My parents are both living, but we need to get my mom on the Elderly Waiver to assist in getting nursing services in her home. She has been diagnosed with Alzheimer's. She qualifies financially as long as we don't include my dad on the Medicaid application, but the application wants to include everyone living in the house. How do we separate her assets so she will qualify. She is doing an Absolute Assignment to the funeral home for her life insurance and taking her off the savings account. Thanks for your help.

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Medicaid will look at the couple's overall finances and is required to do so. Their assets and income are viewed jointly. But all is not lost......

Your dad would be considered the "community spouse" an as such he will be allowed to keep assets & income beyond the limited at-need level required by your mom to qualify for Medicaid. (in general the Medicaid recipient is allowed 2K in non-exempt "assets" and 2K in "income" There is a whole formula - the CSRA or community spouse resource allowance - that is used to determine the amount. Most states have CS assets at about 110K but each state can vary the exact amount and what can be include or more importantly excluded. Medicaid is a joint federal and state program but adminisered by the states so each states law makes a big difference. Some states allow for 401K to be retained and others not so. Really to do it right take CHeryl166 advise & get an attorney to work with you all.

Also for CS situation whatever you do financially needs to be done and completed before the date of the Medicaid application. This is mucho importante as for couples there is a set "SNAPSHOT" date in which all their assets and income is set or fixed as far as co-pay & acceptance in Medicaid. So if they need to pay off stuff (like if there is still a mortgage) or deal with cars, or investments, or get significant repairs to the house (like dad is going to stay living in the house so you want to get all you can done - new AC, roof repairs, prepay whatever - and pay for it to reduce their overall assets) etc....all that needs to go through the bank and be processed in advance of the snapshot day.

If there is a mortgage, that can take time to clear, so this could mean mom will need to be at home a few more weeks before she can go to the NH on Medicaid.

For couples, the car(s) can be an issue and easily solved. Medicaid allows for 1 car, most couples have two. If you give or gift the car to a grandkid, that would spark a transfer penalty for Medicaid. Medicaid will find out as auto ownership is done by local assessor and then dovetails into the state system - it will show up eventually. What is often good for couples is to trade in both cars and then getting 1 new or newer and more dependable car for the CS to drive. You do need to see if your state has a limit on the cars value (most states done't). Also should you need to you can use some of their extra assets to buy the car in full and that is totally legit expense in spend-down.

For couples, really family needs to have a reality check on what is likely for the CS. If the CS is a much younger & healthy spouse (who maybe is wife #2 or #3), then the concerns are different than if the CS if the same age and if likely to need to go into a facility in the near future also. Understand? Good luck and keep a sense of humor in all this. Medicaid can be a maddening maze.
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You need to talk to an Attorney experienced in Elder Law and/or a Financial Advisor who is experienced in Medicaid work. You may find a referral at your Senior Center or even from a Caregiving Agency. Tread carefully with Financial Advisors that you know they are on the up and up. Separating assets is complicated but can be done.
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