Planning ahead for your own care needs can help you achieve a higher level of peace of mind. When you are fully responsible for planning for all of your own future care needs, the process can be rather intimidating. But by planning as early as possible and surrounding yourself with the right experts, the process can absolutely run smoothly with a minimum of stress.
Planning ahead for your own care needs can help you achieve a higher level of peace of mind. When you are fully responsible for planning for all of your own future care needs, the process can be rather intimidating. But by planning as early as possible and surrounding yourself with the right experts, the process can absolutely run smoothly with a minimum of stress.
The first step is to determine exactly the type and level that you may need in the coming months and years. Perhaps retaining a geriatric care manager is your first step. This manager can perform case management duties and guide you through an assessment of your ability to perform normal activities of daily living (adls) and/or instrumental activities of daily living, and to determine the specific areas in which you may have challenges. After this determination, you can then determine the level of care you require, be it home health care, adult day care, residence in an assisted living facility, if a nursing facility level of care or nursing home care is needed, if short term respite care is all that is needed, or a combination of these long-term services and supports.
Once the initial care need has been determined, next will be to identify the method in which the care will be paid. Do you have sufficient funds to fully private pay for your care? Will Medicare pay for your care needs? (Most likely not.) If not, will you likely need to file a Medicaid application to pay for care? If so, early Medicaid planning is vitally important, with a full knowledge of the asset limits for your program in order to qualify for the Medicaid benefits. A full familiarization with the income limits, the eligibility requirements.
If the need (hopefully) is to receive care in your home, and payment is an issue, then planning for Home and Community Based Services (HCBS) is your first step. Medicaid home care can be provided either by a home health agency, or even through self direction by a friend or family caregiver under the consumer directed personal assistance program. Under either method, a Medicaid application to the applicable Medicaid office. If a home care agency is chosen, then research into an agency that can bill to the Medicaid program is required. If the consumer directed option is chosen for personal care assistance, then application would include a description of the tasks performed by the loved one/home health aide: toileting, home delivered meals, etc. These self directed services are very popular today.
If home care is possible but potentially problematic, note that retrofitting the home through home modifications is an allowable use of funds to prepare for care, and may help with the process of lowering funds under the applicable asset limit.
Finally, it is important to note that the same Medicaid requirements for nursing home Medicaid eligibility apply to HCBS. Gifts made within 5 years prior to the Medicaid application will be subject to the 5 year look back period rule. Most other managed long term care programs are not subject to the 5 year look back period, but both Home and Community based services and nursing home Medicaid eligibility rules include prohibitions on gifting.
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