Long Term Care: Fact v. Fiction


I am often amazed by the amount of misinformation out there regarding estate planning, long-term care, Medicaid, and the like.  Today, I want to discuss some of the misconceptions related to Medicaid and nursing home care that I often come across.

Note that Medicaid is a federal program implemented by the states under federal guidelines.  Thus, these rules will vary somewhat from state to state.


1.    When I go on Medicaid, the state will take my home.

Medicaid for nursing home care is means-tested. This means that a patient has to meet certain income and asset requirements for Medicaid to help pay the cost of nursing home care.

Medicaid does not count all assets in determining eligibility, and the home place is one of several “exempt” resources that are not counted.  So, a patient can enter a nursing home on Medicaid and keep his or her home.

However, the state of Georgia has implemented a program called Estate Recovery, where it seeks reimbursement for the amount it paid for patient on nursing home care.  Reimbursement is only sought after the patient and his or her spouse are both deceased.  Medicaid can place a lien on the home to recover this amount.

2.    Medicaid patients are not treated as well as other patients.

Medicaid patients should receive the same care as private pay patients.

3.    I should give away my assets to my children so that I can get Medicaid for nursing home care.

Federal and state law generally prohibit the transfer of assets for the purpose of obtaining Medicaid for long-term care.  Medicaid only penalizes those transfers made in the five years before the patient’s being eligible for and applying for Medicaid.

The penalty is calculated by dividing the amount transferred by $4,988.33 (as of 2013), and the result is the number of months that the patient will not be able to get Medicaid once he or she is otherwise eligible.

4.    If I have to go to a nursing home, I will run out of money.

Several types of assets are exempt for Medicaid purposes, and do not have to be spent down for the patient to get Medicaid for long-term care.  These include a patient’s home; tax-qualified retirement plan such as an IRA, 401K, or 403b (in most cases); burial account up to $10,000; and automobile.

5.   It is always better to stay home rather than go to a nursing home.

The home place is often more dangerous for an elderly person in need of nursing home care.  It is infinitely more difficult for family caregivers, and can result in isolation for the patient.  The stigma surrounding nursing home care should not prevent caregivers from seeking the best environment for their loved ones.

6.    Medicaid covers all types of long term care.

In Georgia, for long-term care Medicaid only covers nursing home care.  It does not cover assisted living.  Assisted living is a lower level of care, appropriate when people need help with activities of daily living (e.g. eating, bathing, dressing) but do not need continuous nursing care.


CAVEAT:  This web site and the information contained herein have been prepared for educational purposes only.  The information on this blog does not constitute legal advice, which would be dependent upon the specific circumstances of a particular case.  In addition, because the law can vary from state to state some information on this site may not be applicable to you.

Image © Andy Dean – Fotolia.com


About Sarah R. Watchko, Esq.

Sarah R. Watchko is an attorney practicing estate planning and elder law in Atlanta, Georgia


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