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gizmoe, do heed igloo572's cautions as there really are "lots of smoke and mirrors" with selling annuities in addition to the potential complexities of Medicaid and VA benefit rules. One correction to the example in igloo572's good explanation is that at age 82, according to SS's Actuarial Life Table, male life expectancy is 7.27 more years and for females its 8.58 years and those are the respective maximum payout durations to be Medicaid compliant at exactly age 82. I suspect the VA also uses SS's actuarial life table, but I don't know for certain. Here's the link to the life expectancy table: www.ssa.gov/oact/STATS/table4c6.html /table4c6.html
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Be very VERY careful as there lots of smoke & mirrors on annuities imo.

Medicaid “qualified” is NOT, again NOT, the same as Medicaid “compliant”.

Annuities can be sold basically by anyone holding an insurance license. They are an insurance product - usually a packaged product - and almost always have a commission structured to be paid to the insurance agent for the life of the annuity. They have very strict terms as to any changes or withdrawals to the annuity with penalty placed outside of those terms.

The “qualified” usually gets interpreted as the $ in the annuity is guaranteed and the amount paid to you each mo counts therefore as reliable income, it’s qualified income. (so its guaranteed income should you need to do say a Miller Trust). But as Bicycler said it’s income that gets counted into your overall income. But if all your “income” and “assets” take you over the allowed limit for VA or for Medicaid you will not be eligible as you are not “at need”. It’s also “qualified” as it’s not considered gifting but the purchase of an investment asset that produces income.

True Medicaid compliant annuities have just a few underwriters - they are speciality underwriting- and most of these are written on SPIA’s (Single Premium Immediate Annuities) for the still living in the community spouse (usually younger) to get her assets over the 119k asset ceiling into the SPIA to become monthly income to her as her income does NOT count to get her husband eligible for Medicaid. Only hubs has to be impoverished, not the community spouse.

Regarding “compliance”, to me by far the biggest issue for annuity be Medicaid compliant is that the annuity must be actuarial sound. They must pay out & pay off within established actuarial/ death tables for your demographic. Death tables for the US are decreasing. Average life expectancy is US is 78.4 (81 women, 76 men). So if you sold your 200k home at age 82 and placed all into an annuity, it would not be compliant for Medicaid as it’s not actuarial. Also to compliant for Medicaid, it must be irrevocable and must have the state named as the primary beneficiary up to the amount paid by Medicaid on your behalf. Only if there’s $ left after Medicaid as first beneficiary is paid will any excess be paid to your heirs as listed as secondaries in the annuity. 

Out of curiosity, were these annuities promoted at some sort of luncheon or dinner elder advisory seminars?  
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gizmoe, converting an asset into an income stream will, by definition, increase total income that the VA uses to determine benefit eligibility and amounts. Beyond that, it's hard to say how an annuity will affect you without knowing your total income and total medical-related expenses. And every state has its own specific Medicaid rules, including how annuities are treated, which may or may not comply with VA rules. I suggest you consult with an elder-law attorney and/or a state veterans affairs representative before selling your house.
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