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About Eldercare Agencies
There are basically four government organizations that furnish long term care services.
Medicare
Medicaid For a single person receiving Medicaid nursing home care, all assets have to be spent down to less than $2,000. ($3,000 total if it's a couple both needing care) For most states there is no income test and after the asset spend down has occurred, and if the income is not sufficient to pay for care, Medicaid makes up the difference. For the states with an income test, if the income exceeds that level (usually 300% of SSI), Medicaid will not pay. However, a Miller Trust is normally used in this case to qualify for payment. For couples, if one needs Medicaid, assets are combined whether they are in a trust or not. (Except for an irrevocable trust established at least five years prior to the need. Very few people have irrevocable trusts. Most of them have "living" or revocable trusts.) Assets are then split in half. The healthy spouse at home keeps his or her half and the other half belonging to the care recipient must be spent down to less than $2,000 before Medicaid will start paying. This spend down can be used for anything; it doesn't necessarily have to be spent on care: a trip around the world, buying a new car, fixing up the house and so on. It after splitting the assets in half, each half is more than $99,540 in the year 2006, a healthy spouse at home can only keep that amount and the rest has to go to the care recipient for spend down. If total assets are less than $19,908, a healthy spouse keeps it all. In some states this minimum allowance is much higher and a healthy spouse can keep everything up to, as an example, $75,000. Depending on state allowances, if a healthy spouse has less than the following income levels in 2006 -- $1,603.75 to $2,488.50 -- that spouse can take income from the spouse receiving care to bring his or her income up to the state allowable level. States use incomes between the minimum listed above and the maximum. It depends on the state.
The National Aging Network The Older Americans Act of 1965 created a program to provide community aging services to Americans 60 years of age and older. Over the years, with numerous amendments, the focus of the act has been changing to provide more long-term care services and caregiver support to help individuals remain independent in their homes and avoid going into long-term care institutions. Programs created by the Older Americans Act are managed by the Department of Health and Human Services, Administration on Aging. The Administration on Aging has guided the development of the national aging services network that today consists of 56 State units on aging, 655 area agencies on aging, almost 250 Tribal organizations, 29,000 community-based provider organizations, over 500,000 volunteers, and a wide variety of national non-profit organizations. This nationwide infrastructure currently provides a wide array of home and community-based services to over 8 million elderly individuals each year, which is 17 percent of all people aged 60 and older, including 3 million individuals who require intensive services and meet the functional requirements for nursing home care. It also provides direct services to over 600,000 informal caregivers each year, who are struggling to keep their loved ones at home. The national aging network is the largest long-term care provider network in the country. Services are designed to support the elderly in the community and keep them out of nursing homes.
Low Income Housing Government subsidies and housing units are usually administered by city or county Housing Authorities. You can either call your local area agency on aging to find out about available housing and subsidies or dial 211 if that service is available in your area.
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