Medicaid, part 3 with Jim Koewler

*The following is the output of transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors.

The following podcast is by Mr Jim Koewler, elder law and special needs attorney, helping and protecting those who need long term care. And Welcome back everyone to the answers for elders podcast network. And we are here with Jim Koewler from the Koewler law firm and we are talking about Medicaid and our first segment we talked a little bit about long term care and what Medicaid is and how it covers and specifically about what we then we talked about spend down and what did that that mean and obviously you just don’t get Medicaid right up front. So we’re going to talk now a little bit about how to be a little bit more creative in your spend down so that you can help your loved one or or yourself qualify for Medicaid. Jim, welcome back to the shop. Thank you. Thank you. Yeah, so we talked a little bit about what is the spend down and it was like, yes, you want to make you need to plan that. I guess the overall thing is planning in advance to switch over. It’s not just a magical thing that happens. And, like what you said, you you can’t go until you have less than two thousand dollars worth of assets, you can’t switch over. So tell us a little bit about where we’re at with the spin down of what we first talked about and now you said you had some other options for yes, okay. First of all, spending down and having a plan and doesn’t necessarily mean we’re planning five years in advance. That’s a whole different animal. Okay, a crisis plan means we’re planning in advance, and it may be days or weeks in advance of a Medicaid application. Right. So don’t let the in advance people five years in your head. Okay, in at least in my terminology. If you need long term care now or it’s imminent, you’ve got dementia and we know that’s going to end up. Yeah, that’s crisis. We’re still planning, but we’re not planning with a five year window, right. They’re not planning to get through the next five years because we know you’re going to need care before the five years runs out. Pre Planning is older an animal and we will have segments on that, but not today. Okay, okay. So when we are planning to get you on to Medicaid, as soon as we can make arrangements. That’s a crisis plan, but it is still a plan. So so planning doesn’t necessarily mean long term. Just let’s make that okay. So, as I mentioned in another segment, Medicaid want you to spend your money rather than give it away. But there are ways to spend it that are allowed. That makes sense. Now, as I mentioned an earlier segment, a purse, a single person has to have no more than twozero and resources meeting what’s left in the bank after income comes in and builds are paid as and bank personal count, the nursing home, everything. Okay. So all of their wealth is too grand as one month rolls into the next. Okay, they we do it by month in, not midmonth. A married person it gets much more complicated because the this presumably healthy spouse. If we have, if both spouses around Medicaid, then they’re just two grand or less each. Okay. But if if we have a healthy spouse, that healthy spouse gets to gets to keep some, and that’s a whole different discussion we’re not going to cover today. But the tow grand is still where the ill spouse has to get. So there is some spend down there as well, but spend down possibilities. For spouses are have a lot more opportunities or less. One enormous opportunity that than a single person doesn’t have. So let’s focus on a single person right now, because I don’t think we can cover both in this one segment. Okay, single person or someone who’s going on Medicaid and the spouse is already on Medicaid for medicate purposes. That that second applicant is single. Okay, they have too much money to qualify for Medicaid, meeting more than two thous what can they do? Well, as I mentioned before, they could buy ten televisions and they could get rid of ten grand. But that’s a stupid way to do it, unless they’re really nuts like my uncle who had to watch every football game on um the so another way to do it is fine spending that makes sense, my favorites bar none. Let’s focus on quality of life. Of the personalities long term care. Does the person wear glasses? If they do, let’s buy two or three or four more pair, because glasses disappear from nursing homes like socks disappear from dryers. We do I just like socks dispiron from driver dryers. I suspect glasses. They get lost, come back as a type of worreld that fits nothing. Do they wear hearing aid or should they? If so, that’s a good spend down it. Yes, it’s not cheap, but hearing and seeing are huge parts of quality of life and if you’re in long term care, quality of life is pretty much all we have left, so let’s focus on that. Do they need dentures or do they wear dentures? Maybe by an extra set? The reason I say extras, just like glasses disappeared. Glasses disappeared because you’re in the dining hall or in the in the activity room playing Bingo. Are you falling? You break them, put them down. Okayow, dentures and hearing aids go on your nightstand and then when the aid comes in to check on you in the middle of the night, some nights bumps the nightstand. These things fall on the floor, nobody notices. They get stepped on the next morning. Okay, because I don’t make a lot of noise when they hit the floor. Yeah, so that these things disappear and they are huge quality of life issues. Okay, if if the person is stable on their feet but have trouble getting up, maybe a lift chair. If they’re not steel on their feet, do not put a given a lift chair, okay, because now are you doing is giving the opportunity to put themselves into danger without help there to keep them steady. So they have to be steadying on their feet to make a lift chair a smart purchase. Okay, but those are my four favorite on quality of life issues. The first things I want to spend money on, regardless of anybody else in the family, including the spouse. I want quality of life for that person who need long term care. Okay, after that, maybe some comfortable clothes. They usually have clothes, but maybe they need you know, maybe they’re just beat up. They haven’t bought clothes in a while and they want things they can put on and take off easily because they’re in long term care. Right, and we’re not talking huge bucks here, but again, quality of life expenditures that make sense, that benefit the person needs care. Okay, so those are the quality of life expenditures that come to mind. Next thing to look at is have they made their funeral arrangements? Here they have, and we will do a whole segment on preplanning and when to pay and how to pay and all that. Okay, but if we’re applying for Medicke now or or soon will be, it’s a crisis plan. Now is the time to pay for the funeral, if we haven’t already. Okay, because that is a perfectly valid spend down thing. And isn’t it true that the cost of funerals can almost double every like three or four years? It’s crazy. I would have been. I do not know that statistic, but yes, it can be crazy. I have also seen huge differences in the cost of funerals just based on family tradition. I’ve met a woman one time who arranged a funeral for her father and it was thirteenzero. Oh my God, what they doing? Bringing a Jazz Band Rock New Orleans? Yeah, it’s so. It’s really thirteen grand is a huge funeral, okay, but that not here. He’s expected here in Washington, in Seattle. I would say it’s double that. A big wow, close to that, if because the barrier plots the land is so you know, I applots are different. You’re separate. Okay, okay, yes, pree, I’m talking about the ceremony. I thought you were talking about the yeah, the ceremony itself is probably easily ten grand. Yeah, okay. But yes, while we’re considering a funeral, by the funeral, plot by the bury, a plot if they’re going to be buried or if they’re going to mausoleum or going to be made it in, fix it. Get that now. Okay, get it now, because one, that’s a ballot. Expend down, spend down, and it’s real estate. If you want that spot under the oak tree, you have to get it before Sudan does. Okay, because it’s one per person. Or if you’re married couple, maybe two. Okay, you may, you know guys. You may want a dream of being buried on top of Marylyn Monroe, and we all know what you mean by that. It ain’t happening. Okay, that spot was already taken. It was auctioned off. Okay, so get the spot you want, because that is real estate. And yes, that can be expensive. So you know, Hio, that’s relatively cheap. If we here, you can buy a barrier plot for two grand. No problem. Okay, NEW ORLEANS, since the entire city is basically about that water, everything’s above ground, but you still have to find plot to put it on. It’s got to be terribly expensive in New Orleans. Okay. So get the burial plot separate from that. Pay For the funeral. Okay. In addition, check with the funeral home. What assuming we’re assuming a burial here or placement into a niche, not simply ashes being scattered. Okay. If ashes being scattered, obviously don’t buy a barrier plot. Check still a funeral, whether if you’re cremated, there’s still a funeral. Okay, yeah, well, that’s the ceremony. Okay, again, I’m splitting the ceremony away from the real estate. Correct. Okay. So ask the funeral home if they will put aside money. If you if they you can prepay the funeral home. Or opening and closing the grave. Okay. Buying a burial plot is one type of income and the one instance they’re going to receive significant income at the cemetery for that spot death. Take care of it forever. Opening and closing the grave either taken the cover off the mausoleum or digging the hole in the ground. That is a labor intensive thing and most cemetery is now charge for that. Yeah, they do. It’s like taking your baggage on the airline you can buy a seat, but you got to pay extra take your bags, okay, or even more in the rule of the NFL, you buy your burial plot. That’s a personal seat license. You just have to pay for the seat. Okay. So if the funeral home will not accept that money, now see if the if the cemetery will. If the cemetery will not accept that money, now look into buying a separate burial insurance policy for it, because opening and closing the grave is the biggest sing with the most common loop. Surprised family. There’s more money on the day of the funeral and that just hurts you know. That’s rubing salt and when you’re at a funeral. Okay. So that’s a surprise thing to consider. Why you’re out there. Pay For the ceremony. You can do it through insurance or pay the funeral home, and we’ll talk about that separately in more detail. Pay For the real estate that you’re paying them arry. Now pay the cemetery for the real estate to lock it in. You’re not, buy an insurance for the real estate by the real estate, okay, and then see how to open, how to pay for opening and closing the grave. In addition, if you’re going to have a breavement lunch, you know, the meal after the service, see how that’s going to get paid funeral homes, unless it’s at the funeral home. The funeral home play will not take money in advance for that. The church may covered if you’re a church going person, but if you’re in a few fewer people at Church going people get a quote from a restaurant for, well, we’re probably going to have twenty people and it’s going to be a lunch and you know. So what do you do to how much do you charge to cater a lunch for twenty people, whether they’re delivering it to your place or you’re going into the restaurant? And during Covid your may not be going into the restaurant. You can get a quote for that and you can buy insurance for that, because that’s there’s a special kind of insurance called burial insurance, and people go up funeral directors insurance. They can give anything about a burial. They can also pay for flights for your cousin who has to plan from the funeral from Denver right and you get a quote today, you buy insurance today. When the funeral comes, we know the price is going to be different, because the price will play be different tomorrow than it is today, but still you’ve set some money aside for it. You can prepay hotels for that cousin who has to come here, okay, and then not stay in a week, two or three days, okay. Yeah, these are things you can use to set aside and buy them now as part of a spend. Yeah, and I think overall, just really at the nutshell and talking about us spend down and doing that. I know when my mother passed away, it was the last gift she gave to me because all I had to do was pull this little card out and call a number and everything was pre arranged. I didn’t have to decide what she wanted. I didn’t have to sit there and figure it out. It was an amazing thing that my mom did for me because everything was already prepaid in advance, and I think that’s something that we did when we qualified her for Medicaid. Is is we paid for, you know, her cremation and her ceremony. So yeah, Jim, thank you so much for your wisdom today with us and on these wonderful topics that we’re talking about. And we look forward to hearing back from you very soon. Thanks, Suzanne. All right, guys, take care. State of Ohio residence. You have a friend to help you navigate long term care while protecting your assets. You can reach Jim at www dot protecting seniorscom or just email him at j Koewler afe. That’s j Taylor AFE at Protecting Seniorscom