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If my husband has to go into a nursing home, would it take his retirement plus his medicare????? That would leave me with nothing since I am not on any assistance. Are there provisions for spouses that remain in the home?

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Under Federal Medicaid law, the at-home spouse is always entitled to a MINIMUM of $1,821/month of income, so that if your income is less than that, you are entitled to have some of your husband's income shifted over to you to bring you up to that level. Indeed, if your expenses are higher, you can even adjust that up to a maximum of $2,739 (or higher, in rare cases where you go to court for additional support).
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Grieving - good you are seeing an elder law attorney. The whole community spouse (CS) situation is so totally different than for an individual qualifying for Medicaid.

Realize that most info you are likely to get or hear is all going to be for individuals - the whole 2K in assets & 2K income requirements. Forget that! You as the CS need to get every cent of his income and keep the maximum assets allowed for a CS as your state allows. the rules for CS are different and the key for you will be getting an elder law guy who does CS work. For CS there is the whole MMNA - Minimum Monthly Needs Allowance or CSRA - Community Spouse Resource Allowance $$ to deal with. I think of it as kinda like alimony for the nonNH spouse. And like alimony you want to get the max! The MMNA/CSRA seem to have a state by state formula of what the CS gets diverted from his NH co-pay to you. But your situation may need more of his funds (like you still have a mortgage or dependents) so having an attny go to bat and organize all this will be key. There was a poster on this site who's mom had their MMNA re-evaluated so that their dad's required by Medicaid co-pay of their income to the NH was $ 42.00. All the rest of his monthly income was diverted to his wife as she was a CS and had pretty significant housing & medical expenses of her own. The CS is NOT expected to themselves become impoverished; only the NH Medicaid spouse needs to.

You are going to be all focused on hubby's care and your son's stuff and you cannot just do it all. Nor should you. For a CS there are all sorts of issues you never thought about…..like most couples have each other as their beneficiary to their life insurance policies. Bad idea if 1 is on Medicaid because if you should predecease hubby, his getting the $ from the policy will disqualify him from Medicaid and possibly he may need to pay all the life insurance $ to the state for the care the state paid for to date. Stuff like that needs to be changed (like maybe the beneficiary is a trust in yours son's name that he gets totally at age 30); attny will provide you options on all this.

The atty will have FA or others you can work with if need be. & that understand how to structure stuff to your best advantage. Most states have the CS with a maximum of 114K in liquid assets and if you are somewhat over that you might be able to do a SPIA for the overage and not have to have hubby use it in spend-down. Personally I hate, hate, hate annuities as a investment strategy but often for spouse/NH situation, you as the CS just have to get say 40K moved and now to qualify your spouse for Medicaid so a SPIA can often do that in a single set of paperwork and totally ok for Medicaid as not his asset. Good luck & keep a sense of humor going in all this too.
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You mentioned that you were on Medicare NOT Medicaid. Medicare will cover up to 100 days of nursing home care IF there is a 3 day INPATIENT hospital stay prior to his being placed in the nursing home (if he is in the hospital, ask for the social worker in order to determine if he is considered an inpatient or not and to make sure that he stays long enough to qualify)............and then there are qualifications that have to be met at the nursing home in order for Medicare to continue paying. Once the 100 days are up or if he no longer meets the qualifications of the stay, then payment will come from private funds (meaning your funds).
If you have not already done so, you should begin looking into applying to Medicaid. You don't have to be destitute in order to qualify - as Mr. Heiser said, you are allowed to keep a certain portion of money, and your home and one car and a very small amount of money in savings.
There are ways that you can "pay down" to Medicaid and this requires some research. Do not just start giving money away to your children, because that is not considered appropriate. Contact your Area Agency on Aging for a referral to an elder law attorney to discuss options.
Best wishes,

Shelley
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In my state, If he is Medicaid eligible, there is a special budget for "the community spouse", allowing you to keep a portion of his income and resources. I don't know about Medicare, or the actual budget a nursing home uses.
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Thank you LME....I figured as much! Thanks for responding
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Is your husband a veteran? The VA has advocates that can help you with the paperwork and they can pay a big portion of an assisted living/nursing home. you can get in touch with VA to ask for information of an advocate. if you can't find one I'll check for your response and see if I can find who we contacted.
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My husband is not a veteran....All of your answers are so helpful and I will look into the options....We are spending 7,400 a month in home care now....that can't go on forever! We are blessed with a pension and SS, so I would imagine from what you say, I will be entitled to enough money to run our home when the day comes....This is such a sad time of life..his care comes first, but it's scary to wonder what will happen to me....Your answers have eased my mind considerably! Thanks and bless you all...
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I like Shelley's response. The three day hospital stay in a full-service hospital is definitiely required before anyone goes to an Assisted Living facility ( paid by Medicare) or a Nursing Home. The 100 day rule is strictly held also. Take him home after 100 days.
Medicare is just for him, not you. That's why we all have separate Medicare numbers. When death occurs ( and it will, dear), you can choose either his S.S. payout or yours, whichiever is greater, but not both. Stop looking for money now, and just take good care of him. Show some affection.
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There is just so much to think about....! You all know that! Taking care and giving affection takes up so much time that by the time evening comes I am exhausted....! BUT you have all routed me in a direction that I can move forward! I thank you all for your answers.....My case is unusual and I have written several things....step children are involved (um, they weren't for 12 years!) Even after he had breast cancer and a heart attack 2 years ago, only one of the 3 had anything to do with him! As soon as it was clear he was slipping, they want to tell me how to run my home, funny huh? I wish they would show affection instead of a 15 minute trip in..no offer of fixing a meal, no offer to run for groceries or meds, nothing......I will always find time to give him attention and my love! Even on those hard days when he is not easy to love! lol....Thanks ya'll
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Sloegin, I am quickly approaching the same situation as you except he does qualify for VA. I fully understand how scared you are. We still have a son in college and I worry how am I going to keep everything up. I have money set aside life insurance from my deceased son that is not his child. To think that I would have to use that when it is set aside for my son's child scares me. I am going to go to an elder attorney as others have stated here and get the information now instead of later. You are doing a wonderful job. It never is easy being the sole caregiver no matter if it is a parent, spouse or child. You give and give until you almost drop. Every bite of food you make, every dose of medication you give, every glass of water you pour is showing affection. I honestly believe you are on overload with the step children, and you need some type of alone time for yourself. For that I can't answer, because I have seen step children do so many wrongful things to the one that takes care of their parent. Hugs to you.
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