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nmanukyan Asked July 2018

I cannot care for my husband anymore due to health problems, if I put him in a nursing home, will I keep his income?

My husband is completely paralyzed and I cannot care for him anymore because I have hernias and need surgery on my knee. I cannot lift him or move him when he needs me to. He has memory loss and has an addiction to pills. I cannot take care of him any longer but he makes ends meet at my home since I left my job to take care of him. If I place him in a nursing home, will I be able to keep his income?

EXPERT John L. Roberts Jul 2018
If the nursing home resident is married to a spouse who lives at home or in assisted living, income from the nursing home spouse can be kept by the "healthy spouse" who is living in the community.

The healthy spouse is allowed to keep an amount of the nursing home resident spouse income (with no questions asked by Medicaid) called the Minimum Monthly Maintenance Needs Allowance ("Minimum MMNA").

Every year, on July 1st, the MMNA is increased. The Minimum Monthly Maintenance Needs Allowance (Minimum MMNA) for July 1, 2018 through June 30, 2019 will be $2,057.00 for all states, except Alaska and Hawaii. The "Spousal Impoverishment figures" are posted here:

https://www.medicaid.gov/medicaid/eligibility/downloads/spousal-impoverishment/ssi-and-spousal-impoverishment-standards.pdf

The Standard Shelter Expense is the amount included in the Minimum MMNA for your rent, or mortgage payment, property taxes and insurance, and/or condo maintenance. If the spouse’s housing expenses are over 30% of the MMMNA, (30% of $2,057 = $617.25), the additional need is referred to as the Excess Shelter Allowance, and it is credited to the community spouse as an additional income allowance.

The Maximum Monthly Maintenance Needs Allowance (Maximum MMNA) as of July 1, 2018 is $3,090.

If you need more to cover your home upkeep expenses or Assisted Living, Federal Medicaid Law [Section 1396a(a)(3)] gives you the right to a fair hearing. Federal Regulations [42 CFR 431.230] require that Medicaid payment for services be continued during the time an application is waiting for a fair hearing, and the state must make corrective payments if the applicant wins the fair hearing.

The other people who posted the advice to call a Certified Elder Law Attorney in your state are right. The CELA can listen to the specific facts of your situation, and explain how much income you can keep to stay safely at home.

Ahmijoy Jul 2018
I was told, at least in my state of Ohio, that if you apply for Medicaid Nursing Home Care, you are considered the Community Spouse. You will be allowed to keep what they decide you need to stay in your home. A Medicaid Advisor told me last week, “We won’t impoverish you.” Call your own local Medicaid office and see what they say. The advisor I spoke with was very nice and helpful.

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gladimhere Jul 2018
You need to consult with an elder law attorney. Rules differ by state.

jjariz Jul 2018
Call a Certified Elder Law Attorney. You may be able to keep up to half of his income

AlfredR Jul 2018
You should apply for Medicaid for your husband.  However, Medicaid eligibility is based on both assets and income limits.  If his income is above the allowable limits, depending on your state of residence, you can set up a Qualified Income Trust (also called a Miller Trust).  Your husband's income is deposited into this trust, and you are allotted a monthly allowance.  If there is anything left after your allowance, and a small stipend to your husband, the balance goes to the Nursing Home.

However, a greater difficulty may exist if his assets exceed the Medicaid limit (which may be as low as $2,000).  If that is the case, then he would be considered ineligible until his assets are spent down to below the $2,000 limit.  The Nursing Home could be paid for privately to spend down his assets in anticipation of switching over the Medicaid at some point.

As others have suggested, you should discuss this further with an attorney specializing in Elder Care law.

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