How Do I Pay for Long-term Care?

Out-of-pocket expenses for long-term care can be overwhelming.  Families are often shocked to find that their care needs will likely outlast their savings.  If paying out-of-pocket is not possible now or sustainable long-term, there are two main sources of assistance to pay for an elder loved one’s care:  TennCare CHOICES, which is Tennessee’s Medicaid program for long-term services and supports, and VA Pension with Aid and Attendance, which is available to some veterans and their surviving spouses.TennCare CHOICES (Tennessee Medicaid)The TennCare program that pays for long-term care is called CHOICES.  Once an applicant is enrolled in CHOICES, the program will pay all or part of their monthly care costs.  These costs are paid directly to the care providers (the assisted living, nursing facility, hospice, professional in-home caregivers, etc.).  The enrollee may be responsible for part of the monthly cost of care, but CHOICES pays a sizable portion of the cost so that the elder’s money lasts for his or her lifetime.VA Aid & AttendanceFor veterans who served on active duty during a time of war (regardless of whether or not they were deployed to a war zone), and for their surviving spouses, the VA offers a non-service connected benefit called Pension with Aid & Attendance, which can be another source of funds to help pay for care.  Unlike the benefit provided by TennCare CHOICES, which is paid to the facility or other service provider, the Pension with Aid & Attendance benefit is paid directly to the elder enrollee.  The elder receiving Pension with Aid & Attendance may use the money to pay for primary care expenses, such as the cost of facility care, or may use it to pay for other medical or personal care needs.Can I Get Both CHOICES and Aid & Attendance?Yes!  Some elders qualify for both programs.  Depending on the elder’s financial situation and care needs, it may be beneficial to apply for both.  A qualified elder law attorney can assess the situation to determine the elder’s eligibility for each program and whether it will be possible or practical to apply for both.Planning for BenefitsIf you or a loved one is likely to need TennCare and/or VA benefits in the future, the best time to start evaluating eligibility and seeking professional help is now.  An assessment by an elder law attorney familiar with both programs will help you make smart choices about how to structure your assets and how to avoid the common missteps that many people make.  A little guidance in advance can save your family thousands of dollars, ensure you or your loved one gets needed care, and preserve your peace of mind.