:13):
hundred thousand dollars on her site. Boom, on paper, we
protected half of the liquid assets for her. She is
the community spouse, she does not need care, she's perfectly healthy,
(23:35):
and she still lives in the house. There's still taxes
due home insurance, homeowners insurance coverage. The water heater still
breaks down, we have electric bills, gas bills, all the
costs of living independently. Personal property tax in many states
(23:58):
cost a lot to live. So at least we've protected
half of the assets for her the community spouse. In
this example, he goes to the nursing home and in
this example he takes one hundred he has one hundred
thousand dollars, and he's going to spend that down to
(24:21):
at least in my area, nine hundred and nine dollars
in Missouri, two thousand dollars in the state of Kansas,
and again all the other states in the country they're
very similar. So the question is, well, what can you
use that money to pay for? And you can obviously
(24:43):
pay for your care. It's going to go out at
the rate of nine to ten thousand dollars a month
for a shared room in long term care. You can
pay off some of your debts. Let's say you've got
you know, eight thousand on a visa over here, and
another four thousand on a master card over there, and
we have a small home equity loan because we had
a new roof put on and a new HVAC system
(25:06):
installed there as twenty thousand dollars. You can pay off
some of your debts, your joint debts from his side
of the ledger, so to speak. You can make some
home improvements. Again, the house is an exempt asset. She
needs somewhere to live, so it's an exempt asset for now.
(25:29):
So maybe you use some of that money to maybe
put in some new carpet, maybe make a few home improvements,
invest into the house. Here's one that I'm just adamant about.
Take some of his money that when it's gone, when
it's down to fifty nine oh nine or two thousand
(25:50):
dollars or whatever the number is in your state, Medicaid
will start paying for the majority of the cost of
his stay in long term care. So while you have
to spend invest eight or ten thousand dollars into a
pre paid funeral plan. Now, this is just a good
financial move on your part. You've taken accountable asset that
(26:14):
you have to spend and you have converted it to
an exempt asset, a pre paid funeral plan. The only
way to look at that is, let's say you're living
in long term care, you're in Kansas, you're down to
two thousand dollars, and at some point you pass away.
(26:37):
Now it's time to arrange the funeral and all of
the things. Average funeral I haven't looked up the number
here recently. It's got to be at least ten thousand
dollars now might be more than that on average. So
let's say your funeral, in your burial, and you know
all of the things that go along with that. We
(27:00):
your final expenses, final arrangements. Let's say ten thousand dollars. Well,
he has two thousand dollars in his account. Who's going
to pay for the other eight thousand dollars? Does she
have it? Can the family pitch in and everybody kind
of chip in and make up that eight thousand dollars difference?
(27:22):
Why would you put that burden on your spouse or
your family when you could take eight or ten thousand
dollars of your spend down and pay for it yourself,
perfectly legal, perfectly great idea. You could even take some
(27:42):
of that spend down and invest it in a new
car or a better car for your spouse who will
be coming, you know, every day to see you or
every other day. So let's say let's say the vehicle
that you have isn't as dependable as you'd like, trade
it in get a better vehicle. You can spend some
(28:03):
of the money of that spend down on that vehicle.
Does that make sense? So pay for your care, pay
off some debts, make some home improvements, take cash, which
is accountable asset, invest some of it into a prepaid
(28:24):
funeral plan which is an exempt asset. Maybe even upgrade
or buy a new car. But once he is down
to nine and nine dollars in Missouri, two thousand dollars
in the state of Kansas, boom he is in. He
is in. Now if you see and this this gets
(28:48):
a little too complicated for me, but I can tell
you in general, if you go to see an elder
law attorney to look at that, and they're going to say, well,
wait a minute. Instead of him spending one hundred thousand
dollars all the way down to fifty nine oh nine
(29:10):
or two thousand dollars, we have a legal, perfectly legal
opportunity to take most of that one hundred thousand, maybe
let's say eighty thousand, ninety thousand, whatever the number is,
invest that into a single premium immediate annuity for the spouse,
(29:35):
which will then pay her an income of whatever the
number is. So what you've done is you have protected
some of the liquid assets on his side, invested it
into a vehicle that will increase the monthly income for her. Now,
(29:55):
why is that important coming up next, I'm going to
talk about what happens to the income. But when your
spouse goes to the nursing home, so does their income. Okay,
most people don't understand that. So if his income is
too I'm just going to use overly simplified numbers. If
(30:16):
his income is two thousand a months, her income is
two thousand a month, they have a household income of
four thousand dollars a month, and that's what they've based
kind of everything on. Now he goes to the nursing home,
his income of two thousand goes with him, and now
the household income is two thousand dollars. It took a
(30:37):
fifty percent reduction for her to live on and she
has half the assets. By the way, so how many
of us could survive on a fifty percent per month
decrease in our income? And I would say none of
us could do that. I don't care how much money
(30:58):
you have, you can't do it. So again, working with
an elder law attorney, they may be able to take
a big chunk of his spend down and legally convert
that perfectly perfectly okay, to do it, convert that into
a financial vehicle. A single premium immediate annuity that would
(31:23):
increase her monthly income for a period of time and boom,
get him qualified for Medicaid fairly quickly. Again, reach out
to Equality Local Elder Law Attorney n A e LA
dot org and I will have more coming right up.
Speaker 1 (31:41):
You're listening to Senior Care Live on the Senior Care
Broadcasting Network. To contact Steve or a guest of his show,
this is Seniorcare Live dot com. We'll have more coming up.
Speaker 2 (32:00):
Hello, this is Steve Keeker, President of Senior Care Consulting.
I'm so excited to announce that we are expanding nationwide
by awarding Senior Care Consulting franchises. We help our clients
find the right senior care community, including assistant living, memory care,
long term care, and continuing care retirement communities. We are
(32:21):
not another run of the mill free referral service. We're
very different. We offer replacement service with integrity. Owning a
senior care consulting franchise offers many benefits. Our market is
not affected by the economy. Operate from your home office
and enjoy work life balance. Pour your passion into a
business you can be proud of. For more information about
(32:44):
owning a Senior care consulting franchise. Call eight three three
seven two two three seven two six eight three three
seven two two three seven two six or visit Seniorcareconsulting
dot com. Welcome back. You're listening to Senior Care Live
(33:11):
on the Senior Care Broadcasting Network. Have a question, visit
Seniorcare Live dot com. All right, today it's all about medicaid,
how it works, how you qualify for it, what does
it pay for, all all of the things. So I've
talked about to spend down what you can use some
of that money for. If you work with a qualified
(33:32):
elder law attorney na e LA dot org. Put in
your zip code you'll get a list of local elderlaw attorneys. Yeah, Steve,
but I don't know. You know, they might charge you know,
eight thousand dollars to help me or tenth five whatever
the number is. Well, here's how I look at it.
(33:53):
If they charge you eight thousand dollars to protect one
hundred thousand dollars, probably ought to do it, because if
you don't do it, there goes one hundred thousand dollars.
It's silly to not do it. Frankly. Just make sure
that you get with a solid elder law attorney that can.
Speaker 1 (34:11):
Help you do that.
Speaker 2 (34:13):
And again, this is all the stuff that we go
through when we have a consulting review with our clients
at Senior Care Consulting. See, when we work with our clients,
we need to conduct and we do conduct a comprehensive
(34:34):
geriatric care assessment. Part of that assessment has to do
with the financial piece of all of this. Is there
a chance you might outlive your assets? If the answer
is yes, and usually it is yeah, there's a chance,
or no, we're definitely outliving our assets, or it's a
long shot, but we want to let's go ahead and
(34:55):
just have that safety net in place just in case. Okay,
then we have a though discussion of medicaid and how
it all works and when that might come into play
given their specific situation. So we talked about all of that. Well,
what about your income, Steve, So if you have to
(35:17):
spend it down to two thousand dollars and get qualified
in Kansas and then I have two thousand dollars coming
in next month, does that kick me out? No, it doesn't.
So let's talk about your income. This is very straightforward.
So whatever your income is here's the calculation. Your income
(35:38):
minus the cost of your Medicare premiums. So let's say
you have a Plan F or a G or whatever
it is, and you're spending three hundred dollars a month.
Your Medicare is your healthcare, remember that. So you want
to keep that up. So whatever your income is your
(36:01):
Medicare premiums, and then you're going to keep a couple
of bucks your personal needs allowance. In the state of Kansas,
you get to keep sixty two dollars a month. Don't
spend it all in one place. In the state of Kansas,
you get to keep fifty dollars a month. And that's
(36:24):
just a little bit of just a little petty cash,
a little slush fund to get a diet coke and
a Snickers bar now. And then okay, So your income
minus whatever you're paying for your Medicare premium minus a
couple of bucks whatever is left over, whether it's two
hundred dollars, whether it's two thousand dollars, whatever the number is,
(36:45):
that goes back to the nursing home. As a copay
now I speak in English, I call it a copay.
Happens every single month. They call it a patient liability
is a patient liability. What's a copay? You see how
I do that? So that's your copay. That's the individual's
(37:07):
contribution towards the cost of their care, and then Medicaid
pays the nursing home the difference. But there's even a
little bit of a catch to that. Let's say the
nursing home normally charges three to fifty a day, three
hundred fifty dollars a day, but Medicaid says, we'll only
pay you three hundred dollars a day. They'll say, yeah,
we'll take that, So the nursing home might ride off
(37:29):
fifty dollars a day. Okay. The individual pays what they
can after they've kept up their Medicare and kept a
couple of bucks, and Medicaid pays them the difference up
to that Medicaid allowable, which in this example is three
hundred dollars a day. So that happens every single every
(37:50):
single month, like clockwork. That's exactly what happens. Now. I
talked about some loopholes earlier in the program. Loopholes are
or maybe just some opportunities to take advantage of some
of the rules in some of the different rules for
different states. Here's one that we do pretty frequently, so
(38:15):
senior care consulting. We help our clients find the right
senior care community that would include assistant living, of course,
long term care. Many times it involves memory care. Sometimes
it's a continuing care retirement community with all of the above.
I have worked with several, several many clients over the years,
(38:37):
and they live in Missouri. And listen to this very closely.
In the state of Kansas, the community's spouse. So this
is the spouse that's doing well living independently. Let's say
it's Missus Jones. Mister Jones needs long term care, mister
Jones needs a nursing home. Even though they're a resident
(39:00):
living in Missouri. If mister Jones moves to the Kansas
side of the state line, the Kansas rules apply. In
the Kansas rules say that the at home community spouse,
Missus Jones, her four to oh one K and her
ira are exempt. Take them off the table. You don't
(39:24):
have to split them in half. They do not calculate
into the division of assets. So I'll never forget this lady.
She was a pistol. I just love her to pieces.
She said. Steve I'm no spring chicken, but I'll gladly
drive to Kansas to save my three hundred thousand dollars
(39:46):
of a four oh one k that I received when
I retired from Sprint. If we would have chosen a
place on the Missouri side of the state line, that
would have to be divided and spent down, yes they could.
They could an elder law attorney be be able to
take part of his spend down and turn it into
(40:06):
an annuity. She didn't want anything to do with that.
She just wanted to hang on to it and have
her financial advisor continue to invest that for her. So
we found an excellent long term care community for her
husband on the Kansas side of the state line. Kansas
rules apply period. That's how you take advantage of some
(40:26):
of the differences in the rules and the laws, and
then just a quick limitation. Medicaid will pay for long
term care, that nursing home level of care, the medical
model all day every day because it's medical. They will
pay very little for the assisted living level of care
because it's not a medical model. So for example, on
(40:46):
this on this Kansas side of the state line, there's
a program. Again, it's all these buckets of money. Under
these different programs HCBS Home and community based services. They'll
pay for part of the cost of assisted living, but
not all of it. It gets very complicated again, and
on the Missouri side, they'll spend a whopping two hundred
(41:07):
and ninety two dollars a month that has no impact. Hey,
why it sounds great, but it doesn't deliver. So look,
if you're looking for any level of senior care and
you need help, and this is a big part of
the equation, give us a call. We'll walk you through this.
It would be our honor to serve you and your family.
Senior Care Consulting nine one three, nine four five twenty
(41:31):
eight hundred or online at Seniorcareconsulting dot com. All right,
I'm Steve Keeker, and I wish you grace and peace.
May God bless you and your family on this day
and always join me next week right here on Senior
Care Life.
Speaker 3 (41:49):
Does your business serve the elderly and their caregivers in
our area? There are hundreds of thousands of people either
receiving or providing senior care, and they need to know
about you. A nique and successful radio program called Senior
Care Live is the perfect opportunity to let your target
audience know about your amazing products and services. Senior Care
(42:10):
Live is currently adding a limited number of partner sponsors,
and if you're aligned with their mission, they want to
talk to you. They're interested in partnering with hospital organizations,
physician groups, home care providers, a state planning and older
law practices, financial advisors, insurance companies, real estate brokers, home
health agencies, and other providers serving the elderly and their caregivers.
(42:33):
Senior Care Live has a limited number of partner sponsor opportunities,
so call now at nine one three nine four five
twenty eight hundred nine one three nine four five twenty
eight hundred or visit seniorcare live dot com seniorcare live
dot com.
Speaker 2 (42:49):
Quid pro quo a Latin phrase that means an exchange
of goods or services where one transfer is contingent upon
the other. Here's an example. I'll recommend your senior community
if you'll pay me a huge kickback from my referral.
The free referral services have a vested interest in you
choosing one of their business partners. That's how they make
(43:11):
their money. Does this paid recommendation sound objective or credible,
of course not. I'm Steve Keeker with Senior Care Consulting.
I'm so proud to say we have never received a
single penny from any provider ever. We offer replacement service
with integrity for help finding the right senior care community,
without conflict of interest and without the quid pro quo
(43:35):
called nine one three, nine four five twenty eight hundred
nine one three, nine four five twenty eight hundred Replacement
service with integrity at Seniorcareconsulting dot com
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