their home is only worth 50,000 and they have 20,000 in bank and ira's. his truck is 20 years old and 200,000 miles on it and he really could use a newer more reliable truck. I wouldn't want to go across town in it. can he get newer truck, say maybe spend about $7,000 and not mess up medicaid? they owe about 3,000 on funeral plans it appears to me they can pay those off with the money they have.
For couples, with 1 in the NH and 1 as the community spouse, it's different as the spouse doesn't have to be impoverished for the other to be in NH on Medicaid so there should be income to pay for car note.
I think his getting a new truck is an excellent way to use their funds. Under Medicaid rules, couples are allowed 1 vehicle as a exempt asset, so you are best off getting one that is newer and more reliable. What some couples do if they each have a car is trade both of them in against a single newer vehicle and that get's around any transfer penalty being incurred from Medicaid. (like if they gave 1 of their 2 cars to a family member as a gift, then it can have a transfer penalty for doing that).
One thing you want to think about is IF they have a life insurance policy that names each other as their beneficiary. Most couples tend to do this and it can be a problem for Medicaid IF the not in the NH spouse dies and then the in the NH on Medicaid spouse "inherits" the $ from the life insurance policy which then takes her beyond the 2K in assets allowed under Medicaid. They can get the beneficiary changed or perhaps have the beneficiary $ named to a special needs trust for them so that get's around them getting the $ being counted as an asset. You really need an elder law attorney to do these so there is no issue later on and so that it meets the specifics of your state law. Good luck and get that truck!