Is private pay for care a spend-down expense? - AgingCare.com

Is private pay for care a spend-down expense?

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I am currently private-paying for my husband's care with his funds. One day, the funds will be depleted and he will apply for Medicaid. Is private-pay for care considered a spend-down expense? Are they similar to buying medicine, adult diapers, and other medical-related expenses? How do I document such expenses?

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Yes, any legitimate expenditure that benefits the future Medicaid applicant is a legitimate use of the funds, and will count as part of the "spend down," and not be deemed a gift by Medicaid at the time of application.
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Worried, have you seen an Elder Care attorney? That's who can guide you through this process, and who can help YOU not become impoverished in the process of caring for your husband.

An attorney is an allowable spend down expense.
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Worried - please heed BarbBrooklyns advice to meet with elder law attorney.
Medicaid planning when there’s a community spouse (you) can be complicated. Medicaid does NOT expect the CS to themselves become impoverished for your hubs to be eligible for Medicaid. Only your husband needs to meet Medicaids financial limits.

Your income is not a factor for his Medicaid. If the two of you have assets that take you over the amount allowed for a CS (for most states this is abt $119K), you should see what options are out there to convert assets over the 119K into income to you (like a SPIA) or pay down debt (like a mortgage) or other things to lessen your financial outlays in the future. Really a good elder law atty will have suggestions.

Also you likely need to change beneficiary on things..... most couples have each other as the beneficiary of thier life insurance policy. Bad idea if you predecease hubs as that insurance $ will take him over the Medicaid asset limit so he will be ineligible and who will be there to deal with all this for him as your gone. Ditto for having banking POD to him.

Your looking at the day to day costs, which I get it, it can be overwhelming. But you need to also think about the long view which is what an atty can help guide you on. Personally I’d look for atty that is CELA Or NAELA level.
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You need to make sure that the payments are being reported to the IRS through either 1099-MISC or W-2 so that the income to the caregiver is related to the expense you are claiming. If you private pay but it's never declared as income by the recipient, then it could be considered a gift by Medicaid. As Barb says, an attorney well versed in Medicaid and community spouse needs is really important at this stage.
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If you are using an agency for his care keep copies of those bills. If not an agency, rather a private caregiver, then the 1099 or W-2 would apply. If you are paying this person cash get to an attorney. This will cause issues qualifying for Medicaid.
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Agree. Find an Elder law attorney. Noticed 'his funds' were written and not 'our funds'. If all is joint or shared much $$ can potentially be saved. Good luck.
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BARBBROOKLYN - what I meant was if all is joint rather than 'his' funds money can be saved because house can be kept, car, and believe it is around $117k the spouse can have in total non countable assets. If it is 'his' funds being spent down then this is a good start but it is key to see an Elder law attorney as they have ideas as to what his funds CAN be spent on or 'other' funds in order to avoid any Medicaid penalties etc. I am not an Elder law attorney but I was recently through the process with one and learned alot. Unfortunately my Mom passed during the process so we never benefitted but I still have my Dad and he will be next to try and get Medicaid for.
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The answer is yes, they will count as a factor in the spend down. You still should retain an elder law attorney.
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KC, I'm not sure I understand what you mean when you say "if all is joint or shared much $$ can potentially be saved." Can you explain?
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I was also going through process with my mom now..be very careful on finds joint or shared because that can be very technical with medicaid and they may solely consider that the funds meaning money gunds belong solely to applicants so best to consult an elder attorney asap before anything else
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