What is Elder Law?

Most areas of the law are defined by the particular type of cases they cover, like bankruptcy or personal injury. Elder Law, on the other hand, is defined by the types of clients it serves. Elder Law focuses on serving the unique legal needs of our senior and disabled population.  As a result, Elder Law encompasses a wide variety of different cases and legal procedures.  Although the scope of Elder Law is incredibly broad, some of the more difficult issues that senior and disabled individuals face (and that come up with great frequency) include:

• Planning for the expense of long term care, which often includes planning for Medicaid; and,
• Maintaining eligibility for public benefits through the use of Special Needs Trusts

Long Term Care & Medicaid Planning

Long term care may not seem like a legal issue.  However, as our population ages and the cost of long term care rises, it has become critical that we address long term care as part of the planning process.  The statistics behind long term care are staggering.  According to a report by the United States Administration on Aging, around 70% of people aged 65 and older will require some form of long-term care in the future.  These services could include in-home care, assisted living, and, in many cases, care in a nursing home.  The length of time this care will last varies, but around 20% of people aged 65 and older will require long term care for five years or more. 

The chance you may need long term care becomes especially worrisome when coupled with the cost of that care.  While all forms of long term care services are expensive, nursing home care requires special attention.  According to a recent survey, the median cost for nursing home care throughout Georgia exceeds $80,000 per year for a private room.  Even for people who have diligently saved money their entire lives, this out-of-pocket cost can be financially devastating. 

Given the high costs of nursing home care (and the lack of other viable options to pay for it), many people will turn to Medicaid coverage.  Related FAQ:
Does Medicare pay
for nursing homes?Medicaid is the only publicly available health insurance program that provides any significant coverage for nursing home care.  Unfortunately, Medicaid also imposes very restrictive eligibility criteria on an applicant's income and assets.  For some people, this means that they will "spend down" all of their assets towards nursing home care before becoming eligible for Medicaid.  However, you do not have to bankrupt yourself to receive the care you need.  With proper planning, you can receive Medicaid coverage for nursing home care, while preserving the majority of your assets (including your home) for your children and future generations.

Public Benefits & Special Needs Trusts

Public benefit programs are a vast network of supports (sometimes called "social welfare") provided by the federal and state governments.  Many disabled individuals will rely upon public benefit programs at some point in their lives.  The majority of these benefit programs are "means-tested", meaning that a recipient of these benefits can only have a certain level of income and assets in order to qualify (which is usually tied to the federal poverty limit).  Although these eligibility requirements overlap somewhat, each public benefit program has its own rules, which can make coordination of benefits difficult.

The public benefits that Special Needs Trusts focus on primarily are Supplemental Security Income (or SSI) and Medicaid.  SSI is a cash benefit provided through the Social Security Administration for the blind, elderly, and disabled.  Whereas, some elderly or disabled individuals qualify for Social Security benefits based upon their past work history (which are referred to as "Title II" benefits)  SSI benefits are available to elderly and disabled individuals who have never worked before.

While the cash benefit available through SSI is relatively low (currently a maximum of $771 per month),  SSI is essential because it provides a gateway to Medicaid coverage.  The State of Georgia (like a majority of states) has entered into a contract with the federal government that allows the Social Security Administration to process and approve Medicaid applications for anyone eligible for SSI benefits.  This means that in Georgia as long as you receive at least one dollar in SSI benefits you automatically qualify for Medicaid.

Medicaid is a healthcare reimbursement program that is jointly funded by state and federal governments. Each state operates its own Medicaid program within federal guidelines, so every state's Medicaid program is unique.Related FAQ:
What are Medicaid
Waiver Programs? Medicaid is the only health insurance available to many elderly and disabled individuals. However, just because it is the only option available doesn't mean Medicaid is inferior to private insurance, and it often provides coverage for many services that private insurers do not (at little or no cost). Medicaid coverage is especially important to the elderly and disabled because it opens up the possibility for enhanced care through Medicaid waiver programs.

like most public benefits, SSI eligibility comes along with extremely low income and asset limits.  However, senior and disabled individuals do not have to be locked into poverty in order to receive the benefits they require.  Through the use of Special Needs Trusts, considerable amounts of property can be set aside to support the elderly and disabled without interfering with benefit eligibility.  If handled carefully, Special Needs Trusts present an incredibly powerful planning opportunity.

Other Elder Law & Special Needs Topics

Here is some additional about Elder Law and Special Needs topics to review before scheduling your free consultation.