By Aaron Paker.
This week in Crisis Corner, overcoming the fear of handouts.
We have had many clients who were children during the great depression and many more who have spent much of their adult lives opposing Welfare and the spending of money on those who have not earned it. They come to our office, usually grudgingly dragged in by their loved ones, and they tell us they do not want a handout and to find another way for them to get help. Sometimes it even gets to the point of the family coming in only after their loved one is too incapacitated to refuse the help or completely out of money and with no other options.
There are a few things that we often share with clients who are of this mindset:
You have likely paid for this. There is no direct “Medicaid tax” that you pay, though you do pay into Medicare and Social Security, at least while you are working. However, roughly 60% of the Federal budget is dedicated to mandatory spending. That primarily consists of Social Security, Medicare, Medicaid, and Veteran’s benefits. If you have paid taxes, you have contributed to the funding of the Medicaid program. You might as well use some of that money rather than have it all go to others who may or may not have paid in.
Your family are the most likely to suffer from your refusal. You have every right to spend all of your life savings paying privately for care. The rules that we use to help clients protect some of their assets make it possible for them to have assets available to improve the quality of life that they experience after their care needs increase and, just maybe, have a little something left to pass on to their children when they are gone. As with any set of rules, there are ways for people to abuse the rules that allow for the protection of assets. We have had several couples with multi-million dollar estate and massive incomes request help getting Medicaid to pay for care and, if we were so inclined, we could have legally helped them do just that. However, most of the people who come to me for help have somewhere in the range of $100,000.00 to $1,500,000.00 and care costs that are reaching the level of $60,000.00 to $180,000.00 per year. It does not take long to become destitute with care costs that reach those levels. For those with more than $500,000.00 there are often other, non-Medicaid, options available, but they are not always practical or appropriate.
Waiting could cost the government even more and give you a lower quality of life. There are a few people who will hold out until every dime is gone and their family cannot help them, physically or financially, any longer. At that point Medicaid, in a nursing home, may be the only option that is left to them. The benefits that Medicaid pays to a nursing home are, generally, larger than the benefits paid in any other setting, with Medicaid paying as much as $10,000.00 per month or more to the nursing home as opposed to the $3,000.00 to $5,000.00 that they would pay in most other settings. For all of that extra money that the government is paying, the person receiving care is living in a situation that almost no one would choose for themselves if there were any other options. Do not get me wrong, we have visited clients in nursing homes that were quite pleasant and that provided a fairly good quality of life. However, the majority of my visits to nursing homes are depressing. We see patients sitting in wheelchairs in the hallway, wearing nothing but a hospital gown, and staring at nothing in particular. We see six patients seated around a horseshoe table being fed by one disinterested care provider. We smell the overwhelming stench of urine and bleach that lingers with me and my clothes for hours. Waiting until you are out of options for where you receive care makes it very difficult to be choosy about which nursing home you land in and we would not wish most of them on our worst enemy if we had any other options.
The key is to recognize that you are not taking a handout, you are taking a hand up. You are using the rules that have been created, by the government, to give yourself and your family the best quality of life possible. Assuming you come to us or another elder law attorney that believes that Medicaid is not always the answer, you will look at other options besides Medicaid unless it truly is the only resource left for you in your current situation. You may still land on Medicaid, but you can at least feel better knowing that you have explored other options and then did what was right for you and your loved ones.
If you want to learn more about Medicaid and how it might fit into your future or the future of a loved one, please give us a call today.