Nursing home care is expensive, costing between $12,000 to $20,000 per month, depending upon the location and the particular state. (These figures are based on nursing homes in New York. Missouri nursing homes cost from $7,500 per month and up.) For that reason, it is important to protect your estate from nursing home costs.
Most seniors should do all they can to prepare for this possibility. According to a recent article from the Times Herald-Record, “Elder Law Power of Attorney can save assets that would go to nursing home costs,” this is something that can be done even when entering a nursing home is imminent. Beck, Lenox & Stolzer Estate Planning and Elder Law, LLC, LLC, has helped over 3,000 families with Medicaid planning in the last 20 years.
A Power of Attorney is used to name people, referred to as “agents,” to conduct legal and financial affairs, if we are incapacitated. Having this document is an important part of an estate plan, since it reduces or completely avoids the risk of your family having to go through guardianship proceedings, where a judge names a legal guardian to take over your affairs.
If a guardian must be named for you, he or she may likely be someone you have never met, who does not know you or your family. It’s always better to plan in advance so you know who is going to be taking charge of your affairs.
Then there’s the Elder Law Power of Attorney, a stronger form of a Power of Attorney that includes unlimited gifting powers. Having this unlimited gifting power lets a single person who applies for Medicaid in a nursing home to protect their assets, by using a gift and loan strategy.
Here’s an example of an individual who lives in New York: Amy, who is single, can’t live on her own and even having home health care aides is not enough care anymore. She has $500,000 in assets and does not qualify for Medicaid to pay for her care. Medicaid will allow her to keep only $15,900. Note: In Missouri, the asset allowance limit is $5,000 for a single individual.
One option is for Amy to spend down all of her money on nursing home costs, until all she has is $15,900. All of her savings will go to the nursing home, with very little left for her daughter, Ellen.
However, if Amy has an Elder Law Power of Attorney, a gift and loan strategy can protect her assets. Half of the money, $250,000, can go to Ellen as a gift under the unlimited gifting powers. The other half goes to Ellen as a loan, under a promissory note with a set rate of interest.
Any gifts made in the past five years, known as a “five year look back,” cause a penalty period. Amy will have to pay for the nursing home for about twenty months. Every month during that period, Ellen will pay Amy a monthly payment that, with her income, is used to pay the nursing home bill. At the end of the 20 months, Amy qualifies for Medicaid to pay for her care for the rest of her life, and Amy may keep the $250,000. Saving half of her assets by using the gift and loan strategy is sometimes called the “half a loaf is better than none” strategy.
With a Standard Power of Attorney, there are no unlimited gifting powers.
A Medicaid Asset Protection Trust (MAPT) created five or more years before Amy needed a nursing home could have saved her entire nest egg for Ellen.
Preplanning is always the better way to go. An elder law estate planning attorney is the best resource for determining the optimal tools to protect a nest egg, if and when a person needs the care of a nursing home.
Many people make the mistake of thinking that it “won’t happen to me.” However, injuries and illnesses often accompany aging, and it is far better to plan for this eventuality in advance than waiting and hoping for the best. Protect your estate from nursing home costs and give yourself peace of mind.
DISCLAIMER: Medicaid planning is complex and the case hypothetical above with “Amy and Ellen” is provided for purposes of illustration. Whether this strategy would work for you or your loved ones depends on the laws of your state of residence, given your unique circumstances. Consult with an experienced elder law attorney admitted to practice law in your state of residence before engaging in any Medicaid planning! Beck, Lenox & Stolzer is licensed to practice in the states of Missouri and Illinois, and our three attorneys are members in the National Academy of Elder Law Attorneys, or NAELA.
Reference: Times Herald-Record (Jan. 8, 2021) “Elder Law Power of Attorney can save assets that would go to nursing home costs”
