For the last five years Medicaid has spent between $140 billion and $200 billion annually on the costs of long term care “supports and services” primarily for seniors. In terms of numbers of people that receive Medicaid, 80% of the dollars are spent on less than 20% of the eligible population which is almost entirely driven by long term care costs. But the irony here is that people don’t want to go onto Medicaid!
When a person is on Medicaid they are no longer able to choose what they want for long term care. Most forms of homecare and assisted living are private pay—which means you must have resources other than Medicaid to be able to pay the monthly “out-of-pocket” expenses. The typical scenario for a person on Medicaid is that they will go into a nursing home and most often share a room with another patient. For most people that have worked their entire lives, raised a family, and participated in their share of the “American Dream”; spending your final days in this scenario sounds more like a nightmare.
State budgets are under extreme pressure to keep up with their share of the rising costs of Medicaid. Families would prefer to look at Medicaid as a last resort (which is what it was created to be) and don’t want to spend-down their assets to get below the poverty line to qualify. Remember, if you go onto Medicaid it means you are below the poverty line and have become a ward of the state.
Families would prefer to remain in control of their health care decisions, maintain financial independence, protect their assets, and preserve dignity in their lives when it becomes time for them to start receiving long term care supports and services. To do so they must plan and prepare as much in the future as possible, and when it comes time to start receiving care they must understand their rights and options to stay private pay and in control for as long as possible.