Will I lose my house, or 1/2 the value of it, if I try to qualify my husband for long term care Medicaid?

Post is from Oct 5, 2021. OP has not responded since Oct 6.

You will NOT lose your house OR one car ( of your choice). Medicaid is not out to bankrupt the communal spouse. Work with an elder lawyer and stop listening to people who don’t know what they are talking about. I’m in the process now with my lawyer .

Get an Eldercare attorney!

Cholokara, you’ve been given lots of great insight on LTC Medicaid. HOWEVER 1 significant thing that is being totally overlooked is that for LTC Medicaid your hubs has to, HAS TO, be “at need” BOTH medically AND financially.

Medicaid is “at need” for eligibility for all programs. Like for those Happy Teeth vans, it’s for low income/TANF elementary school kids, for breast pump rental for nursing moms you have to be on WIC, and for LTC Medicaid the applicant has to show to be “at need” medically for skilled nursing care in a NH.

By & large most states LTC Medicaid is only for placement in a NH. You need to find out if your States LTC Medicaid is purely skilled care in a NH or is also for AL &/or MC just in case hubs actually cannot meet the medically “at need” for skilled. And if it’s AL, MC for hubs, then how truly available a bed will be….. most have situation that you have to be private pay resident for 2 years prior in theory to get a bed. But isn’t guaranteed as $ from State for this type of Medicaid is via waiver within state budget and can change ea legislative session. Plus if it’s only 15 Medicaid beds at the AL and all 15 still living there when it’s your elders 2 yr mark until 1 of them dies or moves out, you remain private pay even if your #1 on the wait list.

Financial stuff you can find, you can work w/elder law atty to shift assets if need be, change beneficiary on banking & investments, do a SPIA if y’all have a lot of nonexempt assets & kinda younger CS. But the medical part is dependent on health care providers to input into hubs health history in detail to show skilled care need & with labs or documentation to establish those needs. Just having dementia or needing help transitioning or w/medication management or being too much for 1 person to deal with at home may not be enough to show “need” for skilled care. I’d suggest that you get a needs assessment done on hubs to see exactly where he is for “need”.

The medically “at need” requirement for LTC is a big reason why vast majority of LTC Medicaid NH admits come from a post hospitalization discharge to a NH.
Here’s usual scenario: dad living in his home falls & breaks a hip; EMS comes & dad admitted to hospital & has surgery (MediCARE pays); dad discharged to a NH that has rehab unit (again MediCARE pays for & up to 100 days if progressing in rehab); week 5 dad realistically is unable to return home so dad stays in the NH and goes from a rehab patient (MediCARE) to a long term custodial care resident and files for LTC Medicaid to pay for this. Medicaid will pay for the daily room&board costs; Medicare will not pay for room&board. Dad has a nice fat file of a health chart filled with Rx’s, labs, MD & RN & therapist & hospital notes so between his hospitalization & his rehab and can totally show “need” for skilled care.

IF your coming from living at home or even living in IL or AL, that fat medical file may not be there. Limited or no documentation to show “need”. Medicaid can review health history & can send out assessment team to do an in person on the applicant at the NH. Medicaid can deny eligibility. This is why IMO a needs assessment is mucho importante.

Dealing with medical at need ineligiblity can be done. POA files an appeal but NH has to do whatever to get the chart to show need and get it up to caseworker. It’s work for the NH & if they start foot dragging, you’re kinda SOL.
I moved my mid90’ yr old mom w Lewy Dementia from IL to a NH w/out a hospitalization & bypassing AL phase. Had medical at need eligibility issues due to RXs & labs left out of her chart. Filed appeal with hearing date like 6 mos out. Meanwhile NH DON got on it, sent up missing stuff, ordered new labs as well so added more comorbidities just for good measure. Mom got medically approved mo 3 and then financially @ 5.5 mos.

Point is, Financial is important but Medical equally so.
Good luck in your quest.

States differ on Medicaid requirements. In my state husband was allowed to give me, the spouse, up to $130,000 of his assets. Other funds above this were put into a medical needs trust for him to get his assets down to $2000. The regulations differ in every state so seeing attorney is best.

Stop listening to "people" and get an appointment with a case worker with your state's Medicaid office. These are the experts on what to do. Please call a get real advice.

When I was in the process of applying for my dad I was told that as long as Mom lived in their house she retained the rights to the property and she was allowed to keep up to $22000 if their assets to support her plus any Social Security or pension in her name, in the state of Ohio. If she died or moved out of the house then it was expected that some of the proceeds would go to reimburse Medicaid for dads fees.

What people don’t realize is that Medicaid is not a right earned by citizens, it’s not something we pay into like Social Security, it’s a government program to help out people who don’t plan and save for old age or who are truly indigent with no income or savings. The program is designed to recoup any funds possible when the recipient dies. You are protected to provide you with income and a place to live so that you too don’t end up on government assistance.

JoAnn29,

In the case of a husband and wife. When one party enters a nursing home, the other party is referred to as the "community spouse." As long as the community spouse (CS) lives in the house, the state will not put a lien on it for the Medicaid benefits received by the institutionalized spouse. If the CS laters sells the property, the CS receives all the funds.

Onholdinmidwest,

Each state has a specific Monthly Maintenance Needs Allowance (MMNA). If you tell me your state, I will give you the specifics.

You can have any amount of income. As long as it comes in your name, you keep it. If your total is less than the MMNA, you get the difference each month from your husband's income. The balance of his income is paid to the nursing home, less a small monthly amount so he can get personal items; it is known as his share of costs.

Every situation is different. I would seek out an eldercare attorney who is also a MEDICAID SPECIALIST - it might be one and the same or someone different but the is where you start. Learn everything you can from the attorney. Then I would also seek information from a Medcaid specialist and speak with Medicare directly. This is so involved, you can't do this alone. Different states have different laws.

Chlokara,

Take what has been said here and see a lawyer.

Chloraka: In regard to Medicaid, a house is a non countable asset.

Apeter,

Your response that between spouses, particularly that an unhealthy spouse can give everything to a healthy spouse is correct, with the exception of IRAs.

Helpingdad77,

If you think there is a good chance that he will make it 5 years, your plan works. Make sure the POA allows you to make gifts to yourself; if it does not, you could face a claim that you breached your fiduciary duty to him.

Onholdinmidwest,

As the community spouse, you retain all the monthly income that comes in your name. If your monthly income does the Monthly Maintenance Needs amount for your State - which amount is $2,739.00 in Illinois, the difference is shifted from your husband's income to you. What remains of his monthly income goes to the nursing home as his Medicaid co-pay, with the exception of $30, which he gets to keep for haircuts, etc.

In the majority of states the spouse who is healthy and living in the house can simply have the sick spouse sign all of their assets over to the healthy spouse. That’s what my parents did. My Dad has been able to keep his house and SS with no penalties for 25 yrs now.

HI, I am helping my dad with that right now. Your elder law attorney is exactly right. You will become the community spouse and you will keep all if your assets, money everything except for whatever the attorney will be charging you. Please let the elder law attorney help you through this. It is well worth the money. You will not be able to do it yourself. Please, the lawyer is correct.

There are safeguards in place for the spouse in situations such as yours. Here's a link for some information: https://www.elderlawanswers.com/medicaid-protections-for-the-healthy-spouse-12019

People give bad advice. Get second opinions from experts. An expert is someone who does something for a living. Lawyers, doctors, nursing home administrators, Medicaid advisors.

Advice from general people, like us here, are helpful for figuring out what questions to ask the experts. Advice from general people, like us here, should never be taken as the final word.

For example, my parents listened to family and friends about how to pay for my mom’s terminal cancer treatment. My parents went completely broke - no house, no retirement savings. They lost everything and then she died.

When my dad got sick I asked experts about how to pay for his care. That’s when I learned the truth: my parents never had to loose their house, never had to loose their savings, never had to become a destitute burden on me. By then it was too late.

They listened to well intentioned family and friends and we suffered for it. Get your advice from multiple experts so you don’t end up like them.

My situation is a little different. Currently my father is in a living assisted facility and I am paying for it with his social security and pension. My brother is currently living in his co op apartment, worth about $180,000. I have poa, should I put the apartment in mine and my brother's name to start the 5 year count down? I am thinking this is our only option or is there another way to do this? I know if my father deteriorates before the 5 years and then has to go into a NH then it is what it is. We can't afford an elder care lawyer. I appreciate any help. Im in New York

If the lawyer you consulted specializes in elder law or family in your location, you can trust their advice. Many people jump through hoops to obtain financing for long term care without consulting a lawyer first. They are usually the source of these horror stories. If you need to get advice from a second source, make an appointment with social security administration about this issue.

I was told your house is not counted as part of you holdings as long as you live there and not Rent it out or sell it

On Hold, Medicaid determines how much of his pension you get to keep. The nursing will get the remainder toward his care.

You can look at it this way, Medicaid is partly if not wholly funded by taxpayers. Don't you think it is fair that people who can pay even a little, take some of the sting off taxpayers,

You could probably get by with one car, so sell the other one(s) (You'll save on the associated costs, such as Insurance, maintenance, etc). That is a start.

Under Medicaid, a spouse is allowed the Social Security and pension of Medicaid recipient as well as their own Social Security and pension up to a set value that varies by stare.

Do this sooner rather than later as assisted living or memory care will rapidly deplete your funds. You are allowed savings that are different per state.

Most states have a recovery program that will put a lien on your house once you pass and as long as their is nonfamily member living in home.

An attorney absolutely best person to listen to. Paperwork is arduous - would get attorney to file first time. Then you will have to file yearly. Massive paperwork.

Chlokara,

I would start the process. You have enough information at this point to ask questions if something doesn't seem inline with what the attorney told you.

I am so sorry that you are being bombarded with different case scenarios at a most difficult time for you.

One thing I highly recommend, send copies to Medicaid, number the documents when you get it all together, ie 1 of 100, 2 of 100. Keep a complete copy for yourself and in the event something goes missing you can ask the social worker to tell you what pages are missing. This will help tremendously in the case of careless handling but, it also stops alot of carelessness because it is obvious that they are responsible, as they received a set number of numbered documents.

You can do it! Best of luck!

You are on the right track by speaking with an attorney. All states administer Medicaid slightly differently but............... the rights of a legally married spouse are totally different than those of children. Medicaid is generally not trying to make the "community spouse" (the person who remains in the house) homeless although you will have to pay for your utilities, house maintenance insurance and real estate tax. You and your husband have a legal relationship. Parents and their adult children, with the exception of a child who has been designated guardian or DPoA, have a moral relationship and even then there are exceptions. When I had to consider placement for my Mom, I was allowed to continue to live in the house because I had lived there as her caregiver for over 5 years even though the title was in both names. That would not have been the case if I had not lived in the house for 5 years.

If your attorney is well recommended and specializes in eldercare and Medicaid, please continue to work with him. The well being friends are coming from a different view.

Check to see if “spousal refusal” to qualify for Medicaid is available on your state. It works. We hired someone to do the paperwork ($3000) and she guided us through the process. Saved us ove $8000 per month for nursing care.

Your home and One car are exempt. Medicaid may place a lien on the home when your husband passes. You can stay in your home until you pass. At your death, Medicaid Estate Recovery may try to collect from your estate. You will not be impoverished. They will not take your pension or SS.

The answer is indeed different for the CHILDREN of the person going into nursing care than for a spouse. If you had an appointment with a lawyer, check back with that person as you begin the process of admitting your husband to care. I doubt he would charge you much, if at all, for particular questions that pop up unexpectedly. I agree that both Medicaid and the nursing homes can answer questions as well. It is complicated and you are wise to be careful. It sounds to me that you are handling it well by asking questions. Good luck; it is worrisome to make such big changes in one's life.

Chiokara,

The elder law attorney advised you correctly. I, too, am an elder law attorney.

As the healthy spouse and to qualify your husband for Medicaid, based on your facts, you retain the family home, one car, furniture and personal property found in the house, a prepaid funeral arrangement, and all the savings.