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If a spouse is placed in a nursing home long term what do people do financially? My spouse is not Medicaid eligible and my understanding is the nursing home will take your property if you don't have the upfront finances. They charge $9,000 per month for care. Help!

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If placement is required by one spouse an elder law attorney can help you to apply to separate finances so that your spouse will spend down his portion before then applying to medicaid. At that time his assets and Social Security will go to his care. Yours will remain yours. The home you share will remain, is not taken for care. It is all quite complicated and nothing that a Forum Post can answer but you can google a lot of it and an hour of time with Elder Law Attorney can explain it to you as well. Medicaid requirements vary state to state as this is a state program combined with federal. As I said, it's complicated.
Are you presently thinking that your spouse will be needing to get placement soon?
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rovana Jan 2022
How would this spouse in the community division of assets work if the spouse needing care is not eligible for Medicaid?
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You begin to look under every rock for help form as many agencies as you can contact.
Your local Area Agency on Aging might be a resource you can tap into.
Your local Senior Center, they may have resources that could help.
Is your husband a Veteran? If so contact your local Veterans Assistance Commission to determine what help the VA can offer. It might be a little or a LOT depending on where and when he served.
Consult with an Elder Care Attorney. Find out how he can qualify and what the process might be to get him Medicaid eligible.
Depending on other ailments he may qualify for Hospice. With Hospice you would get the Supplies, Equipment that you need as well as a Nurse that would come weekly, a CNA that would come a few times a week to bathe him, order supplies and change bedding if needed. And they will offer support and education that is invaluable.
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czechchick Jan 2022
Thank you so much. This is a lot to absorb.
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Consult a certified elder attorney and see what he or she can do. The nursing home will not seize your property. They will require your husband’s social security and pension. You may have to make payments to the nursing home. Consult Area Agency on Aging to find out if there are state or local resources. Another option may be a small board and care home.
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gladimhere Jan 2022
Maybe not if his pension/social security is the only household income.
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They will not take your property. Your liquid assets will be split 50/50 with half going for care. When that is used, then a Medicaid application will be completed and submitted.

Get with an elder law attorney to learn the real laws in your state.
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czechchick Jan 2022
Thank you 😊
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Why do you think he's not eligible for Medicaid?
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czechchick Jan 2022
I have heard that one has to be practically destitute to qualify.
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As said, you will need to talk to an elder lawyer. A home and some retirement plans are not considered assets by Medicaid. Either is one car. Medicaid allows for splitting of assets. Your husbands split going to his care, when its spent down, then Medicaid is applied for about 90days before he runs out of money. Your monthly income of SS and pensions will be looked at. Yes, you will keep urs but you will be allowed part or all of his to be able to live on. There are Miller Trusts, in some states, that allow for any money over the cap to be placed in the trust to qualify for Medicaid. You will be considered the Community Spouse.

I am assuming both of you are on the deed. When ur husband passes, Medicaid will put a lien on your house. You will still be allowed to live there till your death. If you sell the home, that lien will need to be satisfied.

I am just giving you the basics here. Each state is different. But it gives you an idea of how Medicaid works. It will help you to ask questions and understand what the lawyer is saying.
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czechchick Jan 2022
Thank you for the information. I have a lot to learn. I also work full time, so don’t know if that will play a part 🤷‍♀️
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Czech, if there is a "community spouse" the rules are different. Medicaid has no interest in impoverishing you.

Please see a highly qualified eldercare attorney. Worth every penny.
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czechchick Jan 2022
Hi Barb
what is a community spouse?
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Most if not all state Medicaid allow a house for the spouse as well as a car. This wasn’t always the case. Find an elder law attorney to find details.
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Donttestme Jan 2022
A house and a car. But what about funds to pay utilities, insurance, groceries etc? Is the spouse left with any means to keep the shelter and transportation?
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Hello, fellow Czech here. Jak se mas? :)

I cannot answer your question, but may I ask why it's so expensive? I've been calling nursing homes recently for my MIL and they range from $3,000-$5,000 - and we thought that was pricey!
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momof2angels Jan 2022
In NC we paid $9000 per month four years ago and it was not the priciest nor the least inexpensive in our area. It depends on your location. More metropolitan areas tend to be more expensive, I believe.
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Please talk to social services at the places you are looking at. Also get a consultation with a lawyer that specializes in elder law. The local lawyer can help you keep a home over your head while your spouse is cared for.
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Your spouse may not be Medicaid eligible at this time, BUT there is a way to change that situation. There are lawyers that specialize in elder care and SEPARATION of assets. You can get a separation of assets for Medicaid purposes without getting a divorce. It can protect the spouse not in long term care from impoverishment. If you have an attorney check on this or get them to refer you to someone who specializes. Splitting income is the beginning, then allowances or deductions from that income are made to calculate NH expenses. Its complicated but its done every day. I am not a lawyer but you can google the procedure. Look for Medicaid Division of Assets. If the answer isnt immediate for your situation, it will lead you to a better answer. But an elder care specialized lawyer can work with you. You can successfully protect a large portion of your income in a division...and your home.
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11k per month in Connecticut 5 years ago.
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They will not take your home, car since you live in the home with spouse and you are entitled to keep part of his income, savings, etc - you def should speak to an attorney. Would you be able to apply for community medicaid vs institutional ie community is for homecare and he sounds he would be eligible for 24/7 care ...you can also do something called medicaid spenddown where you for instance can only earn 1200 for a couple and lets say you both earn 5000 - the amount of 3800 that you need to pay to get to medicaid earnings can be spent on housing, food, etc so instead of giving it back to govt, you spend it on his care/food/housing costs.....you would have to create a pooled income trust....but if you have savings, etc - there is now i believe a 2 or 3 yr lookback ie meaning if you transfer savings to kids, you would have to have done it 2 or 3 yrs ago in order to protect it....this was just changed last year - prior to that, therre was no lookback for community medicaid and so if you had $1000000 in the bank - you could transfer to your kids today and apply for community medicaid tomorrow with no penalties.....good luck!
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Live247 Jan 2022
I have always understood that Medicaid has a FIVE YEAR look-back, and if you've given away or gifted any money, such as the $100K you used as your example, the Medicaid applicant would be DENIED Medicaid care equal to the amount of money you gave away, that the applicant would be self-paying until $100K was spent, and then they could reapply for Medicaid.
Do NOT give away, buy stuff, or gift any money! Contact your local senior care agencies, and an elder care attorney as soon as possible.
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If he is not Medicaid eligible it is either there is too much in assets like savings accounts (house is not counted) or you have too much monthly income. Take your denial letter to an elder attorney to help you sort it out. They may create a trust where some of his money goes (for his future needs) and a portion of the rest of the money goes to NH - and Medicaid picks up balance.

There is a form that is signed when you get NH Medicaid called MERP - recovery information. There are certain instances where the house would never get caught up in the recovery (after his death). The attorney can help you with the house problem too.

It's possible that if he becomes eligible for a Medicaid bed in a NH, it may not be at the $9000/mo facility. You would have to find a facility with an empty Medicaid bed
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Isthisrealyreal Jan 2022
There is a price point when the house is considered an asset.

Last time I looked it was 500k.
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You should contact your state's medicaid office to find out the eligibility laws as Medicaid is administered slightly differently in each state. I had a family come into my office and say their dad wouldn't qualify for Medicaid because he had a home, 20k in savings and his wife was living in the home. Medicaid looked at the situation - he qualified in two months and his wife (the community spouse was able to stay in the home) She used her social security income and what was allotted to her from his social security to pay her real estate tax and maintain her car. Another man did not qualify because he had a home which he live in alone as his wife was deceased, 100k in savings and the family did want was to spend the 100k putting into a facilty. Medicaid's ruling, upheld by the court, was "he has funds to be used for him at this time and not to be held as the family's inheritance". Then there was the family that thought they had a problem when Dad went into a facility and wanted to protect his home from Medicaid because his disabled daughter, who was also his care giver for the past 5 years lived in the home. So with the help of a snarky supposedly 'elder care' attorney they transferred the house into the daughter's name so Dad could go to the facility and daughter would continue to have a place to live. Big no, no.!! Medicaid to the father was denied because home was gifted to daughter in order for Dad to become eligible for Medicaid. I wanted t kill the family but then I calmed down and realized they had been taken advantage of by a low life attorney. I (Admission Dir. of the facility where they were trying to place Dad) got into my car, drove to the county Medicaid office, found the worker and explained the situation. They were incredulous but agreed if the family could rearrange the deed/title back to the original state (Dad as owner), they would reverse their decision... which they did. So in many states, a child who has been living in the home and functioning as a caregiver is allowed t live in the home after Medicaid acceptance. BTW... that disable daughter visited her Dad every day and became a volunteer activities person! She was something else.

You have to find out how Medicaid is administered in your state and get yourself a good eldercare attorney.... try https://www.naela.org/ (national academy of elder law attorneys) to see who is in your area who can help you. If you have assets including a home, you really should speak with an attorney. Often they will give you 15-20 min consult for free.

And the going rate for Asst. Living in NJ is $4000-7500 depending on the level of care and for LTC $9000-10000. These are generally operated by for profit companies so after they pay bills they want to walk home with a hefty profit and sometimes it is really hefty but it is an expensive business to run (admissions and financial staff, booking, staff, social workers, utilities, maint staff, cleaning floors daily, sanitizing rooms, nursing staff, activities and activities staff, kitchen staff, landscaping, telephones, cable and food).

Good Luck with your research and your journey. Pls. keep us updated and feel free to PM me with any questions particularly on long term care and assisted living differences.
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What if the house has a mortgage? I assume the bank has first dibs on the house, so if the spouse only has her SS and half of his - she would have to move?
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Go directly to your local office (or a qualified estate attorney) to get your answers… they may be different in the state you live. I have learned by experience, do not deny yourself by not applying because you may have wrong information. Apply and let them deny or approve. My husband could have had his disability SS sooner as well as some VA benefits if we applied earlier. We waited based on “what we had heard” which was not all factual or was outdated info. Medicaid for nursing home is not the same as Medicaid as healthcare for low income. Even if he is not eligible when you first apply, you should get answers you need going forward. If he is a veteran there are benefits there he may qualify for.
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Your spouse absolutely can be Medicaid eligible (for LTC) in the future. You need to see a good elder attorney who will know how to structure your assets and income best and get approved for LTC Medicaid. The spouse absolutely has rights and will be able to stay in the home as long as she wishes. MERP may take the home after spouse passes, but spouse will be allowed to stay as long as she likes.
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Speaking from years of experiences in these issues, I assure you there are ways to handle this. I can't tell you all the laws but if you go and speak with an eldercare attorney who is highly experienced in this area, you will solve this. Also, look for information from Medicaid - like a Medicaid specialist. Don't go to anyone - go to someone who specializes in this area of the law. Good luck.
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czechchick: Imho, perhaps you should retain an elder law attorney.
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That’s true. That’s y u hire help snd fo the best u can with ur spouse through thick and thin to the end.
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