Where Are You Going To Live & How Are You Going To Pay?

Here we are, a few days before Christmas – a season of festivities and family get-togethers, with family traveling to spend time together. When families spend time together, it is also a time when kids realise that mom or dad are aging, and are more frail or forgetful.

We almost inevitably get calls the first week of January, from clients telling us about their ailing parents, and wanting to learn more about elder law. In light of this, I thought I would share some information you may need to know if you’re in that situation. Even if you aren’t in this situation, this is information you can reference when needed.

In our senior years, most of us are going to need some help. According to the Alzheimer’s Association, one in three seniors dies with dementia. This is not including other health care issues such as mobility or Parkinson’s disease, for example. Coupled with the difficulty in the provision of care, whether it is a family or care providers doing it, it is expensive. Many people tend to put their head in the sand like an ostrich, thinking it’s not going to happen to them. However, we need to be more intentional about this, because a lot of families are going to need to deal with the threat of long term care.

There are different types of care facilities and different ways to pay for the care. The biggest goal most people have, is that they want to stay in their home. There is a care option available for this, but this is a private pay situation. It is possible that we can get some public benefits, such as veterans benefits as well as medicaid benefits that will pay for care in your home. You would need to have relatively limited income and limited assets, to be eligible for these programs. We do a lot of work to help people in this situation.

LIFE Program

Recently on this show, I was talking to Deanna from LIFE Pittsburgh, about the eligibility for the Life program. When you’re eligible, you can get the LIFE Program to pay, and this program is offered in almost every county around Pittsburgh. It is one of the best programs to keep people in their homes for as long as possible. For more information about the LIFE Program, please listen to the podcast. Click Here or look for the Life and Legacy Show on Apple iTunes or Spotify. When you qualify for Medicaid to pay for the Life program, it is 100% at no cost to you. If you are a senior who may need care down the road, or a caregiver for a senior who needs some help, the LIFE Program may be your solution.

Independent Living

Sometimes it is not possible to stay in your home, so you need to look at other types of residential settings, such as independent living. People can come in and provide care, and they’re not necessarily nurses who provide medical care, but carers. This would suit seniors who don’t want to take care of a garden, or who don’t want to cook and clean any longer, and they want an easier life. Independent living also allows for interaction with other people at social events which seniors enjoy. These places are lovely, and I think many people are open to the independent living way of life. Independent living is 100% private pay, but for folks who can afford it, this might be an option for you. 

Personal Care Homes

The next step up would be a personal care home. In Pennsylvania, we have two different licenses serving the same population. There are personal care homes, and also assisted living facilities, and there is some overlap in what these communities offer. In Pennsylvania, nobody will help you pay for this care, unless you are a veteran and can get veteran’s benefits to help you pay. It can cost anywhere between $6,000 to $9,000 per month. If you go in at the $6,000 level, and you want a bigger suite, you will pay more. If you need additional care with dedicated staff to take care of you, you will go up a tier or two in care, and will pay more. Personal care homes are great, and are usually well appointed, with adequate staff to care for your loved ones. It can be expensive with no public benefit options that apply.

Skilled Nursing Facilities

The skilled nursing facility is more like a hospital than a residential community. The services offered to people in personal care homes, and skilled nursing facilities are similar. However, the nursing home is the only residential care facility in Pennsylvania where the state will pay. Every year the state publishes what the average monthly cost of skilled nursing is. For 2022 in Pennsylvania, the estimated cost is over $14,000. That figure increased significantly, mostly due to the financial implications of providing care during a pandemic. It is expensive if you are going into a nursing home as a private paying person, but not if you are on medicaid. It is of financial benefit to a family for their loved one to be in a skilled nursing facility on medicaid. There is also a higher level of care, with higher-trained staff on site.

Continuing Care Retirement Communities

There are also licensed communities in Pennsylvania, known as continuing care retirement communities, or CCRC. These are usually on big sprawling campuses, and you have all of the different levels of care in one location. If you go in and you need additional care, you have the option to receive it. From a legal standpoint, I need to warn you regarding the contract you sign when entering into any care facilities. Some CCRC’s have certain financial requirements for admission, and certain financial pledges that may be problematic. The different types of care facilities and the licensing of them, means different things regarding what they’re allowed to put in their contracts. I highly recommend that you ask somebody to take a look at the contract before you sign it. 

How We Can Help

A large part of what the elder law practices do is advise people on eligibility for benefits. If you want to know if Medicaid can help pay for care in your home, give us a call. We can analyze your situation to figure out if there’s a way for that to happen. 

The first step of this analysis concerns what the care requirements of the senior are. We can help determine where the person will live, how they will be cared for, and how they will pay. We help families to find the best legal and financial solution for the problem they are in.

For more information, visit our website: On the website, you’ll find all types of information. Every month we have estate planning and elder law workshops, so please join us. We offer a free consult as we need to have a conversation with you. We need to know what your goals are and what’s important to you. Register for the workshops on our website or call 724-841-1393.