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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.)
There are benefits available through the VA for service members exposed to agent orange and class action lawsuits. Have you spoken with the VA? An elder law attorney? A law firm representing former service members exposed to agent orange?
There are also VA benefits that he AND you may be entitled to.
my husband is 100% disabled and the VA in my state follows medicade rules and if they place him in a VA memory care home, it is 4 1/2 hours away, not an option. He has agent orange .
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.
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.
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.
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.
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.
Also, please consider yourself lucky that your husband is eligible for Medicaid, for 2 reasons: 1. Every state has a wait-list which varies in length. In Maryland, the average is 9 yrs. The money pie is only so big, so not everyone can be eligible immediately -or at all. Your husband is one of the lucky few. 2. Nursing homes can be very expensive, so having Medicaid to foot your bills is a blessing. Many families exhaust their savings because of this reason.
I contacted VCS Veteran Care Services. I had no idea my mom was eligible. It took a few months, but they were able to do what I could not and now she receives payment.
Consult with an elder care attorney and the VA immediately. Medicaid cannot improve risk the spouse. You can keep your home, 1 car and approx. $137k (at least in our state), but an attorney will tell you for sure.
If he has agent orange contamination, he has VA benefits that can also help. It’s a lot of red tape, but it will help you both. The sooner you start, the better.
Please don’t sit around being upset, that won’t help either of you. Get started. If you do know how/where to start a social worker should be able to point you in the right direction. Please for your sake, start using the resources that are available. Get elder care attorney referrals from friends or call Natl Counsel on Aging. Google elder care attorney in your areas if nothing else. Talk to more than one (they give free 1 hr consults). Go with your gut on the attorneys your consult with, but get going now. Call the VA as sons as possible.
That your State has the CS asset max set @ 137k really, like REALLY, shows why knowing your States regulations is beyond important.
Medicaid - although a joint Fed/State program - is administered uniquely by each State. For NH/CS couples situation imo is not ever a DIY situation. It’s just way to complicated. & it’s not just the financial segregation of assets & income. But things you do not really think about….. like for most couples they tend to have their life insurance done so that they are each other’s beneficiary. But for couples where 1 is on Medicaid in a NH & the other a CS that is a bad, like beyond bad idea. Why???…. well should that still out & about in the community CS get hit by a bus and die, that becomes a huge problem for the NH spouse. The CS is dead, the NH spouse now get CS life insurance $, so over Medicaid limits and just who, WHO?, is going to be there to deal with all this for the NH spouse??? Changing life insurance is pretty easy but ya gotta do this before LTC Medicaid as it’s a changing of an asset. It’s stuff like this - changing of beneficiary - that a good Medicaid savvy attorney will suggest for couples.
In my armchair not an attorney opinion, for kids dealing with their widow/ widower parent, if you’ve been their POA & involved in their life (so know where stuff is, know their banking), doing their LTC Medicaid application is totally 100% manageable. Major buttrash but doable. It’s get them to that 2K in assets sweet spot (for most states), go thru their bank statements to make sure nothing wonky that looks like gifting and their income goes almost totally to the NM as the required Medicaid copay. But the dealing for couples Medicaid situation is not a DIY.
You should have got divorced 7 years ago. You might try a living trust to protect assets. I am in the same position. Does your husband really need 24x7 care in a facility or could he be home with part time in home care. Our med industry is greedy. Medicare/Medicaid will provide in home care in certain cases. I am getting that now for my wife. I don’t know how long it will last. I requalify every 6 months.
Wrong! Our “med care” is not greedy. What’s greedy is when some people try to scam the system it puts a burden on the taxpayers. There are many people who genuinely need the help from Medicaid, but at the same time there are many who have the resources to afford the care and still wants to scam the system and burden us, the taxpayers, to absorb their costs.
I’m surprised u didn’t know that. Being in those places are not for free. Did u expect him to be in there and u collect the money. No way ma’am. They have to so call take care of him. Otherwise, if u want the money u have to do the work.
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.
I affirm the advice many have already replied to you with: obtain the services of an elder care attorney, ASAP. And, resource the VA system if he is a veteran, ASAP.
No you do not have to give up all of your husband's income and all of your joint savings. That is not how Medicaid works. You will have to give up half of your joint savings with him. If you are dependent on your husband's income because it supports you, Medicaid considers this. You may not be able to carry on and business as usual though. You may have to move to a less expensive home. You may have to learn to live on less. You may have to get a job. Medicaid does not leave a dependent spouse in the street. A nursing home will try to, but Medicaid won't. They will leave you with enough to live on and the home you live in, and you can keep a vehicle. They will not however preserve assets for potential inheritors like adult children or grandchildren. After you go Medicaid will collect on your house and assets to pay your husband's bill. There are ways you could have set up to keep assets and property Medicaid-exempt but most seniors don't want to transfer property or bank accounts to their heirs while they are still healthy and independent. Many aging seniors think that keeping property and assets in their name as a sort of insurance policy that will prevent their heirs from "putting them in a home". It's doesn't though. It would not be to your benefit to divorce your husband now if you are depedent on his income. It would do you good to talk to an estate lawyer though.
Burnt, transferring a deed to an adult child or grandchildren could cause them untold problems. Some states require the deeded owner to ensure the house has water, at their expense if the "tenant" doesn't. You are also required to carry fire insurance, a tenant can't cover your asset from all losses, you have to ensure safe habitability of the structure and other things.
My mom wanted to put her house in my name. NOT! With her living conditions and active pursuits to harm me.
There are safer ways for an elder or anyone to protect their assets.
Some people save all their lives to be able to take care of themselves in their old age. This requires, sometimes, self-discipline and forgoing luxuries. Then they have to watch other people who did NOT save or sacrifice get taken care of by Medicaid. Or other people who want to preserve their assets for their children who try to scam and get Medicaid assistance when they really don't need it. What a system....
Most people who end up needing Medicaid still worked hard their whole lives. They just might not have been in a position to save because they made minimum wage. That doesn’t make them lazy or not worth care.
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
Acording to a message that the OP sent me, she HAS an eldercare attorney.
Medicaid regs vary WIDELY from state to state. Where I live, my retirement accounts are not countable as part of joint assets for Medicaid. That's not true in other states.
I recall Jeanne Gibbs, one of our favorite posters of yore, saying that she had to cash in and pay taxes on HER retirement accounts and spend them down before her much older husband could qualify for Medicaid. That is no longer true in her state, but it was the law at the time.
Get a good elder care lawyer. Split your assets. Medicaid will vary from state the state. My younger sister lived in a group home and had medicaid. My dad had moved back into the family home after mom died and I moved out. He signed a waiver since he was already retired and was not held liable for my sister's care. This is a different situation from yours.
Adding to Barbs comment, there was a thread where a question was asked about a woman having to cash i her retirement plan to pay for her husbands care. Someone replied that there is a form you sign saying you are not responsible for paying for a spouses care. Does anyone remember this?
AJ, I see you are in Indiana. Your state does have laws to protect the community spouse from impoverishment. I don't know what your attorney told you, but either you were given incorrect information or you did not understand what you were told.
I live in Okla and recently attended a seminar w/an Elder law attorney. There have been changes protecting the main residence & medicaid .. He stated that in many cases the primary residence can be protected/exempted up to a certain amount if there is a spouse still residing in the home. It could be helpful to locate an attorney that knows elder law...You can check with senior centers etc,,,Best wishes and prayers your way....
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Medicaid has no interest in impoverishing the "Community Spouse".
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.)
There are also VA benefits that he AND you may be entitled to.
Time to start getting assertive and google!
https://www.va.gov/resources/the-pact-act-and-your-va-benefits/?utm_source=google&utm_medium=paid_search&utm_campaign=ar_pact_fy22_vietvets&gclid=EAIaIQobChMI-aXbh8y9-wIVURXUAR1xJg9AEAAYAiAAEgIYUPD_BwE
Aj, were your assets divided and is your husband's part of the savings currently being spend on MC?
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.
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.
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.
1. Every state has a wait-list which varies in length. In Maryland, the average is 9 yrs. The money pie is only so big, so not everyone can be eligible immediately -or at all. Your husband is one of the lucky few.
2. Nursing homes can be very expensive, so having Medicaid to foot your bills is a blessing. Many families exhaust their savings because of this reason.
Good luck.
If he has agent orange contamination, he has VA benefits that can also help. It’s a lot of red tape, but it will help you both. The sooner you start, the better.
Please don’t sit around being upset, that won’t help either of you. Get started. If you do know how/where to start a social worker should be able to point you in the right direction. Please for your sake, start using the resources that are available. Get elder care attorney referrals from friends or call Natl Counsel on Aging. Google elder care attorney in your areas if nothing else. Talk to more than one (they give free 1 hr consults). Go with your gut on the attorneys your consult with, but get going now. Call the VA as sons as possible.
Medicaid - although a joint Fed/State program - is administered uniquely by each State. For NH/CS couples situation imo is not ever a DIY situation. It’s just way to complicated. & it’s not just the financial segregation of assets & income. But things you do not really think about….. like for most couples they tend to have their life insurance done so that they are each other’s beneficiary. But for couples where 1 is on Medicaid in a NH & the other a CS that is a bad, like beyond bad idea. Why???…. well should that still out & about in the community CS get hit by a bus and die, that becomes a huge problem for the NH spouse. The CS is dead, the NH spouse now get CS life insurance $, so over Medicaid limits and just who, WHO?, is going to be there to deal with all this for the NH spouse??? Changing life insurance is pretty easy but ya gotta do this before LTC Medicaid as it’s a changing of an asset. It’s stuff like this - changing of beneficiary - that a good Medicaid savvy attorney will suggest for couples.
In my armchair not an attorney opinion, for kids dealing with their widow/ widower parent, if you’ve been their POA & involved in their life (so know where stuff is, know their banking), doing their LTC Medicaid application is totally 100% manageable. Major buttrash but doable. It’s get them to that 2K in assets sweet spot (for most states), go thru their bank statements to make sure nothing wonky that looks like gifting and their income goes almost totally to the NM as the required Medicaid copay. But the dealing for couples Medicaid situation is not a DIY.
You will be caring for both of you by doing so.
Best regards
You will have to give up half of your joint savings with him. If you are dependent on your husband's income because it supports you, Medicaid considers this. You may not be able to carry on and business as usual though. You may have to move to a less expensive home. You may have to learn to live on less. You may have to get a job. Medicaid does not leave a dependent spouse in the street. A nursing home will try to, but Medicaid won't. They will leave you with enough to live on and the home you live in, and you can keep a vehicle. They will not however preserve assets for potential inheritors like adult children or grandchildren. After you go Medicaid will collect on your house and assets to pay your husband's bill.
There are ways you could have set up to keep assets and property Medicaid-exempt but most seniors don't want to transfer property or bank accounts to their heirs while they are still healthy and independent. Many aging seniors think that keeping property and assets in their name as a sort of insurance policy that will prevent their heirs from "putting them in a home". It's doesn't though.
It would not be to your benefit to divorce your husband now if you are depedent on his income. It would do you good to talk to an estate lawyer though.
My mom wanted to put her house in my name. NOT! With her living conditions and active pursuits to harm me.
There are safer ways for an elder or anyone to protect their assets.
Medicaid regs vary WIDELY from state to state. Where I live, my retirement accounts are not countable as part of joint assets for Medicaid. That's not true in other states.
I recall Jeanne Gibbs, one of our favorite posters of yore, saying that she had to cash in and pay taxes on HER retirement accounts and spend them down before her much older husband could qualify for Medicaid. That is no longer true in her state, but it was the law at the time.
For nursing home care, please split your assets.
https://www.in.gov/iltcp/medicaid/spousal-impoverishment-protection-law/
The link also has a downloadable pamphlet that usually contain easier to understand information.
https://www.hnwlaw.com/2020/05/08/spousal-refusal-a-powerful-weapon-to-obtain-medicaid-long-term-care-approval/