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I know assisted living is not covered by Medicaid or Medicare. Here is the scenario: two married elderly people still live in their house. They get Medicare, and social security and pension money. The husband falls ill, unable to walk, incontinent, has dementia, and the wife can't care for him by herself. They make too much to qualify for Medicaid so he can go into a nursing home, but is this true? Are there ways around it? Just asking, looking ahead for someone, who is worried. (will consult an elder care lawyer eventually, just want some idea what to expect, what to ASK.) Please direct me to the proper pages pertaining to this, on this site? Thank you.

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She'd better act quick. If something drastic does happen, then medical costs and the nursing home will obliterate the assets. It's getting more and more difficult now that the government is trying to reign in taxpayer costs in any possible way that they can.
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There's one child, but she has problems, not married, is just scraping by.  Not too reliable.... I told her ages ago, sell that damm house and both of you go into senior housing or AL if needed. No, she is hanging onto the house, which is falling apart, and the yard (omg, you can't even walk back there, it's reverted to the wild). I think she wants to give it to their child (yeah, as if she wants it!) or is planning to sell it for some stupid inflated figure. It needs extensive work and is in an older neighborhood just down the road from several developments full of McMansions!....I will tell her to see an attorney, but  (I should clarify), I think he has early dementia, he is not incompetent - yet! and has always been a bully.   She is a doormat, one of those helpless types who sit, weep, wring their hands, and say 'oh, my husband always took care of that!'  She is trying very hard to take care of him herself.  Really I'm worried. They make 'too much' for Medicaid, and a nursing home.  The day will come when he will HAVE  to go to a nursing home. .... I will urge her to go to a lawyer, I will go with her if possible....what a sorry plight.
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Wizer if income higher than Medicaid limits that when Miller Trust comes into use. Folks do Miller all the time but it needs an atty imo. Now Ohio has a diy Miller program for those in NH but it seems to be feasible only for individual Medicaid (widow widower); community spouse really calls for NAELA atty to figure out options for couples.

Lassie - omg wife is 70! She could live another 15 years....or more..... They need to get with elder law atty to figure out how to do community spouse planning ahead of the inevitable fall.

If he falls, EMS called, hospitalization happens & she doesn't take him home, then social services at hospital will find placement for him in a facility. But although this sounds fab as now he's not her problem, it cascades into problems for her...... they have assets, there are funds to pay for care, bills for his care will be stacking up cause Medicare & secondary insurers only pay so much. If she ignores the situation, facilities will issue "30 day Notice" & then contact APS or state to get an emergency ward of the state action done. & he will be made a ward with a court appointed guardian or conservator. They can start attaching assets as she's looked to have relinquished rights.
Their not your parents right? So are there kids and where are they in all this?
Will she go & meet with an atty? Or is this in inevitable trainwreck?
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So what is she to do when he falls down multiple times a day in the house? Or gets belligerent or walks out the door? She doesn't have enough to hire an aid for more than a few hours a week and CAN'T TAKE CARE OF HIM HERSELF 24/7, or till one of them dies.  When he has to go into a nursing home, will they just deny him?   If he falls and goes to the emergency room, and she refuses to take him back, what will they do?  Argue with her?  Dump him off on her front step?  She doesn't care about spending money, she needs enough to live on, she has no addictions or spending sprees or anything, poor woman.
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If the income is higher than government limits, you can expect them to deny eligibility. This is especially true now that politicians in Washington are trying to reign in costs.
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I would never suggest anyone go it on their own without a good lawyer. I am just so terrified this poor 80 pound 70 year old woman is going to be stuck in the house with her 200 pound demented incontinent not-ambulating husband till one of them dies.  I am going to strongly suggest a trip to an elder care lawyer before it's too late.  She is starting to decline somewhat herself, so the sooner the better, huh?
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Probably a combo of Miller Trust aka Qualfied Income Trust AND community spouse asset planning. Neither are DIY. I'd suggest a NAELA elder law atty to do this. Don't wait till 1 of them is needing a facility......

Basically what Miller does is it become the payee for monthly income and then Miller pays the individual whatever is your states monthly income limit with the rest staying in miller but reverting to the state in some way. There's a lot of prior answers on Miller on this site you can read. The "in some way" will depend on just how your state needs for this to happen as per state laws & how your state runs its Medicaid programs and how much CSRA / MMNA the CS is able to retain.

CSRA MMNA would be monthly income diverted from NH spouse (instead of all of monthly income going toNH as their required by Medicaid copay or SOC/share of cost) to CS to enable them to stay & pay for living in the community. Think of it kinda like alimony for the Medicaid NH set.

Really couples planning is complex. Get NAELA elder law atty.
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