The type of long-term care a senior needs often affects how they pay for it. At Kreisher Marshall & Associates, LLC, a Medicaid planning attorney helps State College families coordinate care decisions with Medical Assistance eligibility rules as part of the broader planning process.
Why Medicaid Often Shapes a Life Care Plan
Medicare generally does not cover ongoing custodial long-term care, such as continuing help with bathing, dressing, and eating. Medical Assistance, Pennsylvania’s Medicaid program, may help pay for qualifying nursing facility care and certain home and community-based services when a person meets financial and medical requirements.
Because eligibility depends on income, resources, transfers, and medical need, Medicaid rules can affect decisions about housing, care settings, and family finances.
Where Life Care Planning and Medicaid Intersect
A life care plan considers a senior’s current health and anticipated needs, then coordinates the legal and financial steps those needs may require.
Reviewing Past Transfers
For long-term care coverage, Medical Assistance reviews certain asset transfers made during a 60-month look-back period. Gifts or below-value transfers during that period can affect eligibility and may result in a penalty period. Reviewing prior transactions before filing an application can help identify potential issues.
Protecting the At-Home Spouse
When one spouse needs nursing home care, and the other remains at home, federal spousal impoverishment rules protect certain income and resources for the community spouse. These protections can also apply in specified home and community-based settings. Accurate information about the couple’s assets and income is important when determining how the rules apply.
Timing the Application
An application filed before a senior satisfies applicable financial or medical requirements may be denied. Waiting too long can also mean paying privately for care that may have been covered once eligibility was established. Pennsylvania requires both financial eligibility and a medical need for long-term care services.
Reviewing Powers of Attorney
A durable power of attorney can allow an agent to manage finances and assist with a Medical Assistance application if the senior can no longer act. Under Pennsylvania law, an agent must be expressly granted authority to make gifts, so older or limited powers of attorney may not permit some planning steps.
Planning for Changes Over Time
A senior who begins with in-home care may later move to a personal care home, assisted living residence, or nursing facility. Each change can affect available benefits and care costs. Revisiting the plan as health, finances, and program rules change helps keep it workable.
Talk to Kreisher Marshall & Associates About Medicaid and Care Planning
Kreisher Marshall & Associates advises seniors and their families on long-term care options and Medical Assistance eligibility. Call 570-784-5211 or contact us online to schedule a meeting with our State College elder law attorneys.