How can I stay in my home?

This is a question commonly asked by today's senior citizens.

Typically, people do not wish to spend the rest of their days in a nursing home or other restricted facility, even if 24-hour care is what is needed to keep a person healthy.

So, how does one pay for care?

Use assets

Some people may have enough money to pay for their own care for the rest of their lives.

Unfortunately, not everyone does.

For those who do not, they still have to spend down the assets they do have until they reach the applicable asset limit for the Medicaid program that suits them.

One way or another, spending down at least some assets is usually necessary.

During this spend down, it is a good idea so as not to waste any time to get documentation in order so an application for Medicaid can be filed as soon as funds have reached the asset limit.

Reverse mortgage

Quite often, an individual's largest and most valuable asset is his home.

This is an asset that can also be used to help pay for care. If a person owns his home, he can continue to reside there, while using the equity in his home to pay for care.

Reverse mortgages are a very useful tool for senior citizens who wish to remain at home.

A reverse mortgage allows a person over the age of 62 to draw from the equity in the home to meet expenses.

A reverse mortgage can be an excellent tool for someone who will use the mortgage proceeds to pay for home care and stay at home longer.

The Department of Social Services (DSS), through its Medicaid programs, will cover only a certain number of hours per week, depending on the amount of care required.

After assets have been spent down to the asset limitations set by DSS, an individual may apply for assistance from a Medicaid program.

Since Medicaid will cover only a specific amount of hours, the proceeds from a reverse mortgage can be used to help a person make up the difference in hours of care by providing a source from which to draw funds and pay for that care.

Of course, when the person passes away or moves out of the home, the mortgage is due and payable.

Many seniors feel that they have spent their lives taking care of their homes, and now it is time for their home to take care of them.

Medicaid programs

Connecticut is among the minority of states that does not offer 24-hour, in-home care through its Medicaid programs.

Legislators are beginning to realize nursing home care is more costly and less desirable.

As long as an individual is residing in her home, the home is considered an exempt asset for Medicaid purposes.

This means the state cannot take away a home if the individual or her spouse lives in it, or if she has a blind or disabled child or a minor child living in it.

Just a few years ago, Connecticut introduced a program called "Money Follows the Person," in which seniors who are residing in a nursing home and begin receiving Medicaid benefits can return home and receive 24-hour care at home.

This program was designed to assist those seniors who would have been able to return home, but did not have the resources to pay for 24-hour care.

They would otherwise be confined to a nursing home setting because Medicaid would not cover home care.

Under "Money Follows the Person," they can return to their home or apartment and continue to receive care.

This, however, is currently the only program in Connecticut that provides 24-hour care at home and it requires the person reside in a nursing home for approximately six months before becoming eligible.

The legislature is considering a change to provide more programs to keep people at home.

Long-term care insurance

Most long-term care insurance policies offer an option for home care.

If someone has a long-term care insurance policy, it is important they understand exactly what is covered.

Once a person has reached his 60s, premiums tend to be high and sometimes even prohibitive. It is important for people to obtain a long-term care insurance policy in their 40s or 50s to avoid such high premiums.

In order to have the policy pay for care, a claim must be filed and the policyholder must meet certain medical criteria, including the need for assistance with a number of activities of daily living.

Each policy spells out exactly what its requirements are.

After a claim is filed against the policy, premiums cease and the policy begins to pay for care.

A policy may not cover the entire expense for home care, forcing the policyholder to make up the difference.

This is why it is important to understand the policy.

An individual may need to use his/her assets and/or take a reverse mortgage to help pay for care that the policy will not cover.

On the other hand, having a long-term care policy may help to keep someone at home longer, or even indefinitely.

While the thought of paying for long-term care at home can be a scary one, there are several options available.

Contact your elder law attorney for more information on how you can stay at home in comfort.

Rudolf Kuss and Michelle M. Liguori are partners at the law firm of Kuss & Liguori LLC, dedicated to serving the needs of our senior citizens and their families. Both are admitted to the practice of law in Connecticut and are members of the Connecticut Bar Association and the New Milford Bar Association.