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I’m the community spouse, my husband is receiving Medicaid for long term care.
With the increase sale prices of homes in my area, I’m thinking to sell and downsize to a smaller home then use remaining equity for income.

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Serious problems here as any sale of this home, profits going jointly to you and hubby, will result/may result in clawback on medicaid and removal of medicaid benefits.

As so often is the case here, questions that require EXPERT advice should be referred to experts. See an attorney about this proposal before you do it.
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For anything community spouse (which is you, you are the CS) this can become a real minefield as any change in your income and assets and totally cause a review of your hubs in an NH on LTC Medicaid eligibility.

personally I would NOT do anything without first getting some hard data as to likely sale info on both properties and then find a CELA level of attorney to go over all this with BEFOREHAND. As others have said, hubs has 50% equity in the home. If the State will require hubs to spend it down, that means he goes off LTC Medicaid and you do NoT have any access to the $ plus the fun of dealing with whatever paperwork needed regarding any estate recovery lein releases is yours is a tefra State. Just what the Medicaid regulations are depend on your State and that’s something for an attorney to give you guidance on. It’s NOT a DIY ever for CS / NH Medicaid spouse situations ever imo.

For a CS having debt, like a mortgage or a car note, is actually a good thing because your having debt if it exceeds whatever your own (your income, your SS $ or whatever $ you make from working) is available for you to pay from then you can petition from Medicaid to have some of hubs copay to the NH to instead go to you. (Instead of it going as his required copay to that NH). Think of it kinda like old school alimony. It’s called CSRA or MMNA and it has to be requested. Although some states seem to take it into account in the application process. But many don’t and just look at the Nh spouses SSA awards letter and tell the CS “we need a check for this every month for his copay” or have him make the NH become his representative payee so they get the SS$ directly. But you as the CS can get some of his mo income IF you need it. And if you have debt - like a mortgage - then ya need some of his income to cover those debts. You are fully expected to be able to stay living in the community…. you do NOT need to become impoverished ONLY hubs has to be. If I was a CS, believe me, I would have a mortgage and a car note and whatever else for debt service so that the NH got as minimal as possible each month as their copay from my hubs mo income.

and that’s why a CELA atty can be helpful as they know how to maximize all this. Plus do whatever else needed. Like change beneficiaries on you like insurance policies and wills. If you get hit by a bus and hubs is your beneficiary, that insurance $ will take him over Medicaid limits. You’re dead, who is going to deal with this for him?? The beneficiary has to get changed…. stuff like this ya needed to get done. If you did this then fabulous! But if not, that’s what a good atty can still do.

I’d be concerned that the Realtors are being a bit optimistic. If you are getting Realtor comps, you might want to have them only give you comps from sales done last 30 days and ask how long each of those were on the market (their DOM) and what they were listed for originally - not sold for - but originally listed for. Then go online to look at the listings…. are the houses really similar to yours? Or are these renovated? Like we’re bought 2-3 years ago, fixed up to flip and sold again? If so, it may not be a true comp to what your house is.
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gladimhere Apr 2023
Igloo, is there a difference between a National Academy of Elder Law Attorney certification and a Certified Elder Law attorney? Both organization list attorneys that specialize in Elder Law.

Is NAELA just an organization to pay membership to but you do not need to be certified?

I found the answer, in case anyone else is interested a fee is paid yearly to NAELA for membership. It is not a certification.
https://elder-law.com/naela-nelf-cela-actec-what-does-it-all-mean/

https://nelf.org/
National Elder Law Foundation is a resource to find a Certified Elder Law attorney.
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I would imagine that half of the money from the sale of the house would have to be earmarked for your husband and if he is on Medicaid now that might put him over the $$ threshold. (It might not have an impact IF the house was yours before the marriage)
Talk to an attorney that is versed in Medicaid, an Elder Care Attorney if you have used one in the past.
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Speak with an elder law attorney in your state specializing in Medicaid planning. Rules vary by state.

I wonder if one half of the proceeds will be required to pay for his care of it There would be a lien due and payable at closing for his expenses so far.
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