Only your hubs has to become “impoverished” enough for LTC Medicaid. Not you. Again NOT YOU!
You are the community spouse (a CS in Medicaid speak) and as such your income is yours and if you need some of his monthly income, eg his SS, then you file for CSRA or MMNA. They are resource / needs allowance that waive hubs required by Medicaid copay of his monthly income to the NH to instead go to you. There’s a equation to determine this….. like if your own SS income is super low, or you still have a mortgage or extraordinarily high utilities, or you personally have your own health care costs higher than average, that info gets used to maximize the waiver.
Now assets, like your joint savings or investments, that’s a different issue…. Personally I would not try to DIY deal of with asset division but get a CELA level of attorney to go over y’all’s financials and come up with options that work best for how Medicaid looks at couples division of assets in your state. Most states allow the CS to retain abt 128K in liquid assets, a home (w/homestead exemption & under a certain value) & 1 car. Medicaid is strict on the 1 car rule, so either sell 1 or sell both and get 1 newer more dependable car. If still a mortgage or car note, it - imo - kinda works to your benefit as it’s debt you need his mo income waived over to you as a CS to have the $ to be able to maintain your standard of living (like at that home with a mortgage) in your community.
If you have assets above what state supposedly has as the CS asset maximum, and your on the younger side, you might could do a SPIA. Single premium immediate annuity. Personally I hate like hate annuities but a SPIA is a very special creature… they are speciality underwriting & a better attorney should know about them and if they might could work for your & hubs situation. Roughly it could do this: 210k in joint savings and CS max allowed 100k; you are still kinda young so below actuarial tables for death (yea!); your atty gets the underwriter they deal with to take 108k and it becomes your SPIA that pays you income ea month. Your income, so not a factor for hubs “impoverishment”. Hubs allowed 2k in assets for most states. So 210k - 100k as your own assets - 2K a hubs assets -108k in that SPIA which pays you income. Neither you or I can go and buy a SPIA on our own, ya need a experienced attorney who works with a broker experienced with this type of underwriting.
Do not expect the facility to be helping you understand much less maximize your CS situation. Or for the facility to suggest that you file a waiver so you get CSRA or MMNA from his mo income. The only thing in my experience they’ll tell you to do is open your own bank acct for your SS & retirement income as they are expecting that you & hubs will allow them (the facility) to become his representative payee. You have to get an attorney to do know what to do to maximize your finances for your future as a CS. Not a DIY.
You are not “ giving up” anything ! The State is not TAKING from you they are GIVING discounted care to your husband. They DO NOT impoverish people. Try paying for those services ALONE and see what happens. I speak from experience. I’ve been there and have worked hard my whole life But the cost of care is astronomical and I could not have afforded it on my own even though I’ve worked hard. I am thankful that this was available so that my husband could get the care I really wanted him to have. Be thankful
From your profile: I am caring for my husband Lee, who is 75 years old, living in a nursing home with alzheimer's / dementia, anxiety, depression, diabetes, heart disease, incontinence, and parkinson's disease.
About Me Husband has dementia, heart problems, high blood pressure, parkinsons tremors, 3rd stage kidney failure, and better known as agent orange and i could no longer care for him and had to put him in nursing home who sent him to physo hospital to be chemically made nursing home docile
1: Did you speak with a Certified Elder Care attorney about Medicaid not leaving you, as the spouse, impoverished, before you placed him in a nursing home? It's not their goal to leave the spouse in such a state.
2: Do you think your spouse chose to be riddled with Alzheimer's/dementia in the first place, along with all the rest of his health issues? Being mad at your spouse suggests he had a choice about this diagnosis and chose to leave you in the position you're in, and that you had no choices to make yourself about spouse's placement.
We all suffer when our spouse gets diagnosed with a myriad of health issues. I'm sorry you're in such a position, and suggest you do speak with a certified Elder Care atty immediately if you haven't already.
Wishing you and your DH the best of luck with a tough situation.
Your husband is a Veteran. PLEASE consult the VA and or the Veterans Assistance Commission. If the medical conditions he has classify him as 100% Service Connected disabled he can get help through the VA and you are also able to benefit. There is Aid and Attendance (that is needs based so you will be assessed, but he would qualify for a Veterans Home.)
When my mother was in NH, they received her SS check and after her LTC policy ran out, Medicaid paid for the rest. My father remained in their home. He kept all of his pension, all of his SS, and all of their joint savings. He wasn’t broke in any way. I’m unsure why this isn’t the case for you. I know that Medicaid rules vary by state, but the community spouse is not supposed to lose their income or ability to live normally. Please consult an elder care attorney for professional advice in this.
You saw a lawyer? Was it an elder law attorney that is familiar with Medicaid rules? A family law lawyer probably would have no idea how Medicaid works.I
Have you contacted VA for assistance? I think you need to consult another attorney. Thirty or sixty minute consultations are often free. Go to your state's Bar Association or NELF.org.
Glad, my thoughts too are along this line. For both the OP (AJ2152) & for WorriedSpouse, they imo both seem to have spoken with attorneys who either are not knowledgeable/ experienced in LTC Medicaid or these are “estate” oriented elder law attorneys. Elder law is geared for creating Wills / POA documents, creating Trusts and then all those associated cost$$$ to maintain Trust(s), or enabling guardianship and all those cost cost$, doing things for the elders assets & investments geared for limiting taxes & for years. And the attys get others (financial advisors, CPA, etc) to come in to work on the elders estate. Lots of fees to rack up and on a regular basis.
Getting Grandma impoverished for Medicaid is way way different. Once fees paid for creating documents unless that elder has real $, there’s no $ or assets for an attorney to be able to charge fees for management of. I do think that’s why many have really high documents charge as it removes most elders & their families from going back to see the attorney after the initial “free” consultation.
Medicaid allows for assets to be split. Your husbands split going to his care and when spent down you apply for Medicaid. You will get enough of your monthly income to live on, the home and a car. You need to see an elder lawyer.
Medicaid is administered by the state, so each state has different rules. In Maryland, CS’s income, retirement acct, and assets are considered joint assets. Therefore, it is harder to get Medicaid here. I talked to several eldercare attorneys and they gave me the same info. This is why my husband cannot get Medicaid because I am still working.
The only recourse for us is to get a divorce, but then all of my rights as spouse and power of attorney would be gone and he would be under the care of the state. That would be worse!
Check with a certified eldercare attorney in your state. Good luck.
Why would your POA go away? You'll still be you even if divorced. Definitely follow others advice about an eldercare attorney. You will not have to spend all your money.
Medicaid is for people who legitimately need it. Medicaid does not cover costs for care while the spouse and family carry on as usual. Your husband's income and your savings need to be used to pay for care until those resources are depleted. Only then do you qualify for Medicaid. Medicaid does not cover costs for people with assets above a certain level. Where you see that being done, it is because someone has been clever or duplicitous enough to scam the system.
You are the community spouse (a CS in Medicaid speak) and as such your income is yours and if you need some of his monthly income, eg his SS, then you file for CSRA or MMNA. They are resource / needs allowance that waive hubs required by Medicaid copay of his monthly income to the NH to instead go to you. There’s a equation to determine this….. like if your own SS income is super low, or you still have a mortgage or extraordinarily high utilities, or you personally have your own health care costs higher than average, that info gets used to maximize the waiver.
Now assets, like your joint savings or investments, that’s a different issue…. Personally I would not try to DIY deal of with asset division but get a CELA level of attorney to go over y’all’s financials and come up with options that work best for how Medicaid looks at couples division of assets in your state. Most states allow the CS to retain abt 128K in liquid assets, a home (w/homestead exemption & under a certain value) & 1 car. Medicaid is strict on the 1 car rule, so either sell 1 or sell both and get 1 newer more dependable car. If still a mortgage or car note, it - imo - kinda works to your benefit as it’s debt you need his mo income waived over to you as a CS to have the $ to be able to maintain your standard of living (like at that home with a mortgage) in your community.
If you have assets above what state supposedly has as the CS asset maximum, and your on the younger side, you might could do a SPIA. Single premium immediate annuity. Personally I hate like hate annuities but a SPIA is a very special creature… they are speciality underwriting & a better attorney should know about them and if they might could work for your & hubs situation. Roughly it could do this: 210k in joint savings and CS max allowed 100k; you are still kinda young so below actuarial tables for death (yea!); your atty gets the underwriter they deal with to take 108k and it becomes your SPIA that pays you income ea month. Your income, so not a factor for hubs “impoverishment”. Hubs allowed 2k in assets for most states. So 210k - 100k as your own assets - 2K a hubs assets -108k in that SPIA which pays you income. Neither you or I can go and buy a SPIA on our own, ya need a experienced attorney who works with a broker experienced with this type of underwriting.
Do not expect the facility to be helping you understand much less maximize your CS situation. Or for the facility to suggest that you file a waiver so you get CSRA or MMNA from his mo income. The only thing in my experience they’ll tell you to do is open your own bank acct for your SS & retirement income as they are expecting that you & hubs will allow them (the facility) to become his representative payee.
You have to get an attorney to do know what to do to maximize your finances for your future as a CS. Not a DIY.
I am caring for my husband Lee, who is 75 years old, living in a nursing home with alzheimer's / dementia, anxiety, depression, diabetes, heart disease, incontinence, and parkinson's disease.
About Me
Husband has dementia, heart problems, high blood pressure, parkinsons tremors, 3rd stage kidney failure, and better known as agent orange and i could no longer care for him and had to put him in nursing home who sent him to physo hospital to be chemically made nursing home docile
1: Did you speak with a Certified Elder Care attorney about Medicaid not leaving you, as the spouse, impoverished, before you placed him in a nursing home? It's not their goal to leave the spouse in such a state.
2: Do you think your spouse chose to be riddled with Alzheimer's/dementia in the first place, along with all the rest of his health issues? Being mad at your spouse suggests he had a choice about this diagnosis and chose to leave you in the position you're in, and that you had no choices to make yourself about spouse's placement.
We all suffer when our spouse gets diagnosed with a myriad of health issues. I'm sorry you're in such a position, and suggest you do speak with a certified Elder Care atty immediately if you haven't already.
Wishing you and your DH the best of luck with a tough situation.
Just to clarify;
She is not mad at her husband..She is mad that the state wants to take her income/assets.
PLEASE consult the VA and or the Veterans Assistance Commission. If the medical conditions he has classify him as 100% Service Connected disabled he can get help through the VA and you are also able to benefit. There is Aid and Attendance (that is needs based so you will be assessed, but he would qualify for a Veterans Home.)
Have you contacted VA for assistance? I think you need to consult another attorney. Thirty or sixty minute consultations are often free. Go to your state's Bar Association or NELF.org.
https://nelf.org/search/custom.asp?id=5427
Is your current attorney in this directory?
https://nelf.org/search/search.asp?txt_state=Indiana
Elder law is geared for creating Wills / POA documents, creating Trusts and then all those associated cost$$$ to maintain Trust(s), or enabling guardianship and all those cost cost$, doing things for the elders assets & investments geared for limiting taxes & for years. And the attys get others (financial advisors, CPA, etc) to come in to work on the elders estate. Lots of fees to rack up and on a regular basis.
Getting Grandma impoverished for Medicaid is way way different. Once fees paid for creating documents unless that elder has real $, there’s no $ or assets for an attorney to be able to charge fees for management of. I do think that’s why many have really high documents charge as it removes most elders & their families from going back to see the attorney after the initial “free” consultation.
Medicaid has no interest in impoverishing the "Community Spouse".
The only recourse for us is to get a divorce, but then all of my rights as spouse and power of attorney would be gone and he would be under the care of the state. That would be worse!
Check with a certified eldercare attorney in your state. Good luck.