My husband, 76 years old, about 400lbs, recently admitted to hospital for a serious illness. He won't be mobile. He will need special equipment to be taken care. He will need to go to nursing home after he is released from the hospital. I am 42 and working full time and we have a 15years old son. We have a home, and its title is on both of our names, even though I put down the down payment (half of the house value) with the money I got from my inheritance. My husband is retired and has a good income. I also have a good income that I can get by if I am not in debt. My question is if my husband goes to nursing home, will I have to give up my home and my income? Who do I need to talk about this? It really breaks my heart even thinking about all this, but I need to think about my son's future. I have no family to turn to, it is all me and my son in this world. I feel so between rock and a hard place. I am so happy that my husband is alive, yet there is no way I can take care of him. He never cared about long term care and we are not prepared at all. Please give me some guidance.

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Thank all of you for taking the time to answer my question. I will talk to a certified elderly attorney right away.

I have another question, Do you think divorce and separation of income would help us out with this situation before he goes to a nursing home? We don't have any savings. My husband will be taking his retirement income as long as he is alive then it will cut off, because there is no money left in his pension. We have a home with a mortgage, and one car with a loan. My husband's income $86k, and mine is about $92k. My husband has no life insurance.
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Couple financials when 1 is a CS/ community spouse (that will be you) and the other need LTC, is never ever a DIY. As Barb posted, you need a CELA level of elder law attorney & need to be done ASAP.

Right now, he’s in the hospital, right? Try to have him stay there as long a possible. So it puts off his entry admission into LTC place. See if the discharge planner at the hospital will do this. This buys you time to have atty deal with income & assets & safeguard your & kid’s future.

Any LTC facility will be all “whose gonna pay” as they know he’s likely to stay there till forever & bariatric special needs due to obesity. So they want to ensure payment in some way.
There’s $, right?
This place takes LTC Medicaid, right?
if so, AND hospital just has to discharge him, Personally if it were me & there’s $ in joint saving or checking account, I’d pay whatever minimum deposit the LTC facility needs to have him stay there initially as a private pay resident and do NOT sign a contract as that CELA atty is going to find a way to have him eligible for LTC Medicaid & will shepherd the Medicaid application for hubs. It’ll take likely 3-4 weeks to Review all your financials to come up with a plan. But that’s what a CELA can do. It will cost but it’s not ever a DIY for a CS much less a CS with a teenager. Call abt now to find a CELA and get a list of the items the attys want to see to figure out your options.

if your state allows for SPIAs, I bet that what the CELA guy will do.
Not a Miller Trust for him, but a SPIA for you.
SPIAs are a type of annuity. Personally I hate HATE annuities totally but SPIAs are very special creature perfect for young CS, like you. It’s speciality underwriting.
Why? ok stay with me on this.....
1. LTC Medicaid looks at applicants (hubs) income; CS income not a factor unless it’s really big income. So if you have a way to get more income for yourself, it’s likely of no concern for his Medicaid eligibility.
2. Now Medicaid allows for CS to retain some of her own assets. Tends to be abt $128k but varies by state. Assets not income.
3. for CS, Medicaid has CSRA /MMNA that you can apply for. They are resource allowances. How done, etc. vary by state. But if you can show you need $ to pay your household & dependent child expenses then some of his income gets waived from his required by Medicaid copay to the NH & gets paid to you. Think of CSRA MMNA as old school alimony.

All 3 can factor in for a CS....
Say 250k in savings, hubs $2150 mo income, you make $2k mo, house & kid $3500 a mo all in. You set up your own savings account with 100k in it as CS allowed up to 128k assets. You get your own SPIA with left over 150k, your real young so it could be actuarial sound and pay you very little (let’s say $200 mo) but over 25/30 years. 250k gone.
Now your income is $2,200 (2k job + $200 SPIA), so your $1300 short ea mo. Atty files CSRA to get $1300 from hubs income waived (paid) to you. Your state has a personal needs allowance for NH residents on Medicaid at $75 a mo. that they get to keep in their own bank account or fund acct at the NH. In this scenario, $ that Hubs required by LTC Medicaid copay to the NH would be $775 ($2150 less $1300 less $75).
Yeah, $775.

Stuff like this not ever a DIY. Pretty overwhelming to deal with a spouse needing a NH, much less being decades younger with a teenager plus add in Covid. You need an experienced savvy for CS stuff atty to do this; like CELA level. NOT a DIY ever imho.

Also if you have a mortgage, that’s excellent. It’s a debt that atty can put in your $ needed list to get from hubs income. For a CS, debt in a way is super good as it’s gonna be pulled to be paid as much as possible from his income. Atty going to want to see mortgage, house expenses.

Don’t let NH buffalo you into pulling equity from your home either.

Hubs can get eligible for LTC Medicaid. Let the atty come up with options. Good luck and take time for your son.
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igloo572 Jul 2020
Also do NOT file a Medicaid application for him yet.

This is super important.

why? Well for couples Medicaid does a “snapshot” day. And it’s usually the day application signed off on. That date is what Medicaid fixes ALL your assets and income to. So if you need to move $ to do a SPIA, after Medicaid filed for, it’s beyond problematic. Sit to speak with the CELA attys first. The atty can shepherd all this for you.

? for you? Is 15 yr old getting paid each month his own SSA dependent benefit based on hubs own retirement SS income / award? Not SS disability $ but under age 18 dependent $. If not, why not? SSA pays dependent benefit till they turn 18 or finish senior year in HS. It’s kids income, I don’t think it would be a factor for hubs Medicaid, but it’s something to clearly ask the CELA level elder law atty.
If you have the money, you may want to consult with a lawyer very versed in Medicaid. I am just giving basics here. Each state is different with Medicaid.

You will become the Community Spouse. Your finances will be split. His split will need to be spent down. After the money is gone, you can apply for Medicaid. You will be able to keep your home but you will have to keep it up. You will be allowed one car. Maybe two with a 15 yr old, that would be a question to ask the lawyer. You will not be made impoverished and your son should be considered in all of this. In my state the income cap in approx $2300. If your husbands SS and any pension go over the cap, then this is when a Miller trust comes in. But, that is not considered until you apply for Medicaid.

In your situation, because u still work, I think a lawyer is a good idea. Unlike two people both retired with just SS as income and some savings.
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Here is a good link that I found that explains a lot. Please note that the numbers are from 2018:
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The good news is that Missouri recognizes Miller Trusts. If your husband's income is over the qualification limit for LTC Medicaid, it can go into a Miller trust and the overage reverts to the State when he dies. Your income is not in jeopardy. As Alva says, you need to see an Elder Care attorney right away to make a fair division of assets so that you and your son are not impoverished. This needs to be a CELA certified elder care attorney, not one who does general law with a bit of eldercare on the side.

This is NOT a do it yourself project.
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Long term care insurance very often doesn't work out well for people in any case; don't know if others have experience, on the forum, to say when it worked out well. When it is needed often the fine print proves they will not let you use it unless there is a full time RN. That rarely happens.
So you need now to pay for an hour of time with an Elder Law Attorney in your state to find out. They cannot take your home to pay for his care, but if he requires medicaid funds that can recover them if the house is sold. You need now to understand how to divide things, protect your own assets.
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You need to see an Eldercare attorney.

If you don't have long term care insurance, nursing homes are private pay and cost about 10K per month. No one is going to "take your home" but the bill must be paid if he needs that level of care.

Find out if you are in a state that recognizes " spousal refusal".
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