What are our financial options as we look into paying for additional care?

A fellow caregiver asked...

My husband at 67 has demetia. We have limited investments and a decent income. Our bills still include a home equity lone. Should I cash in our monies, pay the taxes due and pay off the home equity? It will put us an another tax brac. at the end of the year which will prob. mean paying more taxes again. If we do that we will be left with his s.s. and pensions. That would normally be enough but if/when my husband needs more care ie: day care, in home care or a home for people w/ dementia there just isn't enough for me and him. Would we be able to get medicare or help some other way? What are the options?

Expert Answer

Barbara Steinberg is the CEO and founder of BLS Eldercare Financial Solutions, which specializes in helping families pay for long-term care for their loved ones. A registered financial gerontologist, she speaks regularly on the topic of paying for long-term care and is a financial expert for Caring.com.

To prepare for the time when your husband needs more care, you should learn how Medicaid works in your state. Medicaid is the program that pays for long term custodial care. Medicare is a health insurance program that covers medical and skilled care; it does not cover long term care.

Depending on which state you live in, Medicaid may or may not cover Home and Community Based Services (HCBS) such as day care, home care or assisted living. Medicaid does cover nursing home care.

There are income and asset qualifications for Medicaid eligibility. Again this varies among states. However, all states provide protection for you, the community spouse. If your husband goes on Medicaid, you are entitled to a Minimum Monthly Needs Allowance. This means that you may be able to keep some of your husband's income to supplement yours. There is also protection for your investments. This is the Community Spouse Resource Allowance. There is a minimum and maximum for your state. For 2012, these can range from $22,728 to $113,640. You are entitled to keep half of your assets within the minimum and maximum. To find the specific amounts for your state, you can go to www.elderlawanswers.com and select your state. Before you cash in your investments or pay off your loan, you should seek advice from a knowledgable advisor. You need to do appropriate planning to make sure you protect the assets that you are entitled to keep.