Things Can Turn on a Dime

By Barbara Braa, MBA, CTFA

“Life turns on a dime. Sometimes towards us, but more often it spins away…” Stephen King

As investors we all know things can turn on a dime. This article is not about investing. Instead, it is about programs available to help you, your family members or friends when health or fortunes have changed direction and extra help is needed.

There are various assistance programs created, regulated and supported by federal and state taxes. They cover all sorts of needs but finding the right program to fit a specific need is not an easy task. The focus here is on health care and financial assistance programs. Some may be familiar to you, while others are not, and may be difficult to find on your own.

Medicare and Medicaid are widely recognized, but different programs providing health care access. Medicare is a federal program which provides access to health care options to those age 65 or older and to some younger individuals with disabilities. People mistakenly assume Medicare will cover extended long-term care in a nursing facility. It does not. However, it may cover limited days of rehabilitation care post hospitalization but with strict limits on the duration of your stay. Medicaid is run by each state based on federal guidelines and is funded by both entities. It offers health care assistance to very low-income individuals with limited resources. You will only be allowed to keep a small amount of cash. You may be advised to spend down your resources on allowable purchases to possibly qualify for Medicaid sooner, but do not attempt to just give away or have someone “hold” your resources in order to qualify. There is a five-year lookback rule on gifting or transfers and you may disqualify yourself for care to the extent of the dollars given away. Medicaid is often the only program available to help financially strapped individuals pay for long-term nursing care. Contact your state’s Medicaid office for information and to apply.

Division of Assets is a legal strategy designed to help married couples divide their assets equitably so the care costs of one spouse will not impoverish the well spouse. If this might fit your situation, don’t wait too long to learn more so you can maximize the amount the well spouse can retain. Plan ahead by consulting an elder law attorney with expertise in this complex strategy. The National Academy of Elder Law Attorneys may help you with their “Find an Attorney” feature at www.NAELA.org .

Veterans Aid & Attendance is a program to provide a monthly benefit to honorably discharged war-era veterans and/or the veteran’s spouse. The eligibility rules are based on the veteran’s service history, age, and on current income, medical expenses, and available resources. Visit the official VA website at www.va.gov/pensions/aid-attendance-housebound/ to research the program. Contact your state’s Commission on Veteran’s Affairs to locate a local Veterans Service Representative to help determine your eligibility and to apply. Again, if you are tempted to transfer your assets to others or into an irrevocable trust to qualify sooner, VA has a three year look back rule and you risk disqualifying yourself for this and other programs.

Social Security Income (SSI) may provide a benefit to persons with limited income and resources and who also are disabled, blind, or age 65 or older. Some children or disabled individuals may be eligible too. Social Security Disability Insurance (SSDI) can provide income assistance for disabled workers who have earned enough credits to claim a disability benefit. If you have SSDI but want to work, ask what income you are allowed to make and still keep your benefit. Working a little may qualify you to participate in a Medicaid buy-in program such as the “Working Healthy Program” in Kansas and the “Ticket to Work Health Assurance Program” in Missouri. There are beneficiary specialists there to help you.

This article has touched on only a few programs. To zero in on the many programs specific to you or a loved one, visit www.benefitscheckup.org on the National Council on Aging’s website. You can also contact your local Area Agency on Aging or Senior Center for information on all sorts of programs.

Your Central Trust Company advisor may be able to guide you to local programs and resources. Finding the right assistance programs can seem like searching for a needle in a haystack. But when you find that needle, you may be able to stitch together a customized plan to meet your or your loved one’s needs. Taking positive steps may help turn things back to your benefit.