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In-laws live on SS only FIL could need NH care soon. Medicaid approved. MIL would have to live on her SS which is less than $500/month. She has wet macular degeneration and balance issues so we're a little concerned about her living alone. They help each other. Am I right that FIL's SS would go to the NH since he would be a Medicaid resident? We/they are in Colorado.

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Great question. They do depend on each other. I know it would be hard on them to be apart. They help each other a huge amount. I'm not sure she could live alone, although living with us is an option for her. Thank you.
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What is the possibility or probability that she could go into the NH right now? You know if this is a short inevitable, maybe try to just do this now & get them a shared room. If they are very interdependent on each other, it is going to be heart-breaking for them to adjust to being apart. Maybe speak with admissions at a couple of NH regarding this - a tandem admissions - and both being on Medicaid?
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Thank you! Good advice. Neither spouse has any assets - both are Medicaid approved right now. They barely survive on their combined SS income and our concern has been that MIL would be in trouble if she lost his income. They really have fwq assets so this is a tough situation for them. Thank you.
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Your In laws situation involves your MIL being considered a "community spouse", and how it runs is more complex than that of a widow or widower who moves into a NH and applies for Medicaid. Your MIL is NOT required to impoverish herself for hubby to qualify for Medicaid. Only FIL needs to be Medicaid eligible.

Most Medicaid NH admits are for an individual and most of what your read or hear about (even from admissions in a NH) is from that perspective - which basically means they have to be impoverished & use their monthly income as their required co-pay or SOC (share of cost) paid to the NH. Not so for CS situations.

CS can get MMNA - monthly maintenance needs assessment (or allowance) or CSRA - community spouse resource allowance; what it's called depends on your state. Just what the max is determined by each state and what expenses the CS has. Like for TX Medicaid, for an individual the max mo. income is about $ 2,100 but for married its about $ 2,900. If mom can show significant financial need, all income can be diverted to her and the NH gets zero or low co-pay of the income. Your MIL is not expected to be a old lady existing on food pantry or doing without medications because his SS has to be paid to the NH. Personally I think successfully doing a Medicaid application that has a CS really needs an experienced elder law attorney to work through this - I'd try to get one who is NAELA. And it's for more than the MMNA……like for married couples you really need for them to do some degree of planning before the application,as for couple all is done as for their finances set on a "snapshot" day. Everything is fixed on that date, so if any money moves need to be be done it has to happen before the snapshot. Like if they have 2 cars, it's not allowed so maybe turn both in to get 1 newer & more dependable car; or pay off a mortgage; or buy funeral policies …all these things can take a bit of time and need to be done before the snapshot day. The CS is allowed to have their own assets too and up to 114K in most states. But it has to be established that the $ is the CS and not at all a part of the spend-down for the NH spouse (they can only have 2K in assets). If there are funds over 114K, then probably the CS can do a SPIA (single premium immediate annuity) for whatever is the overage too. Personally I hate annuities, but if I had a spouse who needed NH placement asap, I would speak with an elder savvy Financial Advisor to do a SPIA to get hubs medicaid eligible asap. Also for married couples, most of the time they are each other's beneficiary for their life insurance policies - bad idea if one is going on Medicaid - because if the CS one dies first then the Medicaid spouse due to the life insurance $, will ineligible for Medicaid. It's things like this that the attorney & an advisor can guide you through or give you options about and all needs to be done before the snapshot day.
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Thank you. That's a helpful term. We'll follow up on that.
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Check with the Medicaid office in Colorado. Normally, FIL would give the entire amount of SS check to NH less a small personal care allowance as his co-pay for Medicaid. BUT There are rules for Spousal Impoverishment (use this term when you ask about it) that will modify how much of their combined social security goes to NH and how much is used to keep MIL at home in the community. The amount is calculated by the Colorado folks that administer Medicaid so they would be able to give you an answer about exact dollar amounts.
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