VA Aid & Attendance Benefit: The Complete Family Guide

What families need to know about how long-term care insurance works, who it helps, and how it can support assisted living, memory care, or in-home care when it matters most.

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If you're helping a parent or spouse plan for the future, or already navigating the realities of memory loss or declining independence, you're probably asking one big question: how are we going to pay for this?

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Long-term care insurance (LTC insurance) can be a vital tool in answering that question. But many families don’t understand how it works, when it makes sense to buy, or what it actually pays for. This guide is here to simplify the complex. We’re breaking down everything you need to know about LTC insurance, from policy types and coverage options to timing, eligibility, and common missteps that leave families stuck without support.

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Let’s take the confusion out of planning, so you can focus on what really matters: helping your loved one age with dignity, stability, and choice.

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What Long-Term Care Insurance Really Covers

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Long-term care insurance is not health insurance. It doesn’t pay for hospital stays or surgeries. Instead, it helps cover the cost of non-medical personal care, things like bathing, dressing, eating, toileting, managing medications, or simply staying safe at home when mobility or cognition starts to decline. For families dealing with Alzheimer’s, Parkinson’s, or other types of dementia, this type of coverage can make an enormous difference.

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Policies are designed to reimburse the policyholder a fixed daily or monthly amount once care is needed. That care can happen in many settings: at home, in an assisted living facility, in a memory care community, or at a skilled nursing facility. If the care is needed and meets the criteria outlined in the policy, the insurance company will begin to pay.

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Who Should Consider Long-Term Care Insurance?

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Generally, LTC insurance makes the most sense for individuals between the ages of 50 and 65 who are in relatively good health and looking to protect their assets from the prohibitive cost of long-term care. Buying earlier usually means lower premiums and a greater chance of passing medical underwriting.

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Once you reach age 65, premiums rise significantly. And more importantly, even minor health issues, like controlled diabetes, a recent fall, or mild cognitive impairment, can make it harder to qualify for coverage. The cruel irony is that those most likely to need care are often those least likely to get approved for a policy if they wait too long.

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If your loved one already needs help with daily activities or has a diagnosed cognitive impairment, they’re probably no longer eligible to buy new coverage. On the other side, families with very low income and few assets may not need LTC insurance at all since they’ll likely qualify for Medicaid. The policy sweet spot is usually for middle- to upper-middle-income adults who don’t want to rely entirely on their children, or deplete retirement savings, when care becomes necessary.

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What Types of Care Are Eligible?

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Most long-term care insurance policies are broad enough to cover care across a wide range of settings. That includes in-home care services like skilled nursing, personal aides, and homemaker assistance, as well as residential settings such as assisted living, memory care, and nursing homes. Some policies also reimburse adult day programs, caregiver training, respite care for family members, and durable medical equipment like safety rails or lift chairs.

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If your loved one is still living independently but beginning to forget medications or struggle with personal hygiene, it’s worth checking whether their policy includes benefits for early-stage support. Many do, especially newer or hybrid policies.

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How Long Do Benefits Last?

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Policies vary. Some cover care for a set number of years, typically two, three, or five, while others offer lifetime coverage at a higher cost. Each policy also includes a “daily benefit” amount, which is the maximum reimbursement the insurer will pay for care per day. That number matters more than you think. If the policy covers $200 per day but memory care in your area costs $250 per day, your family will need to make up the difference.

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Inflation protection is another critical feature. It increases the value of your policy each year to keep pace with rising care costs. A daily benefit that seemed sufficient when the policy was bought can fall short a decade later without this protection. Most policies allow you to choose a 3% or 5% annual increase. It costs more up front, but it's often worth it.

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Understanding Policy Types: Traditional vs. Hybrid

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There are two main categories of LTC insurance: traditional and hybrid.

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Traditional policies function like any other insurance, you pay a monthly or annual premium for as long as you hold the policy, and if you eventually need care, the policy pays out. If you never need care, there’s no payout. It’s use-it-or-lose-it.

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Hybrid policies combine long-term care coverage with life insurance. If the policyholder never needs care, the remaining value is paid out to beneficiaries upon death. These policies are often more expensive, but they appeal to families who want a guaranteed return. Some even allow lump-sum payment options or offer indemnity-style payouts, which provide flexibility in choosing who delivers the care, including family members.

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When Do Benefits Start?

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Most policies require a qualifying event before benefits begin. This usually means needing help with at least two of the six “Activities of Daily Living”, bathing, dressing, eating, toileting, transferring, and continence, or having a documented cognitive impairment like dementia.

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There’s also typically an “elimination period,” which works like a time-based deductible. It’s a waiting period, often 30, 60, or 90 days, during which the policyholder must pay for care out of pocket before insurance begins to reimburse. The longer the elimination period, the lower the premium, but also the higher the upfront burden when care is needed.

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What Affects Premium Costs?

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Premiums are based on several factors: age at the time of application, health status, benefit amount, benefit duration, and whether optional features like inflation protection or shared care riders are included.

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As a reference point, a 55-year-old male might expect to pay around $2,000 per year for a solid policy with inflation protection. That number climbs quickly with age or declining health. Women typically pay more than men because they live longer and are more likely to use their benefits. For couples, joint policies or shared benefit options can provide savings and flexibility.

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Applying for Coverage: What Families Should Know

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Applying for LTC insurance isn’t like buying car insurance. There’s an underwriting process that reviews your health history, medications, lifestyle, and cognitive status. Pre-existing conditions, especially dementia, Parkinson’s, or a history of strokes, may result in denial. That’s why applying before health issues arise is key.

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If your loved one already has coverage, make sure you know the benefit triggers, the elimination period, and how to file a claim. When it’s time to activate the policy, you’ll need documentation from a physician, a care provider, and possibly a third-party nurse assessment.

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Can the Insurance Company Deny a Claim?

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Yes. Claims can be denied for not meeting benefit triggers, using unlicensed caregivers, or sending incomplete paperwork. If this happens, families can appeal, but the process can be time-consuming and stressful during an already difficult moment.

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Working with an elder law attorney, care coordinator, or a placement agency familiar with LTC insurance, like Care Connect, can reduce the risk of missteps.

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Is Long-Term Care Insurance Worth It?

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There’s no one-size-fits-all answer. For some families, a well-structured LTC policy brings peace of mind, flexibility, and financial protection. For others, the costs may outweigh the benefits, especially if the policy is bought late or doesn't match real-world care needs.

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What matters most is timing, understanding the fine print, and aligning the policy with your long-term care strategy. Whether you’re planning ahead or navigating dementia care today, LTC insurance can be part of a larger plan to help your loved one stay safe, supported, and cared for, without burning through everything they worked for.

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At Care Connect, we don’t sell insurance, but we help families understand how to use it. From reviewing benefits to helping activate claims and coordinating with memory care communities, we’re here to walk with you every step of the way.

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Need help understanding your options or making a long-term care plan that works for your family?

Reach out today. You’re not alone in this.

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Why families shouldn’t have to Google their way through the most important care decision of their lives.

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When your loved one needs assisted living or memory care, the first instinct is to go online. You type in “senior living near me” and suddenly you’re staring at dozens of polished websites and virtual tours. But what you won’t find on those pages are the things that actually matter, fall risks, staff turnover, management changes, or what a place feels like when you walk through the door. That’s where senior placement comes in.

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At Care Connect, we don’t just point you to a list of buildings. We walk you through the process step by step. We meet you in person, at the hospital, rehab, or right in your living room. We evaluate what kind of care your loved one really needs, whether that’s assisted living, memory care, in-home help, or a skilled nursing facility. We pre-communicate your medical history, your mobility level, your family dynamics, and your goals so communities are ready for you. We book and attend tours with you, help with paperwork, and stay with you all the way through move-in.

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This is what care navigation looks like when it’s done right. It’s personal. It’s ethical. And for families facing some of the hardest choices they’ll ever make, it changes everything.

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Isn’t That Just Like a Real Estate Agent?

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It’s similar, but with one crucial difference. A real estate agent sells properties. A senior placement advisor advocates for people. We’re not trying to sell you on the most expensive choice. We’re trying to find the safest, most supportive environment for someone you love, often during a crisis.

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We work for the family, even though we’re paid by the community after move-in. Care Connect has strict internal rules to avoid conflicts of interest. Our care coordinators don’t see payout amounts, and their success is measured by outcomes, not commissions. That means they’re focused 100% on finding the right fit for your loved one, not pushing what pays the most.

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What Kinds of Care Do Placement Advisors Help With?

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Every situation is different, and a good placement advisor should meet you where you are. At Care Connect, we help families navigate the full continuum of care. That includes independent living for older adults who need less support, assisted living for those who need help with daily activities, memory care for those living with dementia or Alzheimer’s, and skilled nursing or rehab when medical needs become more complex. We also help coordinate home care when staying in place is still a possibility.

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Whether you're planning for the future or making urgent decisions from a hospital bed, our job is to bring clarity, and a path forward.

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Can You Help in an Emergency?

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Absolutely. Many of our families call us when time is running out, after a fall, a hospital stay, or a sudden health change. In these moments, we don’t just offer a phone call. We show up. In most cases, a Care Connect coordinator can be at the hospital or rehab within two hours to start the assessment and planning process. But we’re also here for the long-haul planners, the adult children who want to understand options before the crisis hits. For those families, we offer no-pressure coffee chats, education workshops, and support group referrals. Whether the timeline is tomorrow or five years from now, we’re ready when you are.

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Is Senior Placement Really Free?

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Yes. Families don’t pay a dime for our services. Like buyer’s agents in real estate, we’re compensated by the community after your loved one moves in and stays for at least 30 days. That said, we go out of our way to make sure our recommendations aren’t driven by money. We never chase higher commissions. We disclose how we’re paid, and we rank communities by care quality, not by payout.

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Some other agencies don’t work that way. They may negotiate higher rates with certain providers or push you toward options that aren’t the right clinical or financial fit. We’ve seen it. And we’ve built Care Connect to be the antidote to it.

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What’s the Process Like?

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When you call Care Connect, we start by listening. We ask about your situation, your goals, and your concerns. Then we meet you in person, wherever your loved one is. We complete a full care assessment, looking at their medical conditions, mobility, cognitive function, behavioral risks, and social preferences. Based on that, we recommend two or three communities that fit your needs and your budget.

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But we don’t just hand you names and wish you luck. We schedule the tours, attend them with you, ask the right questions, and explain what you’re seeing. When you’re ready to move forward, we help complete the application, gather medical forms, coordinate planning, and follow up post-move. And if your plans change, or if the move doesn’t work out, we’ll help again. No judgment. No pressure.

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Can You Manage Complex Cases?

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Yes. In fact, we specialize in them. Many of our referrals come from geriatric psych units, hospital discharge planners, or overwhelmed social workers trying to place someone with dementia, psychiatric behaviors, or medical complexity. We’ve placed over 1,000 seniors with diagnoses ranging from Alzheimer’s and Lewy Body Dementia to Parkinson’s, schizophrenia, and chronic fall risk. Our team includes Certified Dementia Practitioners who know how to work with behaviors, anticipate risk, and match residents to therapeutic environments that actually help, not just warehouse.

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What Makes Care Connect Different from Online Referral Sites?

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The internet can’t walk beside you during a tour. It can’t answer a crisis call at 9:00 p.m. It can’t step in when two siblings disagree or talk to your loved one’s doctor. That’s the difference between working with a local care advocate and filling out a form on A Place for Mom.

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Online referral platforms send your information to 10 or 20 communities, and then the calls start flooding in. After that, you’re on your own. At Care Connect, we do the opposite. We protect your privacy. We narrow down the best-fit options. We stay with you every step of the way, and we’re still here long after move-in.

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What If I’m Not Ready Yet?

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That’s okay. You don’t have to be in crisis to reach out. Many of the families we help start with a single conversation, a call, a cup of coffee, or a question. We welcome it. We’ll answer your questions, walk you through options, and help you prepare for what’s ahead, whether it’s three months or three years away.

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And if the plan changes after placement? We’re still here. If you need to move again, update care plans, or revisit Medicaid, VA benefits, or long-term care insurance, we’ll help then, too. We’re in this for the long haul.

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Final Thoughts: You Deserve More Than a List

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When it comes to senior care, you shouldn’t have to rely on Google searches, confusing sales pitches, or guesswork. You deserve clarity. You deserve guidance. And most of all, you deserve someone who puts your family’s needs first.

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At Care Connect, that’s what we do. We’re not a call center. We’re not a marketing agency. We’re real people helping real families navigate one of life’s hardest transitions, with dignity, ethics, and heart.

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Wondering if we’re the right fit? Let’s talk. No pressure. Just support. Because the right placement isn’t about where, it’s about who’s walking beside you.

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How Medicaid really works for long-term care, and how families in New Jersey and Pennsylvania can plan smart, avoid common mistakes, and get the support their loved ones need.

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When someone you love begins needing help with daily activities or requires memory care, the emotional strain is often compounded by one tough reality, long-term care is expensive. For many families, especially in New Jersey and Pennsylvania, Medicaid is the only way to afford the type of care their loved one needs without draining everything they’ve worked for.

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But Medicaid is complex. The rules vary by state, the application process is demanding, and misinformation is everywhere. This guide breaks it all down so you can understand how Medicaid really works for senior care, who qualifies, what it covers, and how to protect your family’s assets along the way.

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What Is Medicaid, and How Is It Different from Medicare?

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First, let’s clear up the confusion. Medicare is a federal health insurance program for people 65+ and individuals with certain disabilities. It covers hospital visits, doctor appointments, and short-term rehabilitation, but it does not cover long-term custodial care in a nursing home, memory care unit, or assisted living.

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Medicaid is different. It’s a joint federal and state program that provides health coverage for people with low income, and it’s the only public program that covers long-term care, including nursing homes, in-home care, and in some states, assisted living and memory care.

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In short, when families can’t afford long-term care out of pocket and Medicare falls short, Medicaid steps in, if you qualify.

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Who Qualifies for Medicaid for Senior Care?

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Medicaid eligibility is based on two things: income and assets. These limits vary by state, but they’re strict, and the details matter.

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In New Jersey, adults aged 19 to 64 may qualify for general Medicaid with an income up to 138% of the federal poverty level. For long-term care coverage specifically, income and asset limits are lower. In 2021, an individual could not exceed $2,382 in monthly income, and only $2,000 in countable assets.

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In Pennsylvania, the income limit for long-term care Medicaid is based on 300% of the Federal Benefit Rate, or about $2,901/month in 2025. Asset limits are usually $2,000 for an individual, though Pennsylvania allows a $6,000 resource disregard in some cases.

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For both states, Medicaid will also look back five years to check for asset transfers. If they find you gave away money or property to qualify, they can impose a penalty period where you’re ineligible, even if you meet all other criteria.

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What Care Does Medicaid Actually Cover?

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The answer depends on where you live. In New Jersey, Medicaid may cover assisted living and memory care under special programs called Home and Community-Based Services (HCBS) waivers. These allow eligible seniors to receive care outside of nursing homes, but availability is limited, and there’s often a waitlist.

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In Pennsylvania, Medicaid long-term care only covers skilled nursing facilities. Assisted living and memory care communities are not eligible for reimbursement. However, in-home care, adult day programs, and some non-institutional services may be covered through waiver programs.

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Across both states, Medicaid typically covers:

• Nursing homes
• Home care services
• Medical equipment
• Therapy (physical, speech, occupational)
• Transportation to medical appointments
• Adult day care
• Case management

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Families caring for a loved one with Alzheimer’s or another type of dementia should know that Medicaid can, and often does, help pay for care. But it may take planning and persistence to get there.

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What Are Medicaid Waivers?

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Waivers are special Medicaid programs that allow states to use Medicaid funds for care in settings like your home or an assisted living community, rather than requiring a move to a nursing facility. These programs are a lifeline for families trying to keep a loved one with dementia out of institutional care for as long as possible.

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Services covered under waivers may include:

• Help with activities of daily living (like bathing, dressing, toileting)
• Respite care
• Home modifications
• Meals and transportation
• Support for family caregivers

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Each state has its own waiver programs. In Pennsylvania, the Community HealthChoices waiver is one of the largest. In New Jersey, NJ FamilyCare oversees multiple waiver programs. But again, slots are limited. Planning early helps avoid delays.

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Income, Asset Limits, and the Look-Back Period

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To qualify for Medicaid, most individuals must have less than $2,000 in countable assets. That includes checking and savings accounts, investment accounts, and real estate that’s not your primary home. However, some assets are considered exempt, your home (if you live in it), one vehicle, personal belongings, and irrevocable burial trusts.

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If you’re over the limit, Medicaid expects you to “spend down” your assets on care until you meet the requirements. But there are smart, legal ways to protect your assets without spending everything.

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Common planning tools include:

• Medicaid Asset Protection Trusts
• Life estate arrangements for your home
• Irrevocable annuities
• Strategic gifting (done more than five years before applying)
• The caregiver child exemption (if an adult child lived with you and provided care)

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The five-year look-back period is critical. Any transfers or gifts made during this window can trigger a penalty period where you’re disqualified from receiving Medicaid, even if you otherwise qualify. This is where having professional help is essential.

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How to Apply for Medicaid in NJ and PA

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In New Jersey, applications go through NJFamilyCare. You can apply online, by phone, or through your County Welfare Agency.

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In Pennsylvania, applications go through the COMPASS system or your County Assistance Office.

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You’ll need to provide extensive documentation, including:

• Income verification (Social Security, pensions, etc.)
• Asset statements (bank accounts, retirement accounts)
• Proof of citizenship
• Property details
• Health insurance information
• Legal documents like power of attorney or living will

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The review process typically takes 30 to 90 days. If your application is denied, you have 60 days to appeal.

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Medicaid and Senior Living Facilities

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Not all facilities accept Medicaid, and even those that do may limit the number of Medicaid residents they take. In Pennsylvania, where assisted living and memory care are not covered, families may need to consider a move to a Medicaid-approved nursing facility if funds run out. In New Jersey, assisted living options with Medicaid waivers exist, but competition is high.

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Choosing a facility that accepts Medicaid and matches your loved one’s needs is complicated. You’ll need to think long-term, because Medicaid status can affect your ability to stay in a particular building if ownership or funding changes.

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What About Spousal Protections?

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If one spouse needs care and the other is healthy and living at home, Medicaid offers protections for the "community spouse." These rules are often misunderstood.

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The healthy spouse may be allowed to keep up to $157,920 in assets and $2,555–$3,948 in monthly income in 2025, depending on the state. In many cases, couples are told they must spend down half their assets, which is not true. Proper planning with someone who understands spousal allowances is essential.

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Final Thoughts: Get Help Before It’s Urgent

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Medicaid can be a lifeline for families, especially those caring for a loved one with dementia. But it’s not easy to navigate. The rules are complicated. The paperwork is intense. And the cost of a misstep can be measured in tens of thousands of dollars.

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At Care Connect, we help families understand how Medicaid fits into their bigger care plan. Whether you need help with the application process, want to explore asset protection strategies, or simply need to know what’s even possible in your state, we’re here to help you take the next step with clarity and confidence.

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Want help making sense of Medicaid eligibility, asset planning, or long-term care options?

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Let’s talk. No pressure. Just answers.

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