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They’ve always been the caregiver, not the one needing care. The role reversal may be too much for either party to handle.

Finally, are your family members knowledgeable enough to take care of you? If you require special treatment, they may not be. You may truly need a professional nurse or caregiver to watch over you and make sure that everything is going the way it should. They will also be trained to notice any warning signs of further deterioration, which your child or other family member may not be.

Medicaid and Medicare We discuss both Medicaid and Medicare in more depth in a later chap- ter, but many people believe that these forms of government assistance will be there for them in the case that they need some type of long-term care. The realities of these two programs are startlingly different than what people popularly perceive. First, Medicare and Medicaid are two separate entities. Medicare is a federally run program, while Medicaid is run on the state level and is a form of welfare.

In order to use Medicaid to pay for long-term care costs, you must first be eligible and meet certain financial requirements. These financial requirements dictate that your income must not be above a certain level, plus there is a limit on the amount of assets you can have, all of which vary by state. If you don’t meet the requirements, then you are ineligible for Medicaid. Therefore, many people do what is commonly referred to as “spend down” their assets in order to qualify. Spending down means liquidating and distributing your assets to the point where you are essentially left with nothing. At that point, you can apply for Medicaid to pay for your care costs.

Generally, although this may vary by state law, those receiving Medicaid benefits are allowed to keep a small portion of their income, a very small portion, which may be as small as $50 per month. If they have more money than that, they are expected to pay, in part, for their own care. While the requirements are strict, the federal definition of “income” is very broad. It says that income is anything you receive in cash or in kind that you can use to meet your needs for food, clothing or shelter. If you are financially desti- tute, then Medicaid is the only option for you. But if you have sizeable assets, do not consider Medicaid because you will have to divest yourself of everything you have. Is that what you want to do?

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