When Should You Consider Virginia Medicaid LTC for a Loved One?

When Should You Consider Virginia Medicaid LTC for a Loved One?

Deciphering when to consider Medicaid Long-Term Care (“Medicaid LTC”) for a loved one is a question many families eventually find themselves asking. Sometimes the answer has been worked out with your loved one in advance. However, the vast majority of the time, friends and family face making this decision themselves. This post will offer some practical considerations to keep top of mind.

Your Loved One’s Care Needs are Increasing

One key area to look at when assessing when a loved one needs long-term care is how they are managing their activities of daily living. These are essentially our day-to-day functioning at the most basic level. So here are some questions to ask yourself as you observe your loved one’s ability to lead a happy, healthy life:

  • Personal Mobility: Can my loved one safely get to and from where they need to go around their home? Are they able to get in and out of bed, the shower, or a chair?
  • Nourishment: Can my loved one feed themselves? Are they able to take their medication when they need to?
  • Personal Hygiene: Can my loved one care for their bodily health? How is their ability to shower, brush their teeth, or groom themselves?
  • Dressing Ability: Can my loved one dress themselves? How is their ability to choose the appropriate clothes for the day?
  • Restroom Use: Can my loved one safely and sanitarily use the toilet on their own? Can they make it to the restroom on time?

In addition to their day-to-day activities, consider whether there are other less obvious signs you should consider Medicaid LTC. For example, suppose your loved one is starting to show a mental decline (such as dementia or memory loss). As a result, their safety and ability to complete more complex tasks such as driving or grocery shopping may be in jeopardy, but sometimes basic tasks become a challenge too.

We all want the very best for our loved ones. Whether it is your loved one’s spouse, relatives, friends, or even you who would be left caring for them, consider whether it is a sustainable option long-term. We know the saying: you can’t pour from an empty cup. Let’s be honest: caring for a loved one is a lot of work, often a lot of stress, and it can become overwhelming very quickly. How far the potential caregiver lives from the loved one, how busy they already are, and how they get along with your loved one are valid questions to ask yourself not to exacerbate an already stressful situation later.

Your Loved One Has Limited Ability to Pay for Long-Term Care

Long-term care costs add up quickly, and those with limited income may need help paying for their long-term care. Fortunately, Virginia is one of several states that offer Medicaid LTC, which will help cover the costs of nursing home expenses. However, there are tight restrictions put in place by the Virginia Department of Medical Assistance & Services to ensure that only those with very limited assets qualify.

Assuming your loved one is over the age of 65 and medically eligible (meaning they need nursing home level of care), they can qualify for Medicaid LTC if their assets are below $2,000. There are some assets that are exempt and some modest protections for the spouse of a Medicaid LTC applicant, but the applicant must have assets below $2,000.

When one has to resort to spending down their assets to qualify for Medicaid LTC, they should err on the side of caution regarding how they move assets or spend money. Gifts, asset transfers, and selling property under fair market value will be heavily scrutinized and may lead to a denial. Also, keep in mind that this doesn’t only apply to present-day asset transfers—the screener will look back at any transfers from the past five years.

Learn More About Medicaid

Wondering how it all works? We invite you to attend our informative Medicaid LTC workshop to learn more. If you have a loved one in a care crisis right now, contact us. Applying for Medicaid LTC can seem intimidating—and you aren’t wrong to think so. However, commissioning the help of an experienced elder law attorney can make all the difference when moving through the approval process.

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