In-Home Elder Care FAQs

It can be hard to imagine a time when you will not be able to take care of all your own personal responsibilities, but things change as you enter different phases of life.

The United State Department of Health and Human Services operates the LongTermCare.gov website, and they have compiled a lot of eye opening information.

According to the site, seven out of ten seniors will need some form of living assistance, and 35 percent will move into nursing homes.

A lot of seniors that need help with their activities of daily living can rely on family members, friends, and neighbors. When people that care are willing to pitch in, the situation can be manageable in many instances.

With regard to the living situation, there are aging in place modifications that can be made to a senior’s home. There are many possibilities, including handrails, grab bars, walk-in showers and tubs, motion sensor lighting, nonslip flooring, and smart home solutions.

The modifications can be custom crafted to suit the needs of a given person, and as things change, additional modifications can be added along the way.

At some point, the level of care that is required may exceed the capabilities of the unpaid caregivers. And of course, there are those that do not have anyone that can provide assistance.

Under these circumstances, a paid in-home health aide can provide a solution. However, the costs associated with this type of care are pretty steep by most people’s standards.

In the Los Angeles area, the median cost for an in-home health aide was $66,350 a year in 2020.

The Medicare program will pay for convalescent care after an injury or illness when recovery is expected. However, long-term custodial care is not covered, so this is not the solution.

Yes, Medi-Cal will pay for a stay in a nursing home, and there is a Medi-Cal Home and Community Based Services waiver program that covers in-home care.

It would be nice if it worked that way, but the answer is no. Medi-Cal is a need-based program, so you cannot qualify if you have more than $2000 of countable assets in your name. This also applies the Medi-Cal waiver program.

Your home is not a countable asset, but there is an equity limit for people that live in other states. Here in California, there is no Medi-Cal equity limit, so the fact that you can qualify as a homeowner is good news.

On the bad news side of the equation, Medi-Cal is required to seek reimbursement from the estates of people that were enrolled after they died. A lien can be placed on the home of a deceased Medicaid recipient.

Other non-countable assets include wedding and engagement rings, heirloom jewelry, a motor vehicle, furniture and other household items, and personal effects.

You can give direct gifts or fund an irrevocable Medi-Cal trust to get assets out of your name so you can qualify. However, you can’t find out that you need paid care today, give away assets tomorrow, and qualify for Medi-Cal or a Medi-Cal waiver next week.

There is a 30 month look-back period in California, so you have to divest yourself of assets at least 30 months before you submit your application. If you violate this rule, your eligibility is delayed.