My 90 year old aunt lives at home and her son is her full time caregiver. Her husband died a year ago, so if she requires long term care, her husband is not alive to reap the benefits of spending down their money. How does she spend down her assets to qualify for Medicaid? We filed for Medicaid for him as he required long term care in a nursing home for the last 5 mos of his life. My aunt benefited from the spend down of their assets, as that was the rule. How does the spend down work when a spouse is not at home to have the money spent on their needs? Can her credit card bill be payed off?

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Admit her Now and spend down for by using nursing home care, self pay.
Helpful Answer (10)
Reply to gladimhere

Is she going to move into assisted living or a nursing home? Or is she staying in her home and needing services to come in? First you will want to make an appt with an elder lawyer to discuss what assets she has, the laws of your state and legal ways of spend down.

Several ideas:

*Pre-pay for her funeral
*Maybe her bathroom needs remodeled to accommodate wheelchair or walker access
*Does she need a lift chair
*Does she need a tub that she can walk into
*Does she need clothing that is easy to get on and off
Helpful Answer (9)
Reply to Jamesj

Moving her now as a "private pay" resident will spend down her assets.
Spending down assets has to be for her care, for her benefit in some way.
So the Skilled Nursing facility that you choose make sure they also take Medicaid some do some do not. She will get the quality care that she deserves and when assets run out she can remain in the same facility, same staff. (if she is in a private room she may have to move to a shared room so you might want to think about starting her in a shared room, advantage money will last longer anyway)
Pre plan and pay for her funeral.
But the others are right talking to someone qualified to answer the Medicaid question you have is the first thing to do. Either Medicaid or an Elder Care Attorney or both
Helpful Answer (7)
Reply to Grandma1954

Each state runs its own Medicaid program uniquely. Because we aren't "professionals" here, and this is a global forum, you may not get accurate advice. You can find a Medicaid Planner (a private professional, not a govt agent) who can answer your questions.


...most states have a 5-year financial "look back" period on the application (some states are 2.5 years).

...most states' Medicaid programs will only cover LTC (but not all states).

...Medicaid will scrutinize financial/asset "gifting" during the "look back" period, the amount and definiition of which can vary by state.

...your Aunt's assets should be spent on herself, her needs, health and well-being. Even consider that she can probably go into AL on private pay in a very nice facility that accepts Medicaid and stay there until she nears the end of her funds. At that time she can apply for Medicaid.

This may or may not apply to her state, and so she should contact a knowledgable professional who can review *all* her financial information and give the correct guidance.
Helpful Answer (6)
Reply to Geaton777

It sounds as though you really want someone in the family ‘to reap the benefits of spending down the money’. Not a likely option, and not fair to the taxpayer.
Helpful Answer (6)
Reply to MargaretMcKen

I am going to make a comment..I have seen several comments that imply that Jmhunt90 is asking this so that money/assets can be saved and other family members get the benefit of the assets.
I do not see anything in Jmhunt90's question that indicates this.
The mention of spending down and the aunt was the "recipient" of the spend down.
If there is no spouse to get the advantage of items that were purchased and the person needs little else what can the assets be spent on is the question I am seeing.
Now I am one to see a "hidden agenda" in some of these questions but this one I am not seeing a "how can we hide as much money as we can so that the family can get as much as possible when old aunt Betty dies"
In any case my answer is the same.
Pay for the best care that is possible for as long as possible before there needs to be an application for Medicaid. Wouldn't you want someone to do that for you?.
Helpful Answer (5)
Reply to Grandma1954

Pre-pay funeral and burial expenses. Trust me, you will want to pre-pay that stuff.
Helpful Answer (5)
Reply to DeckApe

Plan the right way: Get a consultation with a qualified elder care attorney without delay.
Helpful Answer (4)
Reply to NYCmama
ConnieCaretaker Nov 1, 2022
Yes and ask if it's true that the Elder Law Attorney fees can be used in the big spend down? If so, that's great news.
Put in the nursing home and pay for her care. When she is close to running out of money, apply for Medicaid.
Helpful Answer (4)
Reply to Becky04469

In my opinion it is fraudulent and places the burden on us the tax payers. I have seen this done twice and ended friendships over it.
Helpful Answer (3)
Reply to Bobtheflyfisher
robert152 Nov 1, 2022
Do you have a lot of friends Bob?
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