Options for paying for long-term and nursing home care in Connecticut

Typically, people needing long-term medical care have three payment options; they must pay for care through private funds, long-term care insurance or Medicaid. Medicaid is a state run insurance program partially funded by the federal government.

Connecticut's Medicaid program, also known as Title 19, covers low-income and low-asset residents who need long-term or nursing home care. Traditional medical insurance and Medicare generally do not pay for long-term care. While long-term care insurance may be an option, such insurance and its affordability depend upon the health, age and financial circumstances of the person seeking the insurance.

Only a few wealthy individuals have the resources to pay the entire cost of long-term care out of pocket. The New York Times recently reported on a study from Genworth Financial that found annual costs for nursing home care averaged $83,950 nationally. With such vast amounts of money at stake, it is important that Connecticut residents explore their payment options through a proper estate plan - in advance of needing long-term care if possible.

Because of the extreme cost of long-term care, many people ultimately end up paying for nursing home care through Medicaid. However, the eligibility requirements are stringent, and many elderly or disabled people find themselves having to deplete their resources and assets, for example by selling the family home, before they qualify for their much-needed care.

If a Connecticut resident qualifies, Medicaid coverage can include:

•· Occasional assistance at home

•· Minimal assistance such as food delivery and homemaker services

•· Day assistance, including at adult day care facilities

•· Round the clock assistance, including at nursing home facilities

Medicaid eligibility

There are two types of eligibility requirements to qualify for Medicaid. One is to establish an individual has a disability and requires care, and the second involves financial requirements. In Connecticut, a person must have less than $1,600 in liquid assets to qualify for Medicaid. For married individuals, there are certain protections afforded to the spouse of a disabled individual needing long-term care, but such protection may only save half of all the couple's assets, and even that is not guaranteed.

Creating a plan

When faced with Medicaid eligibility requirements, it can be tempting to simply gift assets and money to relatives or charities in order to qualify. However, Connecticut state law may impose penalties if it finds that an individual is attempting to purposefully dispose of assets in order to qualify for Medicaid.

Asset protection regarding Medicaid can be a complicated area of the law, as myriad regulations govern eligibility and the individual facts of the case do matter. For example, Connecticut has a "look back" period of five years to determine if a person has gifted assets. Because of the complicated nature of Medicaid applications and eligibility, people who are concerned about paying for the cost of long-term care should contact an experienced estate planning attorney to discuss their situation.