Maryland Medicaid Paying For Long Term Care

By Terry Douglas, Maryland Elder Law Attorney

Douglas Law Office

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Maryland Medicaid Paying For Long Term Care

According to longtermcare.gov, “50% of married couples will spend all their life savings within the first year of entering a nursing home.” With a long-term care plan, that costly mistake can be avoided.
Thomas and Annie Hargrove are married and over 65 years of age. A few months ago, Thomas fell while playing tennis and suffered a hip injury, and he was admitted in a hospital for three nights. Afterwards, he was sent to rehab. Thomas never fully recovered from his hip surgery; so, he was transferred to a nursing home.

Annie continues to go through her regular routine at home, cleaning the house, preparing meals, and paying the bills. Annie visits Thomas every day, and she takes him his favorite food. Today, when Annie returned home, she sat at the kitchen table and opened the mail. There was a bill for $25,902 for three months in the nursing home. Annie started to cry.

If there's an unexpected catastrophic illness that will last more than 90 days, will you have enough money to live on? In addition to retirement savings, look into long-term care insurance or government benefits, such as Medicaid.

Generally speaking, the average cost of care of a nursing home in Maryland is $8,634 per month ($287.80 per day or $104,208 per year).

Medicare pays for medical expenses such as doctors, hospitals, physical therapy, medical devices, and rehab. For short-term care, Medicare pays 100% of days one through 20. For days 21 through 100, the patient or supplemental insurance pays a co-pay of $164.50 per day ($4,935 per month). After 100 days, Medicare pays nothing. (Medicare does not pay for long-term nursing home care.)

Medicaid pays for nursing home care, also referred to as medical assistance. The applicant must need assistance with basic activities of daily living (ADLs), such as bathing, dressing, transferring from bed to a chair, or toileting. There are certain eligibility rules regarding income and assets as well.

Medicaid reviews all income and resources over the last 60 months (five years), including, bank accounts, joint accounts, stocks, IRAs, life insurance with cash value, and tax returns.

An applicant can keep the house (if owned by the applicant or spouse, and there is an intent to return home).

An applicant can keep a car, household goods, and personal belongings.

A well spouse does not have to use their income to pay for the sick spouse's cost of care.

For middle-income Marylanders, there are legal strategies available to become otherwise eligible for Medicaid even if they have $100,000-$500,000.

Medicaid rules are complex with different eligibility requirements and exceptions. If you are in a nursing home or on the way, consult with a Medicaid Planning Attorney to avoid costly mistakes.