Must my 401K be used IF I marry and my spouse needs it for medical bills or nursing home not covered by his insurance?

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Medicaid also does not care if there is a prenup agreement. That is part of the issue here. L and Mom married 8 years ago, put a prenup inplace to protect their own assets, to preserve them for their own families. Nice thought. But L arrives on the scene. Mom's finances are in a shambles because POA sis is not keeping books as she is supposed to do as POA and trustee. His way to fix it, instead of getting sis to take care of things, is to start paying everything for her. It has drained his resources to 25% of what Mom's are. So, low and behold because my mom paid nothing for the first 5 or 6 years he was her her account grew quite well, while his became lower and lower. So now if he runs out of money Mom will have to pay for his care if he needs a facility. Wish they would have thought about just living together, and they actually did for about a year until they decided to marry.

Though Mom's social security check will rise, if he lives another two years, by about 500 dollars a month. So there are benefits either way. Who the heck knows what this 78 year old man and 80 year old woman were thinking!
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There is a little known law about medical bills that a nurse friend told me about. At least in our state, as long as you pay them $25.00 a month they cannot send you for collections or refuse you treatment.
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txcamper, in my experience, no. What's his is ours and what's mine is ours. Medicaid doesn't care if they are in separate accounts under separate names. All assets of either of you belong to both of you.

Sorry.

Perhaps consulting an elder law attorney before marriage would reveal a way to preserve assets for the non-medicaid spouse beyond the limit set by Medicaid.
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What if you don't co-mingle your money? You know, what's mine is mine and what's yours is yours. Wouldn't that keep her money safe?
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If it becomes necessary to apply for Medicaid, all of your assets and his assets will be considered and together they cannot exceed the allowed limit. You might have to spend down some or all of your 401K to get under the limit. (At least this was true in my state, 10+ years ago.)

I am really sorry to say this (I really do believe in "family values") but if you and your potential spouse are older and there is high medical risk, you might want to think through whether you both would be better off as a legally married couple, or simply totally committed to each other.
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The short answer is that your 401(k) is exempt from claims of creditors so it can't be claimed as payment for your husband's medical bills or your own. The longer answer is that creditors, including medical creditors, can take any assets that are not exempt, so you may find it necessary to tap into the 401(k) to prevent creditors from seizing other assets, like your property, bank account, or car. Whether creditors can seize your assets to pay your husband's bills depends on the laws of the state in which you live. I'm not an expert in debtor-creditor law, except for qualified retirement plans in which I have some expertise.
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