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Throughout Central Pennsylvania and across America, the percentage of the population over 60 years of age is growing annually, with people retiring earlier and living longer than ever before. The Elder Law Group has extensive experience in addressing the unique issued which face the elderly individuals of our population. Some of these issues include: independent or assisted living arrangements versus nursing home care; long term health care insurance; reverse mortgages, viaticals; divorce among the elderly; durable powers of attorney; living wills (advance directives); revocable and irrevocable trusts; and wills. With a large number of individuals facing the prospects of high medical costs or possible nursing home placement, our attorneys have experience in Medicaid planning and asset protection strategies. We also have assisted many families with guardianship proceedings and other medical evaluation issues.

Long Term Care Insurance: We are strong advocates of purchasing intelligent and useful long term care policies, particularly where there is an extended possibility of application to a nursing facility. Long term care insurance will make the transition easier and open more doors for you than private pay or Medical Assistance. We do recognize that, unfortunately, many people wait too long to apply for long term care insurance or they are otherwise ineligible for coverage. In those situations, we want to outline the various alternatives for planning.

Nursing Home Applications: Often the first exposure for clients to the complex world of long term care is the review and completion of applications to a nursing home. The applications often require information that is difficult to obtain for the children and also may suggest that you either waive rights that you have or incur liabilities that you are not required to give. For example, many applications ask a child to sign as a guarantor which, under the law, creates an obligation to pay when a child is not otherwise required to pay for their parents' care.

Resource Assessments: One of the many forms presented to individuals when they are admitted to a long term care facility is a Resource Assessment. This form is used to gather asset information and determine the protected share of the spouse living in the community. It is not an application for Medical Assistance benefits, but must be completed prior to applying for Medical Assistance benefits.

Spend-Down: Upon completion and submission of the Resource Assessment, the Department of Public Welfare will issue a statement on the amount that is protected for the community spouse and what must be spent before eligibility is permitted. The spend-down portion may be varied if the community spouse has insufficient income to meet their monthly maintenance needs.

Medical Assistance Applications: The application for Medical Assistance benefits is due at or within three (3) months of the date an individual is seeking eligibility for coverage of their long term care costs. It is not due at the date of admission unless there is a request for immediate coverage.

Ineligibility Period: The ineligibility period is the length of time that an individual cannot receive coverage for Medical Assistance based on the amount gifted or transferred where there was not an equal good or service returned in exchange. The length of time is calculated by taking the amount gifted and dividing by the statewide average cost of care. However, certain transfers are not subject to an ineligibility period. There is no allowance for the federal unified credit or annual exclusion as these concepts are unrelated.

Look-Back Period: This is the period of time that the Department of Public Welfare can examine sales, gifts or transfers prior to granting eligibility for Medical Assistance. This period is the sixty (60) months prior to the date of application.

Medical Assistance Appeals: If an applicant, spouse or family member disagrees with a denial or reduction in benefits, we can assist with the challenge against the Department of Public Welfare. The notice of appeal must be filed within thirty (30) days of the receipt of the denial or reduction in benefits.