Thank you !! It is overwhelming but I think I understand. We changed beneficiaries for policies when my husband was diagnosed w Alzheimer's and redid our wills etc . Also now have a Life Estate on our condo w our daughter's name on the deed. My concern is that I did give our son a pretty large amt of $ over a 2 year period to help him w medical bills when he hurt his back. Hoping my husband doesn't ever have to go into a NH but reality may sink in as that is a possibility. I worry about the 5 year lookback for me as the spouse. I also helped my husband pay some large bills for his business before he retired .( Of course I had no idea that he still has this large credit card debt. - til recently). Best case scenario: he won't need a NH for a few more years and then that lookback period from me giving $ to son and his business will be over with Thanks again for your help. One of the first things we learned in Alz Support group: get financial things in order to protect them and get Elder Atty. Thank goodness we did that.
Also - before I forget - for CS/NH situations, the states seem to do a "snapshot" day in which the couples finances are fixed on for determining spend-down needed for compliance. So if you need to do something big - like pay off a mortgage, or get repairs done, or turn in 2 cars to buy a single newer & more dependable car, or get a fully paid pre-need for both of you - the funds to do these things need to get paid and through your bank before the Medicaid application. SOme of these things can take a bit of time. Mortgage pay off could take weeks as mortgage co and served providers move glacially ……..so think about if there is stuff that would be of a benefit to you to be paid off and not have to worry about and get this done before ever doing the Medicaid application.
Speech - Medicaid for couples is pretty complex as only hubs will need to make himself "impoverished" to qualify for Medicaid and you as the "community spouse" do not have to become poor. Medicaid expects you to retain assets to enable you to continuer to live in the community. But just how those assets get evaluated is totally sticky. Since you have an elder law atty, I would think and hope that they are getting on all this for you and they understand the community spouse nuances in the mice maze that is Medicaid.
Couple of items for you to Google and then ask about are: - CSRA / MMNA community spouse resource allowance or monthly maintenance needs allowance. I think of these as kinda like alimony for the non-NH spouse. Remember than under Medicaid the resident is supposed to do a co-pay or SOC (share of cost) of all their monthly income to the NH less a small personal needs allowance. PNA varies by state from $ 35 - 105 a mo and really just maybe covers beauty salon / barber shop and some toiletries replacement. BUT for CS, you can get some of his income that would otherwise need to be his SOC to instead go to you to enable you to maintain your standard of living. The whole CRSA varies by state and really you need to try to get the max. The atty should be looking into all this for you. Like CRSA / MMNA for TX is right under $ 2,900 a mo (which is higher than most states) and so say hubs got an monthly income of $ 3,100 a mo and then you qualify to get the max CRSA of $ 2,900….then hubs required co-pay or SOC would be only $ 200.00 a month. Comprende?
Now as a CS there is a limit to the assets you can have. For most states its around $ 117K. So again you want to retain the max within this. Now say you all actually have 300K in savings. well you could spend down the 183 difference by private paying for the NH or getting fully prepaid funeral and burial and paying off the mortgage to work the 183K down. But what could possibly be done is for you to get a SPIA (single premium immediate annuity) for you for the whole 183K. If you are a younger and healthier spouse this is totally (imho as a non financial person) a good plan to get funds for your future and work around Medicaid compliance on assets. Personally I hate annuitites as they most often are sold to the elderly who don't understand what they are buying & they have a huge penalty to get out of when they find they flat need the $ to pay for a NH. but for a youngish CS doing a SPIA is likely a winner. Your FA would need to shop around to find them as they have to be Medicaid compliant in structure and that is not easy. But your elder law guy should know about these.
Also if you all are like most couples, you have each other as beneficiary for life insurance. Bad idea once Medicaid is involved cause say you predecease hubs and then all that life insurance $ gets paid to him so he's now over Medicaid assets & income requirements and you are gone so just who is gonna deal with this for him. Often couples name their kids or grandkids as it gets around this issue. Again the atty should know about this and go over these sorts of things with you. It just not simple and loads to deal with.
Yup. That was me. It is being handled by our Elder Atty. He said not to pay any more minimum payments bc my husband is "uncollectible ". I asked what happens when the phone calls and letters start coming to our house about non payment. He said send them to him. So I will do that. I know I have to pay him but at least he is willing to help. Alzheimer's is frustrating enough. This huge credit card debt and deceit ( my husband hid the mail from me by having the bills go to his friend) makes things even more tense. His memory isn't too bad luckily. But his behaviors and depression, anger etc are making this illness extremely challenging. I have my own health issues. I know I am not alone. Many or most of us are dealing w our own health too. Best of luck to all of the caregivers/ care partners out there. So glad I found this site. It is like counseling for me. Thanks to all.
That's a question that should be put to an eldercare attorney. I know that there is provision made for thr "community spouse"--the one who isn't in the nursing home.
Bumping this up so someone with some expert knowledge may have an answer for you.
You should also read the website for your State's Medicaid program.
Thanks again for your help. One of the first things we learned in Alz Support group: get financial things in order to protect them and get Elder Atty. Thank goodness we did that.
Couple of items for you to Google and then ask about are:
- CSRA / MMNA community spouse resource allowance or monthly maintenance needs allowance. I think of these as kinda like alimony for the non-NH spouse. Remember than under Medicaid the resident is supposed to do a co-pay or SOC (share of cost) of all their monthly income to the NH less a small personal needs allowance. PNA varies by state from $ 35 - 105 a mo and really just maybe covers beauty salon / barber shop and some toiletries replacement. BUT for CS, you can get some of his income that would otherwise need to be his SOC to instead go to you to enable you to maintain your standard of living. The whole CRSA varies by state and really you need to try to get the max. The atty should be looking into all this for you. Like CRSA / MMNA for TX is right under $ 2,900 a mo (which is higher than most states) and so say hubs got an monthly income of $ 3,100 a mo and then you qualify to get the max CRSA of $ 2,900….then hubs required co-pay or SOC would be only $ 200.00 a month. Comprende?
Now as a CS there is a limit to the assets you can have. For most states its around $ 117K. So again you want to retain the max within this. Now say you all actually have 300K in savings. well you could spend down the 183 difference by private paying for the NH or getting fully prepaid funeral and burial and paying off the mortgage to work the 183K down. But what could possibly be done is for you to get a SPIA (single premium immediate annuity) for you for the whole 183K. If you are a younger and healthier spouse this is totally (imho as a non financial person) a good plan to get funds for your future and work around Medicaid compliance on assets. Personally I hate annuitites as they most often are sold to the elderly who don't understand what they are buying & they have a huge penalty to get out of when they find they flat need the $ to pay for a NH. but for a youngish CS doing a SPIA is likely a winner. Your FA would need to shop around to find them as they have to be Medicaid compliant in structure and that is not easy. But your elder law guy should know about these.
Also if you all are like most couples, you have each other as beneficiary for life insurance. Bad idea once Medicaid is involved cause say you predecease hubs and then all that life insurance $ gets paid to him so he's now over Medicaid assets & income requirements and you are gone so just who is gonna deal with this for him. Often couples name their kids or grandkids as it gets around this issue. Again the atty should know about this and go over these sorts of things with you. It just not simple and loads to deal with.
Bumping this up so someone with some expert knowledge may have an answer for you.
You should also read the website for your State's Medicaid program.