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My wife is on Medicare and I have health insurance from the business I retired. She has Alzheimer and will soon need to go into a nursing home with memory care. what happens after the 90 days. Do i have to pick up all the bills again, and do i need to sell the home i own now and get ready.

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How do you spend down a spouses assets without spending down your own in a community property state?
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Deeshusband, contact you local Area Agency on Aging (it may be called something else in your state). Get a case manager you can work with and milk her for all the advice and assistance in advocating for you wife that you can get.
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Buttered toast is not sustainability. Deeshusband, you're the one in control so don't serve her the buttered toast. Have you started the Medicaid process? Grandma1954-the medical expenses are only deductible if you itemize your tax returns (fed and state).
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Would love to hear what advice the eldercare specialist gives you. Medicaid help very difficult to get in my state. My retirement is being depleted monthly paying for my mom to be in an Alzheimer's unit at $5000. Her income is $200 too much to get any assistance, but it doesn't even cover half the cost of her care.
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Before deciding to sell your home, consult a lawyer who specializes in elder affairs.
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Tess, Medicare does not pay for NH care if not in a hospital at least three days prior. It's usually for rehab. You need Medicaid.
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If eligible for hospice they wil provide respite care at a suitable facility for 5 days every benefit period. If that helps. Keeping her at home is the best advice with professional help if nyou are able to manage that,
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As I encouraged deeshusband is get an order from her doctor to prescribe professional help in the home. She needs more nutrition than buttered toast every day. That is no way to treat an already starving brain for nutrition. Smash up some avocados, sweet potatoes and maybe some spinach, etc. because she probably is having a hard time swallowing. That reflex is being destroyed when the brain has dementia. It is very hard to see your loved one deteriorate each day and you want to help, yet feel helpless. Do not sell your home (where would you live?) and get professional help to provide services so your wife can remain with you (if that is what you want). Best wishes, it is not going to be easy.
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The 90 days is only for a rehab situation, after a hospitalization for something. To my knowledge there is not a 90 day benefit if going from home to facility without a medical necessity and a doctor's prescription.
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See the interactive list at www.naela.org (National Academy of Elder Law Attorneys) for an elder law attorney in your state who does Medicaid planning. Medicaid is managed by the states so the rules vary from state to state. No state takes a home while the spouse is living in it, Some states have ways to protect the home from the Medicaid Estate Recovery Program, allowing it to pass even to children who are not disabled or living there to help their parent(s). The spousal protected resource amount and how to convert countable assets to noncountable assets vary from state to state as does the need for and availability of a qualified income trust. An elder law attorney should also be able to give you ideas on how to "spend down" your wife's assets (not yours) to under $2,000 in ways which will enhance her life without risking disqualifying her for Medicaid. For people in the situation you describe (living spouse, possibly significant countable assets and income), this is not a DIY exercise.
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Check out "Spousal Impoverishment" rule to get her on Medicaid without you having to give up all of your assets
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Also talk to your tax preparer as some of the expenses for Memory care living may be deductible as a medical expense.
Another option, see if your community as a Senior center. They may be able to help you apply for funds that will allow you to keep your wife at home longer. Also look into Adult Day Care. Great for her and great for you since you both get a break.
If possible keeping your wife at home can be less expensive than Assisted Living/Memory Care.
I may be assuming something that is not true, but if she has had a recent hospitalization you might want to look into Hospice to determine if she would be eligible for Hospice services. They will provide you with equipment, you will get a nurse that will come at least 1 time a week, a CNA that will come at least 2 times a week to help with personal care, a bath, dressing. They are a wonderful resource and even if she does not qualify at this time you will get information that will be very valuable to you.
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Thank you....I know a Elder care specialists and will move forward on your advice.
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Well, first..the 90 days you refer to is not really 90 days. This is only the maximum time that will be covered..provided it is determined that she is improving, and that level of care will be necessary for her to continue to improve. From the people I have known, 45 - 60 days is much more realistic.

Next...you do not need to sell anything. Yes, you will have to pay for her care..but..the rules are different in each State..but generally you will be allow to keep half of the liquid assets (a max of about $80,000 is typical) You will keep all of your income and some additional from her income to bring you up to about $2,000 total monthly (remember..rules change by State). As long as you are living in the home..you keep it. You keep your car. Etc.

When there is only $2,000 left of her half...then you apply to Medicaid for payment for her care.

I suggest you get an attorney ... speciality in elder law and Medicaid right away. You need help getting through this process.

Sell nothing until you have legal guidance.
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