Arizona Medicaid – The 2024 Book

This 2022-2023 Complete Arizona Medicaid & Veterans Benefit Guide covers all aspects of long-term care from, What is it to Who to pay for it.

What is in the book? The Complete Arizona Medicaid & Veterans Benefit Guide

The Introduction, “brief on topics in the book”:

Who Needs Long-Term Care? – 70% of those over 65 will need some long-term care.

Why Consider Long-Term Care? – Often, a family member suffers more when they are providing care than the person that is receiving the care.

And they die before the person receiving care dies trying to be the caregiver

When Will You Need Long-Term Care?  – For most, the need for long-term care is a gradual progression.

Where to Seek Long-Term Care? – This can be a daungting trask. In “Section II” of the book the “How to find the right care and Where to find the right care options?

What Are the Steps? – Seek help; what is a Certified Placement and Referral Specialist or CPRS and how can this professional help?

How to Pay for It? The ways to pay for care are thoroughly explored in the book, from private pay options and planning to Veterans benefits and Arizona Medicaid

An excerpt from the book:
The Perfect Storm. The cost of long-term care has been dramatically affected by today’s out-of-control inflation rate in the United States. The cost increases in the long-term care industry are nearly double ……

Inflation is already a double digits and is only going to get worst.
“Revelations 6:6”

 

Section I – The What, The When

Chapter 1: What’s Extended Care or Long-Term Care?
In chapter one, the author Steve Dabbs, a Certified Medicaid Planner who holds a CLTC® or the Certified Long Term Care designation, talks about what is extended care or long-term care.

Facts and Figures

Alzheimer’s Disease Facts and Figures: Prevalence, Incidence, and Mortality

As reported by the Alzheimer’s Association in 2021

• An estimated 6.2 million Americans age 65 and older will be living with Alzheimer’s Dementia in 2021.
• More than 1 in 9 people (11.3%) age 65 and older have Alzheimer’s Dementia.
• Two-thirds of Americans over age 65 with Alzheimer’s Dementia (3.8 million) are women.
• Deaths due to Alzheimer’s between 2000 and 2019 has more than doubled, increasing 145%.
• 1 in 3 seniors die from Alzheimer’s or another form of Dementia.

For a couple turning 65, there is a 75% chance that one of them will need long-term care. (The Wall Street Journal)

Over 70% of people with Alzheimer’s live at home and receive 75% of the assistance they need from unpaid caregivers. (Understanding Alzheimer’s, Alzheimer’s Association)

63% of caregivers use their own retirement and savings funds to pay for care for another person. (Genworth – Beyond Dollars 2018)

Cost of Care

In 2021, total payments for all individuals with Alzheimer’s or other dementias were estimated at $355 billion (not including unpaid caregiving).

Chapter 2:  When do you know someone needs LTC?

What are the signs that you or a loved one may need long-term care?

Yard and House Not Kept Up and Clean
Depressed and Changes in Mood
Hygiene Issues
Plus eight more are listed and discussed in the book,

Chapter 3: “Mom, I will never put you in a nursing home!”
This is one promise that, for both your own good and your loved ones, you may need to break.

Do you really want your kids cleaning you and helping you off the toilet? Lifting you out of the bathtub?

Do you want to lose your dignity? Do you want to have the government or nursing home taking your family’s inheritance?

I know that this is a little depressing. However, there are solutions to the problem of long-term care.

Chapter 4: What’s the right type of care?
Home care vs Assisted Living what is best for you?

Today’s assisted living is not a Nursing Home!  What do you mean they two bars and a brewery!!!

 

Chapter 5:   How to keep a loved one safely in their home?
Signs and safety tips that make it possible to stay in the home for the most prolonged period of time.

Section II – How to find the right care and  Where to find the right care options?

Chapter 6:   Transitioning to Assisted Living; what’s that look like? 
The emotional part of this journey and how to deal with it.

Chapter 7:   Finding the right assisted living community for care.
What is a Certified Placement & Referral Specialist? 

A Certified Placement & Referral Specialist is the highest standard in the placement industry. But don’t be fooled by someone calling themselves “Certified.” Recently I have seen the word “Certified” added to a title.

In the book, I talk about the unregulated industry of “Senior Placement” This is just another example of the outrageous and unprofessionalism of certain people in the “Senior Placement Industry.”

 

Can you imagine that you hired a certified electrician and learn later that they are nothing more than a “handyman”! An independent contractor affiliated with some company that simply say’s, I certify you, I certify you, I certify you. Now go to work, you are certified!

This would be funny if it weren’t dealing with people’s lives, finances, and emotions.

Beware of fake wannabes that are using the word certified!

In the book, I talk about what a  CPRS  – Certified Placement & Referral Specialist is and how to find one.

Chapter 8:   How do you know a loved one is receiving the best care?
The Secret: You must be involved in their care.

Section III – Vital Information

Chapter 9:  Caring for the Caregiver
Here what is caregiver stress and signs of caregiver stress are discussed.

Chapter 10:  Home Care vs. Home Health Care
“Home Care” and “Home Health Care” seemed so similar, but they are two different types of services. To further understand Home Care and Home Health Care, these are the key differences.

And what is the cost?

Chapter 11:  Hospice and Palliative Care

Hospice Care focuses on the comfort and quality of life of a person with a terminal illness, attending to their emotional and spiritual needs.

Whereas Palliative Care aims to help people alleviate their condition and feel better.

Section IV –Long-Term Care Funding Solutions
 “The ways to pay for needed care.”  

• Section IV, may be the essential part of this book. The cost of extended care or long-term care can ultimately bankrupt a family. Each option is broken down and explored in depth in this section of the book.
• You pay with your current income and life savings, and other assets.
• You ask a family member or friend to pay for care.
• Funds from a reverse mortgage
• Long-Term Care Insurance
• Use your life insurance – Life Settlements
• ALTCS – Medicaid Long-Term Care Benefits
• Veterans Pension Benefits

Chapter 12:  Private Paying for Care
Fourteen percent of those in the United States use their current income to pay for long-term care, including life savings, home sale proceeds, and other assets. Some turn to family and friends to help pay for care.

Chapter 13:  Medicare covers Extended Care – Right?
Some wrongly believe that Medicare also covers long-term care after hospitalization or otherwise. They are wrong. Medicare’s long-term care coverage is minimal and only for a short period of time.

Medicare doesn’t pay for long-term care!

Chapter 14: Long-Term Care insurance what’s new?

By 2030, all baby boomers will be 65 or older; this tsunami of people turning 65 puts a strain on government long-term care programs like Medicaid in Arizona for elderly people – ALTCS and Veterans Pension benefits programs, making long-term care insurance even more expensive and more important to have in place.

How Much Does Long-Term Care Insurance Cost?
When Does Long-Term Care Coverage Begin? The Elimination Period.
When Should You Buy Long-Term Care Insurance?
What Are the Different Types of Long-Term Care Insurance?
—- Modern Asset-Based Long-Term Care Insurance

How Does Life Insurance-Based Long-Term Care Work?
How Does an Annuity-Based Long-Term Care Work?
Where and From Whom Should You Buy Long-Term Care?

 

Chapter 15: Veterans Pension Benefits –
The 3 m’s to Veterans Pension Qualification  (Previously called Aid and Attendance)
The Veterans Administration provided approximately $ 5.1 billion in 2021 to eligible veterans for long-term care-related care and services.

Source: VA.gov

The Three M’s are. Medical need, Military service and Money (income and assets) In the book, each M is broken down and discussed in depth.

This chapter includes 16 secrets that the Veterans Administration doesn’t want you to know.

Chapter 16: What is ALTCS?

Including Six Secrets that ALTCS doesn’t want you to know.

Arizona’s Medicaid Long-Term Care System or ALTCS is a financial safety net for the poor. Yet, keep in mind that the Medicaid/ALTCS program is also for the SMART!

Steve Dabbs, CMP™

 

Chapter 17: Is ALTCS Planning Both Legal and Ethical?

The Courts have answered the question of whether or not ALTCS / Medicaid planning is legal. See book for the answer.

Is Medicaid-ALTCS Planning Ethical?

Chapter 18: Gifting is not Illegal!
Some will tell you it is illegal to gift assets to qualify for Arizona Medicaid.
Learn how to gift and who does it affect your ability to qualify.

Chapter 19: The ALTCS Eligibility and Qualification Requirement

What are the ALTCS Eligibility and Qualification Requirements?

You can be Eligible and still not be Qualified.

In the book, Eligibility is discussed, and then an in-depth discussion on how to qualify regardless of assets or income.

What is an Income Only Trust – a.k.a Miller Trust, and how do they work?

Chapter 20: ALTCS Home and Community-Based Services

Arizona is an HCBS-approved state that allows you to receive care in your home and assisted living.

The HCBS program will also allow you to have the state of Arizona pay a family member to provide care for you.

See book for complete details.

Chapter 21: Hiding Assets to Qualify – this is a Bad Idea!

Gifting and reporting the gift is allowed; hiding assets is Medicaid fraud. Learn more in chapter 21.

Chapter 22: The Spend-Down Myth

Many also believe that the only way to reduce your assets to qualify for ALTCS is to spend down all your assets on care before being eligible for ALTCS. This is a “MYTH.”

In the book is ALTCS SECRET # 5

It is not illegal for a family member to pay the difference between what ALTCS pays and the retail rate (what you pay) with Money preserved through ALTCS Planning. Learn more.

Chapter 23: Medicaid Compliant Annuities – MCA
The Medicaid Compliant Annuity, Single Premium Immediate Annuity, has only one real purpose. It is to convert countable assets into non-countable income to qualify for Medicaid long-term care in Arizona, called ALTCS.

Learn if an MCA is right for your situation.

Chapter 24: The Role of the Socia Worker

The Social Worker plays a vital role in the well-being of our communities. A social worker with a master’s has spent six years in college to obtain their degree.

“Hint.” Social workers are not “Medicaid and VA benefit planners!.

Read more in the book.

Chapter 25: Important Legal Documents needed for Long-Term Care Planning

Each of the following documents are explained in detail in the book.
The Estate Plan Documents Checklist

1. Will and Testament
2. Durable Power of Attorney
3. Trusts
4. Beneficiary Designations
5. Letter of Intent
6. Advanced Healthcare Power of Attorney
7. Living Will
8. Healthcare Power of Attorney
9. Guardianship Designation

         

Chapter 26:  Do you need an elder law attorney in Arizona with ALTCS Planning?

I will save you the money on the book: NO,  you do not!
But if you want to fully understand the NO, read the book

Chapter 27: For the Assisted Living Managers & Owners

Everyone needs to be aware of this sad but true story.

Chapter 28: My Final Words

Helping those with both non-crisis and crisis long-term care planning and assisting veterans with the Veterans Pension and Arizona Medicaid benefits over the past 18-plus years has been the most fulfilling aspect of my career.

As you can now see, finding and paying for the proper long-term care can be a daunting and challenging task. It is essential to seek the help of professionals like a Certified Medicaid Planner™, a Certified Document Preparer, a VA-Accredited Claims Agent, and a Certified Placement and Referral Specialist. Trying to do this on your own can be a costly mistake.

The Elephant in the Room

I charge Arizona Medicaid planning and consultation fees for my service. My fees are one-third to half what a law firm charges for the same service and are allowed and are part of the spend-down or asset conversion process.

Don’t Spend Down, Convert.

Think of my fee as converting a countable asset into a non-countable asset or service.  My service fee is money you will spend on care anyway, but my service will help preserve assets and save time.

The fee you pay will save you thousands of dollars and untold hours trying to do this on your own. As I like to say, “You’re going to spend down assets to qualify anyway, so you might as well use some of it to hire help and save time.”

Thank you very much for buying
and reading my book!

________________________________________________________________
Independent Book Review.
The Complete Arizona Medicaid and Veterans Benefits Guide Beta Report

General Impressions

I think you have a comprehensive and easily understandable book of resource and advice here, one which tackles a specific topic with erudition and concision while maintaining a strong professional tone throughout. I was completely unfamiliar with the topics covered, yet I feel like I’ve come away with a great understanding of the various processes and potential benefits of preparing for Assisted Living, even though I don’t live in Arizona. The advice is complemented well by your interspersed personal anecdotes and the secrets. A few months ago, my grandmother had a bad stroke and is now in an at-home assisted living situation, and it was great to gain some specific knowledge about the types of caregivers as well as the jargon around the caregiving process. The book also feels well-researched, and I really appreciated the specific statistics and quotes throughout. Overall, I think you have a fantastic resource here that I can see many people benefitting from, even those outside of Arizona specifically.

Themes I noticed

• One of the biggest mistakes people make is moving into a community they cannot afford, only to have to move later with fewer resources. / Long-term care planning is essential to avoid making the same mistake that others have.
• The need for long-term care can happen at any time to anybody.
• So don’t be the frog, don’t wait, take action now and jump out of the pot!
• You play an essential role in helping families manage the cost of long-term care. I believe it’s your fiduciary responsibility to inform your residents and prospective residents of the benefits that may be available to them.

My favs

• Without action, there is only re-action!
• While you want to care for them and sacrifice for them in return, you may be overworked, not equipped, or even qualified to care for your aging parent. However, your priority should be keeping your parents or loved ones safe, happy, and protected during their retirement age.
• Long-term care insurance and regular insurance are like chalk and cheese.
• I dare you to tell her it’s unethical to do VA and Medicaid Planning.
• Funny thing, when Bob told the executive director that he was going to gift $50,000 to his niece so he could qualify for Medicaid, she told him, “That’s Illegal!”

Once again, thank you for sharing your work with me! If you have any further questions, comments, or concerns, don’t hesitate to reach out. Best of luck in your writing endeavors!

-J. Flowers-Olnowich