Long Term Care • Medicaid • Medicare • Asset Transfers • Look-Back Rules • Settlements
Chapter 2 covers the primary sources for funding long term care. Medicare Part A covers skilled nursing facility care only if all three conditions are met: skilled care is provided, the patient was hospitalized for at least 3 days in the prior month, and the care is certified as medically necessary. Medicaid is a joint federal-state program; the only federally required LTC service is nursing home care, though many states provide more.
Under the Deficit Reduction Act (DRA), Medicaid imposes a 60-month look-back period on asset transfers. Transfers for less than fair market value result in a penalty period. Annuities are exempt if actuarially sound and the state is named as contingent beneficiary. Non-countable assets include household goods, one automobile, burial plots, wedding rings, and very small amounts of life insurance. Life insurance policies may also be converted to cash through surrender, policy loans, accelerated benefits, viatical settlements, or life settlements.