A Guide to Nursing Home Planning in Pennsylvania

Will I need long-term care?

A lot of variation exists in the duration and level of long-term care that different people will need.

Nearly 70 percent of people currently turning 65 will need some kind of  long-term care.

70

percent

What does long-term care cost?

$116,800

COSTS OF CARE:

This varies by region across Pennsylvania from approximately $69,500 to $135,000.

Median annual cost for a private room in Pennsylvania

How do I pay for the care I need?

About 23 percent of all long-term care expenses are paid for out-of-pocket.

23

percent

About three percent of nursing care expenses are paid by long-term care insurance.

3

percent

Medicaid covers nearly half of all nursing home costs nationwide.

1

2

3

4

Be a Pennsylvania resident Be a U.S. citizen or a qualified non-citizen Have a Social Security number Have a medical need for long-term care services

GENERAL MEDICAID ELIGIBILITY:

To be eligible, you must:

Financial eligibility

There are limits on both income and resources when determining financial eligibility.

Income Limits

1

The general income limit for Non Money Payment Medicaid is 300 percent of the federal benefit rate, which changes from year to year.

Most types of income are counted, including:

PENSIONS

SOCIAL SECURITY

WITHDRAWALS FROM AN IRA ACCOUNT

Most types of income are counted toward the general income limit:

Resource Limits

2

For an individual with income of 300 percent or less of the FBR, the resource limit is $2,000, but in Pennsylvania an additional $6,000 in resources is disregarded.

Most resources are counted, including:

CASH

STOCKS & BONDS

IRAS

NON-RESIDENTIAL REAL ESTATE

BANK ACCOUNTS

How can I protect my assets?

Early Transfers

1

The first strategy is the simplest, but also the riskiest. It requires advance planning to transfer assets before the five-year Medicaid look-back period.

Medicaid examines the five year period before the application, but there is no penalty for gifts or transfers of assets made before the five-year period.

Early transfers

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Converting Assets to Income

2

You can use your assets to pay off existing debts or prepay large bills such as insurance premiums and real estate taxes.

Paying off a mortgage, buying furnishings or buying a new car are all legitimate ways to spend down assets.

Converting assets to income

2

Irrevocable Trusts

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In this arrangement, the trustor transfers assets such as real property or other investments to an irrevocable trust, with a trusted person acting as the trustee.

If the trust is structured to follow Medicaid’s rules, then the assets will not count toward the Medicaid resource limits.

Irrevocable Trusts

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Talk to an attorney to find out what strategy is right for you.

We give families the peace of mind of knowing the best possible planning is in place.