Elder Law, Estate Planning and Family Formation

Two Common Elder Law Myths

As seen in the Richmond Times Dispatch, February 26, 2012.


There are many common misconceptions regarding Medicare and Medicaid, including what it covers and when people become eligible.

Understanding these myths can help your family plan and prepare.

Myth: Medicare and Private Insurance will cover the cost of long term care when my parent goes into a nursing home.

Medicare only pays for limited coverage in a nursing home and only after a hospital stay of at least 3 days. The care must be “skilled care” and the program only pays the full cost for the first 20 days. Days 21 through 100 of skilled care require payment of a deductible amount of up to $144.50 per day in 2012. However, in most cases, Medicare pays nothing because only “custodial” care, not skilled care, is required.

While long term care insurance will pay for covered services in a nursing home (or,

depending on the policy, for custodial or skilled services delivered in the home, or often in assisted living or adult care facilities), generally private health insurance will not pay for long term care services. A supplemental Medicare (“Medigap”) health policy often pays for the deductible skilled care expenses during a Medicare-approved spell of illness.

Myth: There’s no Medicaid disqualification if my parent sells her house to me for $1.00 and apply for Medicaid to help pay for her nursing home bills.

Virginia uses the tax assessed value of the real estate to determine its value for Medicaid purposes, regardless of the over-valuation or under-valuation.

If the parent’s house has a tax assessment of $60,000 and is sold to the child for $1.00 on March 1, 2009, then the “uncompensated value” of the transfer would be $59,999, causing a period of 10.11 month period of ineligibility for Medicaid long term care benefits.

For more information about Medicare and Medicaid, visit liftcaregiving.com

Shawn Majette, Esq. and Paul Izzo, Esq. are Elder Attorneys at ThompsonMcMullan, P.C.

Do not rely on the information on this article as an alternative to legal advice from your attorney or other professional legal services provider. If you have any specific questions about any legal matter you should consult your attorney or other professional legal services provider.