The Decision

Paying the bills

Paying for care typically involves one or a combination of the following:

• Self-pay.

• Long-term care insurance.

• 

Medicaid.

Every state has different requirements. Missouri requires that an individual have assets not in excess of about $1,000. In Kansas, the cap is $2,000.

• Medicare may pay for 100 days or less of care in a long-term care facility if the care is part of rehabilitation due to recent hospitalization.

• Some benefits also may be available through the

Older Americans Act

or

Veterans’ Aid Attendance Benefits

.

Gathering the papers

Here are some of the basic estate planning documents that experts recommend:

• General durable power of attorney: For business and financial matters; can be tailored to be broad or limited as an individual desires; can be revoked; can be made effective immediately upon signing or upon a specific event; allows one to maintain control of future by nominating a trusted person.

• Health care durable power of attorney: Helps avoid need for court-ordered guardianship; becomes effective only if the principal becomes incapacitated or unable to communicate wishes; can include a “living will,” also known as advance directive language, laying out wishes regarding nature and extent of care desired at end of life.

• Living will (advance directive): Allows one’s wishes to be carried out regarding end-of-life care; applies only in the event of an irreversible or imminent terminal condition.

• Last will and testament.

Spending down

Some basic strategies:

• Pay off outstanding debts, credit cards, home mortgages.

• Buy pre-paid funeral plans.

• Replace an old vehicle to secure reliable transportation for coming years.

• Pre-pay taxes and insurance obligations.

• Make needed home improvements and update furnishings.

• Take a needed vacation.

• Make gifts to children, although this will need to be reported to Medicaid. Depending on the amount, gifts will create a period of ineligibility for Medicaid benefits anywhere from a few weeks to five years.

Source: Karen Weber, elder care attorney

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