CSA Adult Care Planning 3 — Questions and Answers
Question 1: Which Medicaid planning strategy involves converting countable assets into an income stream to help a community spouse retain more resources while qualifying the institutionalized spouse?
- Spend-down approach
- Medicaid-compliant annuity (Correct answer)
- Special needs trust
- Irrevocable funeral trust
Correct answer: Medicaid-compliant annuity
A Medicaid-compliant annuity converts a lump-sum countable asset into an income stream, which can help the community spouse retain assets above the standard CSRA while qualifying the institutionalized spouse.
Question 2: A senior's long-term care insurance policy has a 90-day elimination period. What does this mean for the policyholder?
- Benefits are limited to 90 days of coverage total
- The insured must pay out-of-pocket for the first 90 days before benefits begin (Correct answer)
- The policy expires after 90 days of non-use
- Coverage begins immediately but only reimburses 90% of costs
Correct answer: The insured must pay out-of-pocket for the first 90 days before benefits begin
The elimination period is essentially a deductible measured in days; the policyholder must pay for care out-of-pocket for 90 days before the insurer begins reimbursing claims.
Question 3: Under Medicare Part A, how many days of skilled nursing facility care are fully covered following a qualifying hospital stay of at least three days?
- 0 days — SNF care is never fully covered by Medicare
- Up to 20 days (Correct answer)
- Up to 60 days
- Up to 100 days
Correct answer: Up to 20 days
Medicare Part A covers the first 20 days of SNF care at 100%; days 21–100 require a daily copayment, and coverage ends after 100 days.
Question 4: Which document specifically designates a trusted individual to make healthcare decisions for a person who becomes incapacitated?
- Durable Power of Attorney for Finances
- Healthcare Proxy (Durable Power of Attorney for Healthcare) (Correct answer)
- Living Will (Directive to Physicians)
- POLST (Physician Orders for Life-Sustaining Treatment)
Correct answer: Healthcare Proxy (Durable Power of Attorney for Healthcare)
A Healthcare Proxy, also called a Durable Power of Attorney for Healthcare, names a specific agent to make medical decisions when the principal lacks decision-making capacity.
Question 5: The 'sandwich generation' refers to caregivers who:
- Are 65–75 years old and caring for a spouse
- Simultaneously care for aging parents and dependent children (Correct answer)
- Alternate caregiving duties between two siblings
- Provide part-time care across multiple unrelated households
Correct answer: Simultaneously care for aging parents and dependent children
Sandwich generation caregivers face dual demands of raising children while also providing care for aging parents, creating significant stress and financial strain.
Question 6: Which type of elder housing provides a private apartment, meals, housekeeping, and some personal care, but not skilled nursing services?
- Skilled Nursing Facility (SNF)
- Assisted Living Facility (ALF) (Correct answer)
- Continuing Care Retirement Community (CCRC)
- Adult Day Service Center
Correct answer: Assisted Living Facility (ALF)
Assisted Living Facilities offer supportive residential care including meals and personal assistance but are not licensed to provide skilled nursing or medical care.
Question 7: A CSA client asks about the 'look-back period' for Medicaid eligibility. Which response is most accurate?
- Medicaid reviews asset transfers made within the past 12 months
- Medicaid reviews asset transfers made within the past 36 months for all transfers
- Medicaid reviews asset transfers made within the past 60 months for most transfers (Correct answer)
- There is no look-back period for Medicaid in any state
Correct answer: Medicaid reviews asset transfers made within the past 60 months for most transfers
For most asset transfers, Medicaid applies a 60-month (5-year) look-back period during which gifts or transfers for less than fair market value can trigger a penalty period of ineligibility.
CSA Adult Care Planning 3
Which Medicaid planning strategy involves converting countable assets into an income stream to help a community spouse retain more resources while qualifying the institutionalized spouse?