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Medi-Cal

Q&A: An aging relative is spending her nest egg on round-the-clock care. What happens when the money runs out?

October 22, 2024 By Liz Weston

Dear Liz: A family member is 90 and lives by herself at home. She has around-the-clock caregivers paid for by her investment accounts. Her teacher pension pays for all everyday expenses. She is high maintenance and unwilling to accept she will one day run out of money for caregivers. What would you suggest?

Answer: That depends on how much money she has, and why you’re asking.

In-home, round-the-clock care can be mind-bogglingly expensive. The median cost nationally for 24/7 at-home caretaking was about $24,000 a month in 2023, according to Genworth’s latest “Cost of Care” survey. By contrast, the median cost for a private room in a nursing home was closer to $10,000 a month.

Not many people could pay for around-the-clock care for long, but your relative may be one of the exceptions. If she has enough savings to pay for care for a few years, then perhaps she’s making the calculated gamble that she’ll run out of breath before she runs out of cash. (And if she’s the suspicious type, she may be convinced your concern is more for your potential inheritance than her well-being.)

Once her resources are depleted, though, her situation could become pretty bleak. Her income may be too high to qualify for Medicaid, the government program that otherwise might pay for nursing home care. (In California, the program is known as Medi-Cal.) Perhaps her home could be sold to pay her care. If not, she might have to turn to relatives for financial help.

If you’re one of the relatives she would turn to, then you can certainly let her know how much help you could afford to give her, if any. But first, suggest a session with an elder law attorney who can review her situation, calculate how long her resources might last and offer suggestions for managing her care bills. She may be more willing to listen to a professional third party than to her family. You can get referrals from the National Academy of Elder Law Attorneys at www.naela.org.

Filed Under: Elder Care, Q&A Tagged With: caregivers, long term care, Medi-Cal, Medicaid

Q&A: An update on the inheritor trying to stay below the poverty line

August 12, 2024 By Liz Weston

Dear Liz: I have an update about a recent question in your column. A reader wrote that they had been low income but had recently inherited $175,000. You noted that Medicaid has strict asset limits. Actually, that is no longer the case in California, where Medicaid is known as Medi-Cal. I just received literature from it that says, “A new law means assets will not be counted during Medi-Cal renewals.”

Answer: Again, quite right! Some other states have increased asset limits for Medicaid, the government health program for the poor, but California is the first to remove asset limits entirely as of January 2024.

This column appears in different states, which can vary dramatically in their laws and policies. That’s why I constantly suggest getting personalized advice from attorneys, tax pros and financial planners. A column can dispense general education but can’t offer individualized advice tailored to the realities of where you live.

Filed Under: Follow Up, Inheritance, Q&A Tagged With: IRA inheritance, Medi-Cal, Medicaid

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