This document provides information about preparing for long term care expenses and qualifying for benefits from Medicaid and the VA. It summarizes that wartime veterans and surviving spouses may qualify for monthly benefits from the VA of up to $2,054/month and $1,113/month respectively, if they served during specified war periods and meet other requirements. It also outlines asset limits for qualifying for Medicaid long term care benefits, exempt assets, estate recovery after death, and strategies like Medicaid annuities and irrevocable trusts that can help qualify for benefits while protecting assets.

1. Preparing for Long Term
Care Expenses
Presented by:
Larry S. Hartley
Board Certified Specialist in Elder Law
by the North Carolina State Bar
Certified Elder Law Attorney
By the National Elder Law Foundation
Strauss & Associates, P.A.
77 Central Avenue Suite F
Asheville, NC 28801
(828) 258-0994
Founder: Andrew A. Strauss, Board Certified Specialist in Estate Planning and Probate Law by the NC State Bar

2. Larry S. Hartley
• Associated with the law firm of Strauss &
Associates, P.A., with offices in Asheville, NC
and Hendersonville NC.
• Member of NAELA, the National Academy of
Elder Law Attorneys
• Certified Elder Law Attorney by the National
Elder Law Foundation and Board Certified
Specialist in Elder Law by the NC State Bar
• Admitted of the NC State Bar in 1996

3. There Is Money Available
For:
• Wartime veterans
• Surviving spouses
of wartime
veterans
The key is to
qualify!

4. Extra Money for Veterans
and Spouses
Wartime veterans
with spouses may be
eligible for up to
$2,054/month
A surviving spouse
may be eligible for
up to $1,113/month.

5. Service Requirements
• Served at least 90 days (if before
1980) of actual duty
• Served at least 2 years 1980 and after
• Served at least one day during a war
period during active duty
• Other than dishonorable discharge

6. U. S. WAR PERIODS
• World War I - April 6, 1917November 11, 1918
• World War II – Dec. 7, 1941 – Dec. 31,
1946
• Korean War – June 27, 1950 – Jan. 31,
1955
• Vietnam Conflict – Aug. 5, 1964 – May
7, 1975 (Feb. 28, 1961 – May 7, 1975 if
in the country of Vietnam)
• Gulf War – Aug. 2, 1990 – date to be set
by law by Presidential Proclamation

7. Additional Benefits
FREE VA medical (no co-pay) and FREE
prescription through VA pharmacies for
formulary drugs

8. Limits On Net Worth
•Approximately $80,000
for a couple
•Approximately $50,000
for a single Veteran or
surviving
spouse
•This is where the
greatest need for
planning exists.

9. Assets VA Does Not
Count
• Residence
• Burial Policies/plans
• Small life insurance
policies
• Personal property

10. Say Yes to Medicaid
Eligibility
• Yes Medicaid can pay the catastrophic
cost of a long term stay in a nursing
home.
• No, you do not have to spend your
family’s whole inheritance on the
nursing home first.
• It is a myth that you must spend all of
your own money on the cost of a long
term nursing home stay before you can
qualify for Medicaid benefits.

11. How can these costs be
paid?
• Medicare: Only pays up to 100 days, and must
first be hospitalized for at least 3 days. Also upon
entry to nursing home they must be improving (or
the rehab must at least prevent the patient from
getting worse).
Note: There has been recent litigation that may
end the need for improvements
• Private Pay: Use your own funds
• Long Term Care Insurance: This is an underused method, but some people can’t get it.
• Medicaid: Many people end up on Medicaid,
like it or not.

12. Exempt Assets
(a partial list)
• The homesite (the principal residence): If the
patient has an intent to return home, or if there is
a community spouse or dependent relative in the
home.
• For a single person this is limited to equity of up
to $536,000 as of January 1, 2013
• Life estates in the primary residence
• Tenancy-in-common ownership in real property
(actually just non-available)

13. More Exempt Assets
• One licensed motor vehicle. (no limit on value)
• Personal effects and household goods
including jewelry, furniture, appliances,
artwork and other decorative items.

14. More Exempt Assets
• Life insurance cash values if the total face
amount of all policies is $10,000 or less. This
is a NC rule; most other states are limited to
$1,500 face value of all policies.
• Prepaid funeral contract if it is irrevocable.
• Or up to $1,500 burial funds if no irrevocable
funeral contract.

15. What is Estate Recovery?
• Estate Recovery is the next big concern
for the family of a person receiving
Medicaid benefits for long term care
expenses.
• Estate recovery is the government
efforts to recover its payments for long
term care from your assets after your
death.

16. •
Medicaid Qualified
Annuities
Must be immediate annuities
• Must be irrevocable
• Must be non-assignable and non-sellable
• Must be actuarially sound
• Must be substantially equal payments (no
balloon payments)
• Annuitant must not be terminally ill
• The state should be named as a contingent
beneficiary to avoid penalties

17. Irrevocable Trusts: The
Secret Weapon of Medicaid
Planning
• These work best with time to spare.
• Irrevocable means grantor can not
change it.
• Grantor can retain income rights.
• Grantor must relinquish rights to
principal.
• Can be structured to avoid or at
least delay gift taxes.

18. THANK YOU