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My husband has Parkinson’s/Lewy Body disease and fell down our back steps June 13th while I was gone a few hours. He had tripped on his shoes that were laying just outside our door. He couldn’t get himself back up and laid in 98 degree heat approximately an hour before I came home and found him still breathing but unresponsive. He was taken to a trauma center for two days and then transferred to the VA hospital where is has been for two months going thru rehab. He has reached a point where he is no longer progressing and is still considered a fall risk and was determined he needs to go into long term care. We have to pay out of pocket the for a certain amount of time which I have not found out how long the requirement is because they have to review the application and get back with me. We only have enough money to pay out of pocket for less than a year. I know I have to have a lawyer do a division of assets but don’t know when that is done? Do I need to have it done now? I am afraid of everything ending up going to the care center and I won’t have anything left to live on.

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Neither LTC Medicaid (in a facility) nor VA will expect community spouse (a CS & that’s you) to themselves become impoverished in order for Medicaid or VA to pay for his care. But doing any of this not a DIY. I’d suggest that you schedule a couple of CELA level of elder law attorneys to meet with in Sept. & B4 meeting pull together an end of August $ amount on all banking, investments, tax assessor bill on all property, car info to take to atty.

Realize Only NH spouse needs to become impoverished.

I don’t know how VA does this but for LTC Medicaid, CS retains their own monthly income (like salary if working or your SSA / retirement if not) & can redirect a certain amount of joint assets which get moved over to a new in CS name & Ss# only as CS assets. Asset limit is set by ea state & avg $128K. Should CS have debts - mortgage, car note or extraordinary health or living costs - that your own personal mo income isn’t enough on its own to enable you to live in the community then you (atty to do this imo) file for CSRA or MMNA. These are resource allowances that get “waived” over from hubs SS$ that normally would go as his required copay to NH but instead gets waived to you cause your atty has shown State u need some of his $ to make your mo costs met. CSRA & MMNA have max limits, like for TX, I think it’s $2800, so in theory younger non working CS w/mortgage & kids could ask for $2800 of Nh spouses income; if he gets $3k a mo then she gets $2800, NH gets $140 & he gets $60 a mo personal needs allowance for himself.

CS asset $ you have can just sit there & make interest, you do not need to take $ from it. But have to keep your exempt assets under the max.

VA has its own “aide & attendance” $ (tends to pay 2K) to offset paying for care in a facility that is other than a NH (like AL or MC) or to use if in a NH if u need to do a spend down over time if your joint assets are way too high even after u could take CS 128K out.

I know it’s confusing…. Say 200K joint assets as savings. No mortgage but have a $500 HELOC. You get $1500 a mo and he gets $2100 a mo SS$. It costs $2700 a mo to cover your living costs, so you will file for CSRA once he files for LTC Medicaid. BUT no matter what, he’s going to be over in assets to be eligible for LTC Medicaid. $200K - $128K (yours) - $2K (his max assets) = 70K in spend down needed.

This is what u imo want the atty to give best options on. Might be best to get VA A& A 2K & private pay to stretch out 70K spend-down if Nh cost is lower or yiur take a hit in cashing out investments. But if he needs lots of care so private pay add on costs so his Nh bill runs 15K+ a mo then getting 70K spend down done & over might be best. Costs are staggering so try to get a feel as to what his costs may be if he were to go private pay for a while.

Medicaid allows for 1 car so if there’s 2 either sell both and get 1 newer one or keep the better one. Car note is a CS cost so may be good to actually have note to capture CSRA. Ask the atty.

Also y’all will need to redo all beneficiaries if it’s each other. If you were to predecease him & he’s life insurance beneficiary, $ takes him over Medicaid limit. Ask atty for options.

whatever the case VA will pay him a VA personal needs allowance of $90 a mo. This in addition to the LTC Medicaid personal needs allowance they get to keep as per your state LTC Medicaid rules (tends 2 be $50-$60 a mo).

its overwhelming. Again only the NH spouse has to become impoverished.

If he is going into a purely VA facility, (we have one over in Gulfport and it seems to be a terrific built in 2008 facility but has a waiting list) VA sets the rules on how those deal with eligibility & copays. That I’m not familiar as to how they run. Good luck!
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I would get my assets split now using an Elder lawyer. One not just versed in Medicaid but the VA rules too.

If you go for Medicaid, your husbands split would be spent down then Medicaid applied for. You should not be made impoverished either way. Medicaid or VA. Your life savings should not all go for husbands care.
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Have you looked into the % of "Service Connected Disability" that your husband is classified at?
There is a good possibility that he may qualify for housing at/through the VA.
Talk to a VA Social Worker or contact your local Veterans Assistance Commission if you do not know the % or what he qualifies for.
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