Part 2… Please please pls do not yourself pay for your dads NH care. Your 62 you have to be mindful of your own long term finances.
If there is a mortgage in your parents name and you are paying it, cause otherwise house would face foreclosure, please realize that means nothing to the mortgage company. They don’t care who pays the monthly note, only that it gets paid. If this is happening, speak with the CELA atty as to possibly structuring your payments as a loan or note or memo of understanding with your parents. It may allow you to be a lienholder on that property& can matter if Medicaid estate recovery happens.
also speak with the atty as to if LTC Medicaid in your state has the expectation that anyone living in the house outside of the community spouse is expected to pay rent. This gets sticky as “rent” is income for the owners and changes the amount of $ in theory the NH spouse has as a copay due to the NH. A Medicaid savvy atty will know how to deal with this.
Again couples when 1 in a NH and the other remaining in the house is way way more complicated. It’s really not a DIY. Plus y’all have the extra that you have a FT job and live in the home with them. Try to make it yiur goal to find a CELA atty this summer and get the NH needing one into a facility by Oct. Get a notebook or two going to have the details on all their old legal, their assets, their debt, their income and the same for you. Good luck.
Please see elder law Atty as they are experts in these cases. Home, I believe will be exempt from Medicaid since you have been caregiver in home. Hugs 🤗 Consult is free
Ok thanks for the addl info…. So it’s 80’s mom & dad & you (62) at the house, which I assume is in your parents name & you work FT. And let’s say it’s dads care that has gotten beyond what you & mom can do as you have your own health issues and mom is herself aging. And right now all 3 incomes needed to keep household afloat. This is it, rite?
Heres my thoughts….. I’m assuming folks both get their own SS$ and you have your own income as you work FT, so why, why?, is $ so tight? - Is there a mortgage or a HELOC & this is what eats up y’all’s pooled incomes? If parents have a mortgage this can actually be used in favor for the nonNH spouse if dad applies for LTC Medicaid, more below.
Or is it dad has extraordinary medical or pharmacy costs? If he goes into a NH and into LTC Medicaid all medications, diapers, etc get covered either by Medicare / Medicaid as health insurance or as a room&board cost paid by LTC Medicaid program.
Or is it everyone worked lower wage jobs or self-employed so their SS is very much on the low side or if still working income varies. (If it’s this it, I so get it, my MIL had SS of like $600 and I’m a freelancer so some months serious $ but others zero).
And you have heard that if dad goes into a Nh that all his money (the Medicaid copay requirement) & all their savings will be used to pay NH, that the house will have to be sold…… statements like these are not actually entirely accurate
Please realize that yes as your parents are married, should he go into a facility and apply for LTC Medicaid, Medicaid will look at all their assets jointly. BUT!!! Medicaid does NOT require for your mom to herself become impoverished; only dad as the applicant has too. For most states that means he has a max of 2K in nonexempt assets and his income under abt $2200. AND mom as she is going to stay living in her home becomes a “community spouse” and can keep joint assets up to a fixed limit (tends to be 128K) and her income (like her SS) is hers alone. Mom will need to open her own bank account for these funds & the timing on this has to be done in tandem with his LTC filing, bc of this it’s not a DIY (more below) AND IMPORTANTLY if mom needs dads income to enable her to continue “living in the community”, she can file for CSRA / MMNA. They are resource allowances that waive some or all of the dads income copay requirement. So if she needs his income to be able to pay mortgage or to pay extraordinary utility costs, etc. then she files to CSRA / MMNA. Imo this is not a DIY but needs an elder law atty & one that has experience in LTC Medicaid applications. It’s important to have documentation on their living costs so that the atty can get the maximum waiver for mom. Say dads SS$ is $ 987.00 but mom needs $800 to cover her living costs above what she herself brings in, then his $800 gets waived over to her, dad still gets his in the NH personal needs allowance (PNA & ranges from $45-125, avg is $60) from his $987 mo income and the NH only gets $ 127copay (987 - 800 - 60).
Couples Medicaid planning is way more complicated. Besides the above items, there’s other stuff, like the need to change beneficiaries if they have each other named for life insurance. Because of all this, personally I would never ever try to do a LTC Medicaid application as a DIY. Find a elder law atty that is CELA and have them shepherd your dad application and also review all their legal, esp POAs, perhaps update if needed.
im going to do another post on what all this may mean for you.
To be clearer, 3 adults live in the home , parents and daughter. All are 62-84. Expenses have been divided 3 ways. The daughter works full time but has health problems. The parents are retired. Without all 3 participants, the bills cant be met, but the care for the sick member has become too much physically . No one wants the NH option but the physical demands have become too great.
And that's why you dont give up your livelihood to take care of someone. Because when you can no longer do said caregiving or whomever you are caring for dies you may very well be left financially devastated and homeless. And the dead don't care because they are dead and the living are left with the fallout. It's a real kick in the teeth from the universe to know we are so insignificant that nothing we do good or bad seems to matter.
Please correct me if I'm wrong because I want to understand your post. You and others are caregivers to a relative in that relative's home. You're unable to continue taking care of him and he's being placed in a facility. This relative financially supports you and the other caregivers. None of you can get by without his income. How many of you are living in the house? Do any of you own part of his house or other property with him? Do any of you work even part-time and bring any money into the household? When your relative is placed, his regular monthly income will have to go to the facility he's placed in. If the home is in the relative's name, it will have to be posted for sale. You will get some time still in the house after he's placed, but not indefinitely.
Please provide more information. Are you saying that this person's income supports you? Or, that you think you will have to subsidize money for the LO's care?
So is it the situation that your elders income - like their Social Security monthly income or other retirement income or their savings - is what is needed and used to keep the entire extended family household afloat?
Honestly this is way more common than families ever admit.
Im going to assume this is what’s happening & I’m going to also guess that you & your family live in the elders home and have in some way been caregivers for him for a significant amount of time. My answer is based on this….. if elders care needs have gotten beyond what you can ever now realistically provide then the usual next step is for the elder to go into a facility, like a NH. If he does this, it’s private pay till he runs out of $ and can be low income / low assets enough to be eligible for LTC Medicaid. Assets are 2 types: exempt which is home in his name with a homestead exemption and a (1) car & non-exempt which means all $, savings, beyond a maximum of $2K; low income tends to be as long as it’s under $2,200 a mo it’s ok. BUT - & this is important- that income is basically almost all required to be paid to NH as a required Medicaid copay. So he will have no-nada-zero $ to pay on anything needed for his exempt asset for his lifetime home (like taxes, insurance, utility bills still in his name as is his house). Whomever living in the house or his family or future heirs will need to pay all property related costs till basically beyond his death. LTC Medicaid cannot require him to sell his home as it’s lifetime exempt but due to the copay if he wants to keep it and his family want to honor his wishes, then house can stay exactly as it is, BUT fam has to, HAS TO, have the $ to deal with all property costs, maintenance, yada yada and do this till beyond his death. Could be 6 mos or 6 years.
If this is your situation, can you do this? Look at past couple of years of property costs & your own living costs, do you entirely on your own from your own wallet or purse have the $$$? And likely have $ for all this for at least 3 years? (average stay in a NH is 2.5 yrs). If you do, then he applies for LTC Medicaid, you stay in the still in his name home and then eventually after he dies and then you deal with whatever Medicaid or their outside contractor does for estate recovery aka MERP or MERS. NOW if you don’t, and you will be homeless, your choices are stark: - you continue to caregive as best you can for him in his home and enlist as many family members as possible to help - he applies for community based Medicaid & hopefully that Medicaid program has caregivers maybe 3-4 times a week for maybe a max of 28 hrs a week. Bathing, vitals, therapy, lite housekeeping, medication management. This too will have future estate recovery issues. - he applies for hospice and MediCARE pays for this & they send out a hospice person 2 maybe 3 times a week for 3/4 hrs & help with bathing, vital signs & medication management. Family will need to be there for all the non hospice & non community rest of the time to oversee his health needs and his security.
Should community or LTC Medicaid be applied for after age 55, both have a required attempt by the State for recovery. There are all sorts of exclusions and exemptions to recovery. Caregiver for 2+ years with documentation is such an exemption. It’s on you to do what’s needed to get exemptions done.
If a decision is made to sell the house, imo do not spend a penny on the house. You will not be able to be easily reimbursed. Realistically imo you’d need to go beyond death & into probate as executor to deal with costs incurred.
Do you mean that you depend on his income to live or you can't afford to pay for his care? As said, you are not responsible for his care, there is Medicaid.
If its you depend on his income, sorry that will be used for his care and you are going to need to find a way to support yourself.
If there is a mortgage in your parents name and you are paying it, cause otherwise house would face foreclosure, please realize that means nothing to the mortgage company. They don’t care who pays the monthly note, only that it gets paid. If this is happening, speak with the CELA atty as to possibly structuring your payments as a loan or note or memo of understanding with your parents. It may allow you to be a lienholder on that property& can matter if Medicaid estate recovery happens.
also speak with the atty as to if LTC Medicaid in your state has the expectation that anyone living in the house outside of the community spouse is expected to pay rent. This gets sticky as “rent” is income for the owners and changes the amount of $ in theory the NH spouse has as a copay due to the NH. A Medicaid savvy atty will know how to deal with this.
Again couples when 1 in a NH and the other remaining in the house is way way more complicated. It’s really not a DIY. Plus y’all have the extra that you have a FT job and live in the home with them. Try to make it yiur goal to find a CELA atty this summer and get the NH needing one into a facility by Oct. Get a notebook or two going to have the details on all their old legal, their assets, their debt, their income and the same for you. Good luck.
Heres my thoughts….. I’m assuming folks both get their own SS$ and you have your own income as you work FT, so why, why?, is $ so tight? - Is there a mortgage or a HELOC & this is what eats up y’all’s pooled incomes? If parents have a mortgage this can actually be used in favor for the nonNH spouse if dad applies for LTC Medicaid, more below.
Or is it dad has extraordinary medical or pharmacy costs? If he goes into a NH and into LTC Medicaid all medications, diapers, etc get covered either by Medicare / Medicaid as health insurance or as a room&board cost paid by LTC Medicaid program.
Or is it everyone worked lower wage jobs or self-employed so their SS is very much on the low side or if still working income varies. (If it’s this it, I so get it, my MIL had SS of like $600 and I’m a freelancer so some months serious $ but others zero).
And you have heard that if dad goes into a Nh that all his money (the Medicaid copay requirement) & all their savings will be used to pay NH, that the house will have to be sold…… statements like these are not actually entirely accurate
Please realize that yes as your parents are married, should he go into a facility and apply for LTC Medicaid, Medicaid will look at all their assets jointly. BUT!!! Medicaid does NOT require for your mom to herself become impoverished; only dad as the applicant has too. For most states that means he has a max of 2K in nonexempt assets and his income under abt $2200.
AND
mom as she is going to stay living in her home becomes a “community spouse” and can keep joint assets up to a fixed limit (tends to be 128K) and her income (like her SS) is hers alone. Mom will need to open her own bank account for these funds & the timing on this has to be done in tandem with his LTC filing, bc of this it’s not a DIY (more below)
AND IMPORTANTLY
if mom needs dads income to enable her to continue “living in the community”, she can file for CSRA / MMNA. They are resource allowances that waive some or all of the dads income copay requirement. So if she needs his income to be able to pay mortgage or to pay extraordinary utility costs, etc. then she files to CSRA / MMNA. Imo this is not a DIY but needs an elder law atty & one that has experience in LTC Medicaid applications. It’s important to have documentation on their living costs so that the atty can get the maximum waiver for mom. Say dads SS$ is $ 987.00 but mom needs $800 to cover her living costs above what she herself brings in, then his $800 gets waived over to her, dad still gets his in the NH personal needs allowance (PNA & ranges from $45-125, avg is $60) from his $987 mo income and the NH only gets $ 127copay (987 - 800 - 60).
Couples Medicaid planning is way more complicated. Besides the above items, there’s other stuff, like the need to change beneficiaries if they have each other named for life insurance. Because of all this, personally I would never ever try to do a LTC Medicaid application as a DIY. Find a elder law atty that is CELA and have them shepherd your dad application and also review all their legal, esp POAs, perhaps update if needed.
im going to do another post on what all this may mean for you.
The community spouse will retain his or her own assets and enough of the joint income to be able to live at home.
Without all 3 participants, the bills cant be met, but the care for the sick member has become too much physically . No one wants the NH option but the physical demands have become too great.
If we [place our relative in a nursing home and we pay for the nursing home] then we will not have funds to sustain ourselves.
You and others are caregivers to a relative in that relative's home. You're unable to continue taking care of him and he's being placed in a facility.
This relative financially supports you and the other caregivers. None of you can get by without his income.
How many of you are living in the house?
Do any of you own part of his house or other property with him?
Do any of you work even part-time and bring any money into the household?
When your relative is placed, his regular monthly income will have to go to the facility he's placed in. If the home is in the relative's name, it will have to be posted for sale. You will get some time still in the house after he's placed, but not indefinitely.
Honestly this is way more common than families ever admit.
Im going to assume this is what’s happening & I’m going to also guess that you & your family live in the elders home and have in some way been caregivers for him for a significant amount of time.
My answer is based on this….. if elders care needs have gotten beyond what you can ever now realistically provide then the usual next step is for the elder to go into a facility, like a NH. If he does this, it’s private pay till he runs out of $ and can be low income / low assets enough to be eligible for LTC Medicaid. Assets are 2 types: exempt which is home in his name with a homestead exemption and a (1) car & non-exempt which means all $, savings, beyond a maximum of $2K; low income tends to be as long as it’s under $2,200 a mo it’s ok. BUT - & this is important- that income is basically almost all required to be paid to NH as a required Medicaid copay. So he will have no-nada-zero $ to pay on anything needed for his exempt asset for his lifetime home (like taxes, insurance, utility bills still in his name as is his house). Whomever living in the house or his family or future heirs will need to pay all property related costs till basically beyond his death. LTC Medicaid cannot require him to sell his home as it’s lifetime exempt but due to the copay if he wants to keep it and his family want to honor his wishes, then house can stay exactly as it is, BUT fam has to, HAS TO, have the $ to deal with all property costs, maintenance, yada yada and do this till beyond his death. Could be 6 mos or 6 years.
If this is your situation, can you do this? Look at past couple of years of property costs & your own living costs, do you entirely on your own from your own wallet or purse have the $$$? And likely have $ for all this for at least 3 years? (average stay in a NH is 2.5 yrs). If you do, then he applies for LTC Medicaid, you stay in the still in his name home and then eventually after he dies and then you deal with whatever Medicaid or their outside contractor does for estate recovery aka MERP or MERS.
NOW
if you don’t, and you will be homeless, your choices are stark:
- you continue to caregive as best you can for him in his home and enlist as many family members as possible to help
- he applies for community based Medicaid & hopefully that Medicaid program has caregivers maybe 3-4 times a week for maybe a max of 28 hrs a week. Bathing, vitals, therapy, lite housekeeping, medication management. This too will have future estate recovery issues.
- he applies for hospice and MediCARE pays for this & they send out a hospice person 2 maybe 3 times a week for 3/4 hrs & help with bathing, vital signs & medication management.
Family will need to be there for all the non hospice & non community rest of the time to oversee his health needs and his security.
Should community or LTC Medicaid be applied for after age 55, both have a required attempt by the State for recovery. There are all sorts of exclusions and exemptions to recovery. Caregiver for 2+ years with documentation is such an exemption. It’s on you to do what’s needed to get exemptions done.
If a decision is made to sell the house, imo do not spend a penny on the house. You will not be able to be easily reimbursed. Realistically imo you’d need to go beyond death & into probate as executor to deal with costs incurred.
If its you depend on his income, sorry that will be used for his care and you are going to need to find a way to support yourself.