The only real problem of a CCA is the cost. You have to “buy in” (can be well over $200,000), then pay the monthly fee(can be well over $4,000). Medicaid is not accepted, so if you live long enough and can no longer afford the fee, out you go. Some use an algorithm to refund a portion of the “buy in” when you leave by moving out or to family upon death.
For those who have long term care insurance, be sure to check your policy- most are now for a certain number of years or for a certain dollar amount, NOT for as long as a person needs the care.
Our policy is 5 years or $450,000. My husband is in AL and is soon going on Year 4. I’m starting to research what to do next. He has vascular dementia, heart issues, and brittle diabetes, but is SO much healthier with the structure of the facility.
I’ve met with an Elder Law attorney. Approaching the 5th year, they recommend gathering info about AL and SNF facilities that do accept Medicaid. In the 5th year, making the application with their assistance (counselors at your county’s Area Agency on Aging also can do it with you). Medicaid gives you a “spend-down amount” that you must use from your funds/assets and after the LTC insurance stops, you spend down, paying the facility bill and other allowable expenses (pre-paid funeral, electric lift chair, medications/incontinence briefs/MD co-pays). You can move your loved one to a facility that accepts Medicaid and do the “spend down” there. Medicaid follows your state’s rules as to the well-spouse’s half share of funds/assets and the spouse lives in the house until death or sale (such as the spouse deciding also to move into an AL).
If the “spend down” funds are used up and the person goes on Medicaid, the state will attach a lien to the house to reclaim the taxpayer funds used, up to the half-value (the person’s share) of the sale price. The spouse gets the other half value.
Lastly, the state does a 5 year “look-back” from the date of application. It’s very important not to look as if you tried to dump assets- money gifts over $500, putting an adult child on your house deed, adding a relative to a brokerage account, etc. If your spouse is a veteran and is eligible for VA services at home or in a facility, they do a 3 year look-back and do not attach the spouse’s assets after the veteran’s death.
Sorry to go on so long, but I think it’s important to get ready for what might be coming, just in case.