1. MEDICAID SOLUTIONS, LLC NAVIGATING YOU THOUGH THE MAZE OF LONG TERM CARE

2. My Background :  Masters Degree from Columbia University  Licensed by the State of NY ie; Licensed Clinical Social Worker (LCSW)  Director of Admissions and Social Work in two Nursing Facilities  Independent social worker seeing clients of various Visiting Nurse agencies  Owner of Medicaid Solutions, LLC for the past six years with a total of 25 years experience working with Seniors and their families on addressing long term care needs

3. WHY MEDICAID? HOME CARE CAN COST UPWARDS OF $27 PER HOUR A LIVE IN HOME CARE AIDE CAN COST UPWARDS OF $300/DAY NURSING HOME CARE AVERAGES $14,000 PER MONTH WHO CAN AFFORD THIS AND A LONG TERM BASIS?

4. WHAT ARE MY LONG TERM CARE OPTIONS FROM A FINANCIAL STANDPOINT? 1.Use your long term care Insurance Policy - if you have one and if the benefits are enough to meet your needs for the remainder of your life! 2.Use your personal funds to pay for care 3.Qualify yourself for Medicaid to assist in the cost of long term care

5. CASE STUDY: MARY AND JOHN HAVE: A HOME $250,000 IN INVESTMENTS - JOINT $300,000 IN IRA – JOHN $3,000/MONTH INCOME – JOHN $1200/MONTH INCOME – MARY JOHN HAS DEMENTIA AND NEEDS LONG TERM CARE AT HOME WHICH COSTS ABOUT $3000 PER MONTH MARY WANTS TO KEEP HIM AT HOME. SHE STARTS REQUESTING LARGE WITHDRAWALS FROM INVESTMENT OR IRA FUND TO PAY FOR HIS CARE….BECAUSE WHAT ELSE CAN SHE DO?

6. TRUE OR FALSE TO qualify for Medicaid:  There is a five year look back at asset transfers or gifts  You cannot own your own home  You cannot have income such as pensions or IRA/401K

7. COMMUNITY MEDICAID VS. INSTITUTIONAL MEDICAID Community Medicaid Coverage for services in the community: Home Care Day Care Assisted Living Medical Transportation Some Durable Medical Equipment Institutional Medicaid Coverage for services in a skilled nursing facility otherwise known as a nursing home or long term care facility.

8. Community Medicaid income and asset limits: INDIVIDUAL  $ 825 PER MONTH INCOME  $14,850 IN ASSETS* COUPLE  $1209 PER MONTH INCOME  $21,750 IN ASSETS* * RETIREMENT ASSETS SUCH AS IRA OR 401K DO NOT COUNT IN ASSET LIMITS IF THE REQUIRE MINIMUM DISTRUBTION IS TAKEN

9. Spousal Impoverishment Medicaid The “well” spouse can keep:  119,000 in non retirement Assets  $2980.50 per month in Joint income.  This type of budgeting can be used both for community or institutional Medicaid

10. Spousal Refusal Medicaid  The Well spouse transfers all assets to their name and signs a Spousal Refusal form – This means all income and assets belonging to the well spouse cannot be counted toward the “ill” spouses Medicaid eligibility.  Community Medicaid Levels for an Individual then applies to the ill Spouse (ie; $825 Income and $14,850 in Assets) This type of budgeting can be used both for community or institutional Medicaid

11. MEDICAID POOLED INCOME TRUST (used only for Community Medicaid)  THIS IS USED TO PROTECT INCOME IN EXCESS OF THE MEDICAID INCOME LIMITS FOR INDIVIDUALS OR COUPLES APPLYING FOR MEDICAID:  THE EXCESS INCOME IS PUT INTO A POOLED TRUST.  THE TRUST CAN PAY ALL NON MEDICAL LIVING EXPENSES ON BEHALF OF THE MEDICAID APPLICANT USING THE DEPOSITED FUNDS. **ENROLLMENT FEES, MONTHLY AND ANNUAL FEES APPLY.

12. MEDICAID SOLUTIONS, LLC HELPING SENIORS AND THEIR LOVED ONES NAVIGATE THE MAZE OF LONG TERM CARE OPTIONS