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Long-Term Care at Home Consumer Guide

Walter Feldesman. Long-Term Care at Home Consumer Guide. Walter Feldesman, New York, NY. 2009. 393 pages. $23.66 print copy on Amazon.

The story of Walter Feldesman is as inspiring to the elderly as his books are helpful to them. After a 67-year career as a corporate attorney, Feldesman has devoted the last decade to developing consumer-friendly guides about elder care benefits and services, including the heralded Dictionary of Eldercare Terminology (3rd edition, 2012).

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Now 91, Feldesman has just published his third book, the Long-Term Care at Home Consumer Guide. As with his previous volumes, the author is making the book available online so that families and professionals can download and search the entire contents free of charge.

In the guide, which strives to offer "one-stop shopping" for anyone needing to learn about caring for the elderly at home, Feldesman sets out to answer three crucial questions: What is home care? Where and how can it be obtained? and, What are the sources for paying for it?

The resulting answers fill nearly 400 pages and provide a readable roadmap to the maze of programs and rules that make up our patchwork home care system. All the information is easy to locate thanks to the book's question-and-answer and outline format, with key terms highlighted in bold type.

Readers will learn, for example, the advantages and disadvantages of obtaining care through a home care agency; how to qualify for Medicare-covered home care; the steps in Medicare's complex appeals process; Medicare Part D's rules; what Medigap plans offer; and how to use a home or a life insurance policy to pay for home care.

Notable for its absence is any discussion of veterans' home care benefits, although this would have added to the volume's girth. And, while Feldesman's writing is clear, readers who come to the book with little background might benefit from case examples to illustrate some of Medicaid and Medicare's more arcane rules.

But this is akin to looking a very strong gift horse in the mouth. A wealth of information is contained here and it's exceedingly easy for consumers and professionals alike to peruse it -- even in the print version, which has a useful topical index.

We understand that Feldesman, who recently won the National Council on Aging's first "Exemplars of Vital Aging" award, is currently working on an encyclopedia of eldercare that will combine all of his previous books -- and that will, of course, be available free online. We eagerly await it.


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Medicaid 101
What Medicaid Covers

In addition to nursing home care, Medicaid may cover home care and some care in an assisted living facility. Coverage in your state may depend on waivers of federal rules.

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How to Qualify for Medicaid

To be eligible for Medicaid long-term care, recipients must have limited incomes and no more than $2,000 (in most states). Special rules apply for the home and other assets.

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Medicaid’s Protections for Spouses

Spouses of Medicaid nursing home residents have special protections to keep them from becoming impoverished.

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What Medicaid Covers

In addition to nursing home care, Medicaid may cover home care and some care in an assisted living facility. Coverage in your state may depend on waivers of federal rules.

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How to Qualify for Medicaid

To be eligible for Medicaid long-term care, recipients must have limited incomes and no more than $2,000 (in most states). Special rules apply for the home and other assets.

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Medicaid’s Protections for Spouses

Spouses of Medicaid nursing home residents have special protections to keep them from becoming impoverished.

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Medicaid Planning Strategies

Careful planning for potentially devastating long-term care costs can help protect your estate, whether for your spouse or for your children.

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Estate Recovery: Can Medicaid Take My House After I’m Gone?

If steps aren't taken to protect the Medicaid recipient's house from the state’s attempts to recover benefits paid, the house may need to be sold.

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Help Qualifying and Paying for Medicaid, Or Avoiding Nursing Home Care

There are ways to handle excess income or assets and still qualify for Medicaid long-term care, and programs that deliver care at home rather than in a nursing home.

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Are Adult Children Responsible for Their Parents’ Care?

Most states have laws on the books making adult children responsible if their parents can't afford to take care of themselves.

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Applying for Medicaid

Applying for Medicaid is a highly technical and complex process, and bad advice can actually make it more difficult to qualify for benefits.

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Alternatives to Medicaid

Medicare's coverage of nursing home care is quite limited. For those who can afford it and who can qualify for coverage, long-term care insurance is the best alternative to Medicaid.

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ElderLaw 101
Estate Planning

Distinguish the key concepts in estate planning, including the will, the trust, probate, the power of attorney, and how to avoid estate taxes.

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Grandchildren

Learn about grandparents’ visitation rights and how to avoid tax and public benefit issues when making gifts to grandchildren.

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Guardianship/Conservatorship

Understand when and how a court appoints a guardian or conservator for an adult who becomes incapacitated, and how to avoid guardianship.

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Health Care Decisions

We need to plan for the possibility that we will become unable to make our own medical decisions. This may take the form of a health care proxy, a medical directive, a living will, or a combination of these.

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Estate Planning

Distinguish the key concepts in estate planning, including the will, the trust, probate, the power of attorney, and how to avoid estate taxes.

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Grandchildren

Learn about grandparents’ visitation rights and how to avoid tax and public benefit issues when making gifts to grandchildren.

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Guardianship/Conservatorship

Understand when and how a court appoints a guardian or conservator for an adult who becomes incapacitated, and how to avoid guardianship.

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Health Care Decisions

We need to plan for the possibility that we will become unable to make our own medical decisions. This may take the form of a health care proxy, a medical directive, a living will, or a combination of these.

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Long-Term Care Insurance

Understand the ins and outs of insurance to cover the high cost of nursing home care, including when to buy it, how much to buy, and which spouse should get the coverage.

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Medicare

Learn who qualifies for Medicare, what the program covers, all about Medicare Advantage, and how to supplement Medicare’s coverage.

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Retirement Planning

We explain the five phases of retirement planning, the difference between a 401(k) and an IRA, types of investments, asset diversification, the required minimum distribution rules, and more.

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Senior Living

Find out how to choose a nursing home or assisted living facility, when to fight a discharge, the rights of nursing home residents, all about reverse mortgages, and more.

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Social Security

Get a solid grounding in Social Security, including who is eligible, how to apply, spousal benefits, the taxation of benefits, how work affects payments, and SSDI and SSI.

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Special Needs Planning

Learn how a special needs trust can preserve assets for a person with disabilities without jeopardizing Medicaid and SSI, and how to plan for when caregivers are gone.

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Veterans Benefits

Explore benefits for older veterans, including the VA’s disability pension benefit, aid and attendance, and long-term care coverage for veterans and surviving spouses.

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