Financial Options

Financial Options

Relates to other financial options to help pay for senior care services. Options include: life settlement, reverse mortgage, VA benefits or low income options.

Recent Answers

Senior Advisor

There are a few ways of doing this.  I'm not sure if you have friends or family nearby to help.  If you do, I would recommend that they help you with a simple "garage sale".  Have them separate the valuable from the not so valuable.  Garage sales are not for big ticket items.  Furniture, yes... (more)

There are a few ways of doing this.  I'm not sure if you have friends or family nearby to help.  If you do, I would recommend that they help you with a simple "garage sale".  Have them separate the valuable from the not so valuable.  Garage sales are not for big ticket items.  Furniture, yes.  Diamond bracelets... No.  This is the easiest and cheapest.  And you keep all the profits.  There are companies that you can pay to come in and do this. They are called estate sale companies. These type of companies have their advantages and disadvantages.  They are going to take a percentage of the money made, but they will be asking a premium price for the items they sell.  Here is the thing with them... they will do it all.  From organizing to pricing to advertising... everything, that's why it costs you.  Another way I can recommend is going through your church.  The second part of your question about "health care and other advice as we plan to age in the home".  Don't hesitate to ask your questions, that's what were are here for.  

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Senior Specialist

Having to talk to our parents about various senior care issues is difficult and depressing. But it could also be a great bonding opportunity for parent and child. As our parents grow frail, roles reverse where the child now has to take charge to do what's best for mom or dad. Take this as an... (more)

Having to talk to our parents about various senior care issues is difficult and depressing. But it could also be a great bonding opportunity for parent and child. As our parents grow frail, roles reverse where the child now has to take charge to do what's best for mom or dad. Take this as an opportunity to really connect with your mom and understand what she needs and wants. You mention your mom can be difficult, but no matter how difficult she can be, she needs you now more than ever.
 
Start by asking your mom what she wants, such as whether she prefers to age in home with family or is comfortable with an assisted living facility. Your mom could be upset for many reasons and the discussion of moving to a facility may not be the root cause of her anger. You really need to have that heart to heart conversation with her.

As for affording the cost of an assisted living facility, there are states that have Medicaid Waiver programs which provide assisted living subsidies for low income individuals. You need to contact your state's Medicaid program for details. Here's a link for Maryland: http://mhcc.maryland.gov/consumerinfo/longtermcare/caregiverresources.aspx

There are other options as well, but I do not have all the specifics to your situation. You can contact me directly for help. Good luck.
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Private Fiduciary, Trustee,Conservator, Financial Advisor

This is a hard situation, when Medicaid only pays for nursing homes and not a less restrictive assistant living community.  You are not expected to bring her into your home, as so many people want to "guilt trip" you with this argument.  You may not have the resources to help her, and could hurt her... (more)

This is a hard situation, when Medicaid only pays for nursing homes and not a less restrictive assistant living community.  You are not expected to bring her into your home, as so many people want to "guilt trip" you with this argument.  You may not have the resources to help her, and could hurt her trying to move her in with you.  

Contact your local agency on aging and see if there are any sliding scale or Medicaid paid home care and chore services.  This way she may be able to stay a little longer in her home.

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Senior Advisor

To be eligible for the VA's Aid and Attendance Benefit program you must meet certain parameters.  You must have served 90 days of active duty, 1 day beginning or ending during the following Wartime Periods... Under current law, VA recognizes the following wartime periods to determine eligibility for... (more)

To be eligible for the VA's Aid and Attendance Benefit program you must meet certain parameters.  You must have served 90 days of active duty, 1 day beginning or ending during the following Wartime Periods...

Under current law, VA recognizes the following wartime periods to determine eligibility for VA Pension benefits: 

  • Mexican Border Period (May 9, 1916 – April 5, 1917 for Veterans who served in Mexico, on its borders, or adjacent waters) 
  • World War I (April 6, 1917 – November 11, 1918) 
  • World War II (December 7, 1941 – December 31, 1946) 
  • Korean conflict (June 27, 1950 – January 31, 1955) 
  • Vietnam era (February 28, 1961 – May 7, 1975 for Veterans who served in the Republic of Vietnam during that period; otherwise August 5, 1964 – May 7, 1975) 
  • Gulf War (August 2, 1990 – through a future date to be set by law or Presidential Proclamation)
Other parameters are financial and the type care that is needed. If your father is eligible for these benefits, he can use these funds to offset the cost for the care at home. Let me know if you have questions about applying. This can seem difficult, but it's manageable if you follow the steps.  
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Private Fiduciary, Trustee,Conservator, Financial Advisor

Contact the local VA and make an appointment with a Veteran's Service Officer for more.

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Senior Specialist

Assisted living facilities can get quite expensive especially if you are need of special services like Alzheimer care. Costs can range from $2,000 a month to $10,000 a month depending on location and services. Since you are needing to find a facility in California, the state does have a program... (more)

Assisted living facilities can get quite expensive especially if you are need of special services like Alzheimer care. Costs can range from $2,000 a month to $10,000 a month depending on location and services. Since you are needing to find a facility in California, the state does have a program called Assisted Living Waiver program which assists those seniors with disabilities and provides them with a subsidy to help defer some of the monthly costs. Please be aware that the assisted living facility also needs be an accepted participant of the program. You can read more about the program here:

http://www.dhcs.ca.gov/services/ltc/Pages/AssistedLivingWaiver.aspx 

There are also benefits that the VA provides as noted in Scot's response. Some other alternatives include: reverse mortgage and long term care benefit plans. It is best to connect with a financial adviser who specializes in senior care options.

I hope this helps and let us know if you have any more questions.

Admond

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Private Fiduciary, Trustee,Conservator, Financial Advisor

A board and care is a licensed facility in your state that can provide basic services including housing, meal service and limited assistance with basic activities of daily living.  They are generally self pay, and less expensive than "assisted living" facilities. There can be state fund to help pay... (more)

A board and care is a licensed facility in your state that can provide basic services including housing, meal service and limited assistance with basic activities of daily living.  They are generally self pay, and less expensive than "assisted living" facilities. There can be state fund to help pay, but qualifying can be difficult.

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Estate Planning Attorney

Medicare is a federal insurance program paid out of Social Security deductions. All persons 65 or older who have made Social Security contributions are entitled to the benefits, as well as persons under 65 with disabilities who have been eligible for Social Security disability benefits for at least... (more)

Medicare is a federal insurance program paid out of Social Security deductions. All persons 65 or older who have made Social Security contributions are entitled to the benefits, as well as persons under 65 with disabilities who have been eligible for Social Security disability benefits for at least two years, and persons of any age with end-stage renal disease.

Medicare does not pay for all medical expenses, and usually must be supplemented with private insurance ("medigap") or consumers can enroll in an HMO plan that contracts with Medicare. After 3 days of prior hospitalization, Medicare will pay up to 100% for the first 20 days of skilled nursing care. For the 21- 100 days, the patient will pay a co-payment. The premiums and copayments are increased every year. There will be no Medicare coverage for nursing home care beyond 100 days in any single benefit period.

It should be noted that Medicare only pays for “skilled nursing care,” does not pay for “custodial care” and the average stay in a nursing home under Medicare is usually less than 24 days. Thus, few can look to Medicare to pay for any substantial nursing home costs.

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Private Fiduciary, Trustee,Conservator, Financial Advisor

Unfortunately, no, Medicare does not pay for long term care in a nursing home.  Only your own money or if you and she can qualify will Medicaid  pay for your wife's nursing home care.  Your state is an income cap state, you if your income is too high, regardless of the assets you have, you still may... (more)

Unfortunately, no, Medicare does not pay for long term care in a nursing home.  Only your own money or if you and she can qualify will Medicaid  pay for your wife's nursing home care.  Your state is an income cap state, you if your income is too high, regardless of the assets you have, you still may not qualify for Medicaid.  Contact and elderlaw attorney in your State for more advice on Medicaid planning.

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Senior Advisor

Without understanding your plans or financial situation completely, I’ll explain the rules and give guidance of where to turn to for specific answers on your situation.  Medicare Part A only covers skilled care given in a certified nursing facility for individuals who meet certain conditions... (more)

Without understanding your plans or financial situation completely, I’ll explain the rules and give guidance of where to turn to for specific answers on your situation.  Medicare Part A only covers skilled care given in a certified nursing facility for individuals who meet certain conditions.  Medicare doesn't cover all services. In most cases it doesn't cover long-term care stays in a nursing home.  The services that Medicare doesn't cover, you'll have to pay out of pocket for them, unless you have other insurance or a Medicare health plan that covers those services.  You may still have to pay your deductible, coinsurance, and co-payments.  To sum it up… you may still have out-of-pocket expenses each month.

Remember that Medicare is based on 3 main factors:

1) Federal and state laws.  

2) National coverage decisions made by Medicare about whether something is covered.

3) Local coverage decisions made by companies in each state that process claims for Medicare.

                    a. These companies decide whether something is medically necessary and should be covered in their area.

It’s almost impossible for one to know and understand each state’s rules and regulations as well as reimbursements that might be covered by each individual plan, so I recommend that you talk to your State Health Insurance Program (SHIP). Contact information is available at the “Contacts” link on the Medicare Website

www.medicare.gov/Contacts/


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Private Fiduciary, Trustee,Conservator, Financial Advisor

In some states, you can be paid by Medicaid to provide home care services.  Also, you can be paid by Long Term Care insurance as long as you qualify as a Home Health Aide.  Check with your area agency on aging on Medicaid home care waiver programs.

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Senior Advisor

The answer is not so much a yes or no.  It might be a strong maybe.  There are several ways to get paid as a caregiver. Let me list a few and go into some of them for you... State run programs  Long term care insurance VA Benefits (Aid and Attendance) Drawing up a personal care agreement (Caregiver... (more)

The answer is not so much a yes or no.  It might be a strong maybe.  There are several ways to get paid as a caregiver. Let me list a few and go into some of them for you...

State run programs 

Long term care insurance

VA Benefits (Aid and Attendance)

Drawing up a personal care agreement (Caregiver contracts)

Life settlements

Reverse mortgage

Dependent tax exemptions

State Run Programs - In some states, they have programs that help financially crunched people pay for a caregiver.  In certain circumstances that could even be a family member.  Sometimes these programs have restrictions, waiting lists and remember that this is the government, so funding comes and goes.  To see availability and to see if you might qualify, visit your local Medicaid or aging services department.  In Las Vegas your aging services department can be found at   http://adsd.nv.gov/

LTC Insurance - If your parents a have a policy, contact the company and see how to initiate the policy.

VA Benefits - Please visit one of my articles that I previously wrote about this.   http://caregivinganswers.com/questions/how-do-i-qualify-my-dad-for-va-benefits-and-what-are-those-criterias

Drawing up a personal care agreement (Caregiver contracts) - If your parents have some savings or other assets set aside, they may be willing to work out a caregiver contract to help pay for things.  Please consult with a lawyer to make sure that the contract meets all the right conditions.  You don't want that to come back and haunt you.

Life Settlements - If your parents have a life insurance policy, a portion of it could be used to pay for care.   For more information on items like this visit    http://www.lifecarefunding.com/

Reverse Mortgage - Self explanatory?  If not, visit our icon to better understand.  http://caregivinganswers.com/topics/reverse-mortgage

Dependent tax exemptions - If all fails... and this isn't going to help with money coming in, but look to add your parents on as dependents.

As you can see there are options out there.  Whether or not you qualify for them... is another thing.  

Hope this helps!  

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Private Fiduciary, Trustee,Conservator, Financial Advisor

If you are legally married, then all money is both of yours as far as Medicaid is concerned.  While the nursing home nor the government can "access" this account, if you refuse to pay the nursing home bills and your husband is not otherwise qualified for Medicaid, then he will be evicted and you... (more)

If you are legally married, then all money is both of yours as far as Medicaid is concerned.  While the nursing home nor the government can "access" this account, if you refuse to pay the nursing home bills and your husband is not otherwise qualified for Medicaid, then he will be evicted and you could face criminal charges for neglect. Get legal advice now in the state your husband lives in and the state you live in.

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Estate Planning Attorney

Typically Medicaid rules, which vary state to state, allow the well spouse to maintain an amount of what would otherwise be available assets for qualification purposes at the time you apply for Medicaid. Assets acquired after the spouse is institutionalized are not protected and will be counted at... (more)

Typically Medicaid rules, which vary state to state, allow the well spouse to maintain an amount of what would otherwise be available assets for qualification purposes at the time you apply for Medicaid. Assets acquired after the spouse is institutionalized are not protected and will be counted at the time of the application. You would want to see what amount is allowed in your state.  Since it sounds like your husband is not yet institutionalized, at least a portion, if not all, should be protected. 

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Estate Planning Attorney

This is a great opportunity to be proactive. There are a couple essential documents to start with. The first two deal with incapacity: the power of attorney and advance health care directive. Each nominates a person or persons to handle your parents' financial and medical decisions during periods on... (more)

This is a great opportunity to be proactive. There are a couple essential documents to start with. The first two deal with incapacity: the power of attorney and advance health care directive. Each nominates a person or persons to handle your parents' financial and medical decisions during periods on incapacity. If your parents already have these documents, they should be updated every 5 years or so to ensure they are not outdated. I just reviewed a power of attorney that only went into effect upon incapacity and incapacity was defined by not one but two doctors and the children had to agree. Practically this would be difficult and could lead to delays. So it is important to review the terms. 

The second two are a Will or a Trust and three documents would deal with a passing. Depending on what types of assets your parents own and other factors, one or the other might be more appropriate. It helps to discuss these options with an estate planning attorney. 

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Private Fiduciary, Trustee,Conservator, Financial Advisor

As I always ask "have you done your planning?"  If you haven't done yours, then you can't expect your parents to do theirs.  Lead by example.  Show your mom and dad you Will, Trust and Powers of Attorney for financial and health care matters.  Show them you have and are saving for your retirement... (more)

As I always ask "have you done your planning?"  If you haven't done yours, then you can't expect your parents to do theirs.  Lead by example.  Show your mom and dad you Will, Trust and Powers of Attorney for financial and health care matters.  Show them you have and are saving for your retirement.  Then ask them what they have done?  Then you can discuss what their unique financial picture can provide them if they need care in the future.

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Senior Advisor

I applaud you for being proactive!  You are touching on multiple topics with this question.  I reached out to a very special person, Chris Cooper to help answer this.  Chris is the owner and founder of Chris Cooper & Company, a financial planning firm working with people who own small businesses... (more)

I applaud you for being proactive!  You are touching on multiple topics with this question.  I reached out to a very special person, Chris Cooper to help answer this.  Chris is the owner and founder of Chris Cooper & Company, a financial planning firm working with people who own small businesses, with persons preparing to retire, and very elderly persons. Chris provides counseling and guidance in the areas of investments, taxation, and estate preservation.  As you can see he is perfect to answer this question.  

Chris suggested that you start with your own preparation for getting older, then it will be easier to talk to your parents about theirs.  First, take stock of where you are now; assets and liabilities, income from what sources, risk management tools such as insurance policies for life, health, Disability Income & Long Term Care,  home, car, and liability, Wills, Trusts, Powers of Attorney for financial and health care matters.  Then make an appointment to see a comprehensive fee only financial planner and an estate planning attorney.  

As you are going through the process, you will see what things you think may be lacking in your parent’s planning, and then you get show them you are “all grown up” and are taking responsibility for your own aging, and wanted to ask Mom and Dad, “What planning have you done?”

Thank you Chris for answering this!


Chris Cooper MSFS, CFP®, EA

California Licensed Professional Fiduciary #615

4080 Centre Street, Suite 202

San Diego, CA  92103

EMAIL: chris@chriscooper.com

VOICE: (800) 352-7674

ChrisCooper.com

Baby Boomers Guide to Aging

Elder Care Advocates

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Estate Planning Attorney

This would be a great idea! I find it helpful when speaking to parents to let them know you've just gone through the same process. So if you have done a budget for yourself, show it to your dad. If you have not done a budget for yourself, your should! Also it is important to put together an asset... (more)

This would be a great idea! I find it helpful when speaking to parents to let them know you've just gone through the same process. So if you have done a budget for yourself, show it to your dad. If you have not done a budget for yourself, your should! Also it is important to put together an asset inventory so that you know where assets are located. 

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Private Fiduciary, Trustee,Conservator, Financial Advisor

First, have you put your own affairs in order?  Do you have your Will, Health Care documents, investments, and all.   Sometimes, but showing your parent you have made an effort at putting your own affairs in order will help your parent to discuss his own situation.  Also, depression can cloud the... (more)

First, have you put your own affairs in order?  Do you have your Will, Health Care documents, investments, and all.   Sometimes, but showing your parent you have made an effort at putting your own affairs in order will help your parent to discuss his own situation.  Also, depression can cloud the judgement of many adults, so he may feel like he might as well enjoy it now, because "you can't take it with you".   Discuss if your father will need long term care services in the future, does he want to end up in a nursing home?

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