Title 19

As most people know, the cost of receiving long term care in an assisted living or skilled nursing facility is quite high. Unfortunately, these costs show no sign of doing anything other than continuing to increase as time goes on. At these prices, many people who need long term care will see their retirement savings and other assets (that have taken a lifetime of hard work to acquire) entirely exhausted by nursing home bills as quickly as in a matter of months.

Title 19 (also referred to as “Medical Assistance” or “Medicaid”) is a joint federal-state program which provides funding to cover the costs of long term care for individuals who meet certain income and asset requirements. The eligibility requirements for married applicants are different from those for unmarried (including widowed) individuals. These rules are extremely complex and often apply differently to one person’s situation than they do to another’s based on seemingly insignificant or minor differences between the two.

Further, the laws governing the Title 19 program are subject to frequent change, and usually the changes make it ever increasingly difficult for people needing long term care to qualify for benefits while still keeping assets for themselves or to pass to their families. Even after the changes to the law are enacted, however, the extent to or manner in which the agencies administering the program will enforce or apply these changes often remains unclear for months or even years.

For these reasons, it is not practical for us to here provide you with a thorough overview of the Title 19 eligibility and application rules, or to summarize the way in which they might apply to a particular individual’s situation. Instead, if you or someone you love needs long term care or would like to begin proactively planning in case a need for long term care arises, please consider the following general tips:

• Don’t do anything hasty! When an individual needs long term care now or in the near future, taking certain actions (such as giving away money, or annuitizing certain assets) may have an adverse impact on the individual’s ability to qualify to receive Title 19 benefits.
• Don’t panic! Although the Title 19 program has rules designed to limit who can receive benefits, the way the rules apply to your situation may not be as bad as you fear. For example, if your spouse needs long term care in a nursing facility, your home will probably not count towards your asset limit as long as you remain living in the home.
• Explore your options! Whether you have an immediate care need or you are trying to be proactive in case a care need arises in the future, a skilled elder law practitioner may be able to help use the Title 19 rules to your advantage and allow you to keep more money for you and your family without interfering with the ability to qualify for Title 19 benefits.
• Have you considered long term care insurance? Most people are familiar with life and health insurance, but have you looked in purchasing long term care insurance? While they are not right for everyone, long term care insurance policies may provide a way to protect assets in the event they develop a need for long term care in the future.
• Do you have a well-drafted lifetime and estate plan? When a care need arises unexpectedly, often the extent to which an elder law attorney can help you or your family preserve assets depends upon the terms of your estate planning documents (such as your powers of attorney or trust document). You should make sure your documents have been drafted by an attorney familiar with the Title 19 rules.

Trying to plan for or deal with long term care needs can be an extremely difficult experience. If you or a loved one is facing this type of situation, please take the time to consult with a skilled elder law attorney to review your situation – once you know how the Title 19 rules apply to your unique circumstances you can make an informed decision as to the best way to proceed. Contact an elder law attorney at Moertl, Wilkins & Campbell, S.C. today!

Please click below to hear a discussion with Attorney Terry Campbell about important elder law topics and considerations!”