I am responsible for my husband's medical bills and the insurance has reached the max. Any advice? - AgingCare.com

I am responsible for my husband's medical bills and the insurance has reached the max. Any advice?

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Now being billed for dialysis. He failed to sign up for Medicare Part B. (shaking head). Now he is being billed thousands of dollars a month for dialysis. We are trying to sell our raised ranch home and move to a single story home because he is now a double amputee and cannot do stairs. I need my "spend down" money to go for a new home. Also trying to get him on Medicaid so I can get help. What a mess!

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Ant - you really really really need to make sure the attorney is well versed in your state's Medicaid rules for "community spouse" situations. That is what you will be in Medicaidspeak. For CS the rules are very different and the state does NOT expect you to yourself become impoverished. Only hubs has to be. Basically most states allow the CS to retain about 114K in liquid nonexempt assets (excluded home & 1 care). You want to maximize just what is in the 114K. Some states allow for SPIA's to be exempt, other states don't. Some states place all financials to a set "snapshot" day at which all $ is fixed - other states allow for a grace period from the date of application. (Like if you pay off a mortgage and that alone gets rid of any spend-down but takes like 60 days to clear paperwork on) Really mucho importante that your legal is good on CS details.

Most Medicaid is for an individual is pretty straightforward: 2K in income 2K in non exempt assets. For CS there are all sorts of variables and interpretation.

One ? to ask is how they (the attorney) deals with CS MMNA or CSRA. MMNA is Monthy Mainteneance Needs Allowance. CSRA = Community Spouse Resource Allowance. What it's called depends on your state. Both are kinda like alimony for the non NH spouse. The formula is state set and varies. You want to get the max MMNA that you can from the get go. SOme state have the base figure set hysterically low, so you appeal to get more MMNA $. Other states max is pretty high (Like TX max MMNA is $ 2,200.00 which is high). I think you need an attorney to maximize all this. It is really hard for a CS to deal with the minutia of details as you are probably more focused on the day to day needs of hubby.

Also Medicaid for NH will be somewhat different than his getting Medicaid for community based services. Really so much of this will be depend on your state.

About the house, I totally understand why the move. You should look at what happens if the sale of old home is more that purchase of new home as the gain may make him ineligible. Ask attorney what the debtor laws are for your state. Some states (like TX) do not at all allow CC / medical creditors to place a claim on the house. Your bank account they can but not your house. Other states not so much pro-property rights. Whatever the case, do realize that if he goes onto Medicaid, upon his death the state has to do an inquiry as to whether or not a Medicaid Estate Recovery claim or lien can be done. As the spouse, you are exempt from this but will have to in a timely manner file paperwork as to that.
Once again the elder attorney will come in handy to deal with this. Your relationship with the elder lawyer will be for years, so make sure you are comfortable with their style. Good luck and try to take time for yourself.
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Just make sure that the attorney you are hiring is someone who does elder law and knows the insulin and outs. You don't spend down to get into another house. You spend down so he'll qualify for medicaid. Please get some clarity about what you're doing.
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Thank you. I do have an attorney. We are currently playing phone tag. I am overwhelmed right now.
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Penny wise, pound foolish. Lots of people decline part B and part D and end up in your position. You need an Elder Law attorney to separate your finances, Call your County Office of the Aging for help. With large outstanding debts, you won't get another mortgage. Stay put.
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You need a Medicaid savvy elder care attorney asap. Click on the Money and Legal tab. Others will have more and better info.
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