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My wife has dementia and needs care. The Medicaid income limit of $1,750/month here in PA is based on both our incomes or only hers? The Medicaid financial asset limit of about $2,000 here in PA is based on total family assets or only her half of family assets (joint savings, house, etc.)?

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AgingCare.com members have posted some great answers to this question. The best advice to start with is from OldBob1936, who recommends that you first understand the difference between 1) income and 2) countable assets.

1) Income is the amount of money that comes in every month. If your wife needs Medicaid, you keep all of your income + plus you also keep her income if the total income amount is below the "Minimum Monthly Maintenance Needs Allowance." But you may be able to keep more than that monthly amount, if you can prove you need it to pay your living expenses. As "gladimhere" explained, the Medicaid regulations are intended to help you "stay in your home and pay for what you need."

2) Countable assets are what the regulations allow you to keep with no questions asked. Your state has a baseline figure for countable assets. But even if you own more than that figure, the amount of countable assets can always be adjusted by arranging them properly, so they comply with your state's Medicaid regulations.

Some of the other people who posted here mentioned some asset ideas that might, or might not, apply to your situation. You won't know until you talk with an elder law attorney in your state who can look at your income and assets, and explain how they fit in to the Medicaid regulations.

Read more about Minimum Monthly Maintenance Needs Allowance:
https://www.medicaid.gov/medicaid-chip-program-information/by-topics/eligibility/downloads/2016-ssi-and-spousal-impoverishment-standards.pdf
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I just went through this. They took both of our incomes including SSI and Pensions, plus assets, whole life insurance, annuities, any savings accounts, like your retirement. They add it all together and give you some to keep (I think it was 35,000 for me to keep. Then you split everything else in half. You definitely need a medicaid specialist to help you. Most nursing homes have them there to help you without any charge. I also had to see a lawyer so I knew what I could spend for the "spend down". I had my house all fixed up with the spend down money. Anything you spend on your house is legal.........like a new roof, a new floor, fixing the basement, remodeling anything in the house. Then when you are out of money you go on Medicaid. They give you an allowance. It isn't much but so far I have been getting by. I now have about $2000 a month for myself. But I have my house, and my car. I had to borrow against Bill's whole life insurance to pay for the home, and expenses. But I still have some of it and I can still get that back upon his death. So I have to pay off the interest on the loan in order to do that. It was very complicated and very stressful but the medicaid specialist at the Veteran's Home walked me through it. You need to present receipts for almost everything. That is the hardest part. I hope this has been a little help. I applied in Dec, got approved on May 1, and recently got about two free months at the home as a reimbursement. It was retroactive to the date you apply for it. That is why I got the reimbursement. Bill will be in the home a year in Sept. He is happy and smiling when I go to visit, so I am happy too. His Alzheimer's was just too much after 11 years of home care. Good luck. I didn't think I could do it, but I did!
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There is a difference between income and countable assets.
The one applying for Medicaid is limited to so and so much income from Social Security, pensions and so on....The spouse who is still at home, so to speak, has no limit on income.

Assets are totally another horse of another color. It's complicated...See a WELL RECOMMENDED elder attorney. (There are plenty who don't measure up.) If you hold joint accounts that provide you both with income (such as dividends or interest, etc.) get them out of the name of the person applying for Medicaid so that at least that part of her income is stopped. You will still have to count the assets as countable. You cannot "hide" assets. however, from needing to be spent down to a certain level by isolating them into one name..It is complicated as I said..I only scratched the surface, and hardly that.

Grace + Peace,
Bob
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I highly suggest you see an ElderCare Attorney
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Get an Elder Care Attorney!! They will help you through the process. Also, if you contact your local Office Of The Aging, they have people there who know all the answers to everything you're asking. Also, the facility has someone there who does the Medicaid process and that person will apply for the Medicaid. They will tell you what documents you have to supply them with. But make sure you get an Elder Care Attorney, too!!
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Warren, how did the meeting go today?

Medicaid is a State Program. Different regs for different states. Also, different regs for Institutional Medicaid where a community spouse is involved. Get to an Eldercare Attorney.
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warren631: It's all about countable and non-countable assets. I hope that wamnanealz didn't break any laws.
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longtermcareservices/medicalassistanceandpaymentoflongtermcareservices/index.htm

It looks to me, from the PA long term care website, like the Community spouse can keep in excess of $100,000 in assets, not including the house.
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Im not sure that link posted correctly. I looked at the Pennsylvania Medicaid website, under long term care. Institutional Medicaid is different.
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Warren631: See the below information---

Medicaid Countable Assets



Countable and Non-Countable Assets

The Medicaid program does not consider every asset belonging to an applicant or a couple to be "countable" for purposes of eligibility. If an asset is "non-countable," it is ignored for purposes of determining how much property the individual or the couple owns.

Non-countable property may be targeted for other purposes — for example, for purposes of recovering the amount that Medicaid paid for an individual’s care from his or her estate after death. But for purposes of determining whether the individual has more than $2,000 in assets at the time of application, or for determining his or her spouse’s CSRA [go to Medicare and Medicaid,, section on CSRA] at that time, it is as if the individual or the couple did not own the non-countable asset.

Countable and non-countable assets are listed below. To learn more about any of these terms, click on it and a definition or other information will appear.

Countable Assets

1. Cash.

2. Bank deposits.

"Bank deposits" include any savings, checking, term deposit ("CD") or other account of any kind in any financial institution. Money that is held jointly with another in a bank is treated as if all of it belongs to the applicant or his or her spouse, including money that has been set up as a trust account for someone else. The burden is on the applicant to prove that any funds in a joint account were not his or hers before they were put into the account.

3. IRA’s, Keogh plans, pension funds and annuities.

An "IRA" is an individual retirement account that you maintain at a bank under special rules that allow you to avoid income tax until you are retirement age. Tax laws impose a financial penalty for early withdrawal of IRA money, but this fact does not prevent such accounts from being considered countable assets under Medicaid rules.

A Keogh plan is like an IRA, but it is operated by your employer. Like an IRA, a Keogh incurs a financial penalty for early withdrawal, but this fact does not prevent it from being considered a countable asset under Medicaid rules.

Your pension fund is countable as an asset only to the extent that you have the right to remove the funds as a lump sum. If you do not have this right, your pension payment is income, but the fund itself is not a countable asset.

Like a pension, an annuity is countable only to the extent that you can remove the funds as a lump sum. Very few policies give you this right after they have begun to pay out monthly amounts, but you should read your policy carefully to see whether and to what extent it can be cashed out.

4. Securities.

"Securities" means stocks, bonds (including government bonds and Treasury bills), stock options, futures contracts, debentures, mutual funds, money market funds, promissory notes and other financial instruments of any kind.

Unlike bank accounts, jointly held securities are not presumed to belong entirely to the applicant or his or her spouse. Rather, they are presumed to be owned by those persons in whatever percentage appears on the ownership certificate. A different percentage of ownership may be accepted if the applicant can prove that the securities actually belong to someone else.

Securities that are traded publicly are valued as of the most recent closing bid price. Securities that cannot be traded are valued at whatever equity value they may have. If there is no market for a security and it has no equity value, or if it cannot be reached for some reason, it is not considered countable.

5. Cash surrender value ("CSV") of life insurance policies.

The CSV of an insurance policy is the amount of money that has been saved inside the policy at the time it is canceled, including both a part of the premiums and all of the interest that has been earned since the policy was started. Old policies sometimes have a large CSV.

Group policies do not accumulate CSV for the owner. Only "whole life," "universal life" and similar policies have this feature. Often such policies also allow the owner to take out reduced-interest loans of CSV while the insured is alive. Such loan proceeds would be countable as cash assets if a loan has been taken out, unless the proceeds are spent on consumable or non-countable assets.
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