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Medicaid does not require the community spouse (you) to themselves become impoverished. Only hubs needs to in order to be eligible for Medicaid. Joint assets come into play for his eligibility. BUT Your income not a factor for his eligibility. But how to make things work and do it so that any $ shifted is Medicaid compliant is complicated. Take guests shoppe advice and speak with an atty & before ever filing for Medicaid. I’d try to get one NAELA or CELA level.
Also TX MMNA / monthly maintenance needs allowance for the community spouse is pretty high. About $2900 a mo. So you want the attorney to look into filing for MMNA for you if at all possible.
Thank you, for giving me more info. Do you know of other questions that might be helpful to ask? I am getting all our info together to bring to a CELA lawyer. They gave me a form to fill out{kids income, medical, etc} if you can think of anything else I would be very appreciative; thank you
In most states, Medicaid considers married couples' assets as joint/community property. This usually applies to investments and retirement accounts in regard to the asset eligibility rules. Most states allow the community spouse to keep all income in their name, but in the case of investment income, they may count the total cash value towards the asset limit. Most states allow the community spouse to keep an additional amount of assets, and the amount may differ from state to state. I highly recommend calling your local Aging & Disability Resource Center. If you don't know where/who is your local ADRC, you can call a state number, and they will transfer you to the ADRC closest to you. For Texas, the # to call is 855-937-2372. ADRCs are a free service, and the staff will help screen you for programs, explain the eligibility rules, and help you have a good understanding of what your options are. I agree that it would be a good idea for you to consult with an elder law attorney--your local ADRC may very likely have a list or referrals for elder law attorneys in your area.
Jan - since you asked.... I’d suggest you ask your CELA atty their thoughts as to whether your turning some of that 401 $ & other assets into a SPIA just for you. Normally I hate hate annuities as I view them as just so often sold by someone holding an insurance license to not so savvy elders under high commissions, but a SPIA - single premium immediate annuity- is a very special creature. For a community spouse (you!) that is likely to outlive their in a facility spouse and outlive for a good period of time, the 120k in assets allowed by Medicaid for the CS isn’t enough assets. You’ll more than likely find yourself financially insecure & without a partner or spouse to help ever again financially. If he’s 94 & your 92, then yeah 120k can work. If your a younger CS, 120k is not gonna do it. But remember your income (not assets as those are “joint”) should not be a factor for hubs eligibility for LTC Medicaid. If you can properly shift assets into income tied to just you then you’ll have $ longer yet not affect hubs medicaid. Comprende? A SPIA can do this but imo you need to have it done just right so that it’s Medicaid compliant and ok for actuarial tables and due to all this SPIA are specialty underwriting done by a few.
So say your likely to outlive hubs by 15 years, you all have $100k in savings and you have a 401k 100k and whole life insurance with 5ok cash value for each. You have 300k in assets as viewed by Medicaid. 300 -120 (its actually an exact amount which varies by state but avg is 120k) = 180k & goes in its entirety to become a SPIA that is income paid to you. You want it to be as low as possible but still actuarial ok for IRS actuarial tables. (Btw these can also get used for determining remainderman stuff for life Estate for Medicaid, I don’t even try to understand them). Must be Medicaid compliant which means actuarial ok, Medicaid as the beneficiary & in some states commission fixed.
Why “low” is due to Medicaids income rules. Say His monthly income is $2100 and yours $1500 and you still have a $1800 mo mortgage and you have higher than most RX costs that runs you $1k. COL is say $1200. But your monthly is $4k. You need $2500 more, so you get the SPIA paying you $ and ALSO file for MMNA of $ his income. So his $2100 mo income Medicaid required copay gets minus $ as it’s “waived” to go for your MMNA. It’s a real #s dance. A good CELA level of atty will have FAs they work with to do whatever changes ahead of hubs actual filing of his Medicaid application. Everything has to be done BEFORE application filed as Medicaid does a “snapshot” day to which all $ is affixed to. None of this is a diy.
Tx PNA (personal needs allowance) is $60 a mo. That is all the flexible income $ hubs will have once on LTC Medicaid.
Other stuff is change beneficiary on all life insurance. If you get hit by a bus and die and have hubs as beneficiary, it kicks him off Medicaid & who will be there to deal with all this for him then.....
Also if you both are on the younger side and possibly have parents who have you as heirs, you may want to ask they codicil thier will to have it go to a Testamentary trust. My understanding is for TX anything put into a Testamentary Trust is outside of Medicaid as it stays in probate. I’d ask atty about this if it might be a possibility. If you would let us know how things shake out, as we all learn from each other!
Also on the “face sheet” your working on, be sure to include any info IF any of your kids could be considered special needs.
My understanding is that Medicaid allows for assets to get shifted to special needs trusts. If you all have $ left even after you SPIA, you may want to think about SNT for a child. If it’s just a little amount left, look into establishing the initial maximum ABLE account for them. TX seems to be finally rolling out ABLE and perhaps $ could go into those although smallish 14k max. But you yourself can add $ into it for them each year afterwards.
Also paying down debt debt may not be in your favor. Like if paying off a mortgage leaves you super cash poor, maybe don’t do it, especially if the mortgage has good terms and the monthly manageable. Like I’d probably never pay off our mortgage early as our interest rate is under 2%.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
Also TX MMNA / monthly maintenance needs allowance for the community spouse is pretty high. About $2900 a mo. So you want the attorney to look into filing for MMNA for you if at all possible.
I am getting all our info together to bring to a CELA lawyer. They gave me a form to fill out{kids income, medical, etc} if you can think of anything else I would be very appreciative;
thank you
I highly recommend calling your local Aging & Disability Resource Center. If you don't know where/who is your local ADRC, you can call a state number, and they will transfer you to the ADRC closest to you. For Texas, the # to call is 855-937-2372. ADRCs are a free service, and the staff will help screen you for programs, explain the eligibility rules, and help you have a good understanding of what your options are. I agree that it would be a good idea for you to consult with an elder law attorney--your local ADRC may very likely have a list or referrals for elder law attorneys in your area.
So say your likely to outlive hubs by 15 years, you all have $100k in savings and you have a 401k 100k and whole life insurance with 5ok cash value for each. You have 300k in assets as viewed by Medicaid. 300 -120 (its actually an exact amount which varies by state but avg is 120k) = 180k & goes in its entirety to become a SPIA that is income paid to you. You want it to be as low as possible but still actuarial ok for IRS actuarial tables. (Btw these can also get used for determining remainderman stuff for life Estate for Medicaid, I don’t even try to understand them). Must be Medicaid compliant which means actuarial ok, Medicaid as the beneficiary & in some states commission fixed.
Why “low” is due to Medicaids income rules. Say His monthly income is $2100 and yours $1500 and you still have a $1800 mo mortgage and you have higher than most RX costs that runs you $1k. COL is say $1200. But your monthly is $4k. You need $2500 more, so you get the SPIA paying you $ and ALSO file for MMNA of $ his income. So his $2100 mo income Medicaid required copay gets minus $ as it’s “waived” to go for your MMNA. It’s a real #s dance. A good CELA level of atty will have FAs they work with to do whatever changes ahead of hubs actual filing of his Medicaid application. Everything has to be done BEFORE application filed as Medicaid does a “snapshot” day to which all $ is affixed to. None of this is a diy.
Tx PNA (personal needs allowance) is $60 a mo. That is all the flexible income $ hubs will have once on LTC Medicaid.
Other stuff is change beneficiary on all life insurance. If you get hit by a bus and die and have hubs as beneficiary, it kicks him off Medicaid & who will be there to deal with all this for him then.....
Also if you both are on the younger side and possibly have parents who have you as heirs, you may want to ask they codicil thier will to have it go to a Testamentary trust. My understanding is for TX anything put into a Testamentary Trust is outside of Medicaid as it stays in probate. I’d ask atty about this if it might be a possibility.
If you would let us know how things shake out, as we all learn from each other!
My understanding is that Medicaid allows for assets to get shifted to special needs trusts. If you all have $ left even after you SPIA, you may want to think about SNT for a child. If it’s just a little amount left, look into establishing the initial maximum ABLE account for them. TX seems to be finally rolling out ABLE and perhaps $ could go into those although smallish 14k max. But you yourself can add $ into it for them each year afterwards.
Also paying down debt debt may not be in your favor. Like if paying off a mortgage leaves you super cash poor, maybe don’t do it, especially if the mortgage has good terms and the monthly manageable. Like I’d probably never pay off our mortgage early as our interest rate is under 2%.