Seeking wisdom: Medicaid and my pension.

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My current eldercare attorney seems to be AWOL for some time, so I contacted another attorney yesterday to inquire about Medicaid planning. He said that my TSP (in case you didn't know, it is a 401K-equivalent in the federal service) will be considered on my husband's Medicaid application. I was shocked to hear that. I am pretty sure my AWOL attorney told me NO. I cannot reach her to confirm.


This new attorney has been in the business for decades and claims he knows the rules well. Is he correct about my TSP? While I am waiting to locate my AWOL attorney, I would like to hear from you all.

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Sorry, reread your post. I Can't see why your pension would be considered. But your husbands pension and SS maybe be used to offset costs. A friends father is on Medicaid. He and wife had inherited 60k and Medicaid had them use 1/2 of it towards his care.

My friend did have a question after the death of the wife, her Mom. The couple's will was set up what mine is his and what his is mine. Friend was wondering if her Mom could have changed her will taking the husband out and leaving the other 30k to her kids. Since she never changed her will the other 30k went to his care.
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WS - it could be that both attys are right....up to a point.

First of all it’s good you are seeking legal advice, Medicaid planning if theres a community spouse like you are is eons way way more complicated. It’s not a diy. But then it all gets down to the unique situation that is you & hubs & having atty who understands what options are out there for CS and what your future is looking like.

The current is that hubs probably going to move into a facility much sooner than anticipated from when he came home last Oct (Nov?), is a that it?? and your starting to super fret??? I’m assuming this is what’s what & my answer is based on this....

For couples all income & assets are reviewed. However Medicaid does not expect the CS (you) to themselves become impoverished. Only hubs must and only hubs income becomes the required copay or SOC (share of cost) to the NH. In theory your income NOT a factor for his eligibility - this lil missive is mucho importante. My understanding is that TsP is sticky cause although it pays income to you each mo that is NOT counted for hubs, BUT the $ in the TSP is being counted as a joint assets.

So to me you need to go back to figuring out what all total assets are. Then pull out whatever your state has as the maximum CS asset limit. Most states are 119k but it varies. Kaiser has pretty comprehensive tables on Medicaid #’s for each state from personal needs allowance max to house value limits, you may want to google this. So whatever is left is subject to a spend down UNLESS you (your atty) can find a place to park funds & still be ok for Medicaid.

If I had a CS situation with extra assets for myself if I’d look into:
- totally paid preneed funeral and burial
- turn in all cars and get 1 newer & more dependable one & within medicaid limits.
- pay off mortgage. If I had time and House was too big for me to age in place, or my kid didn’t see using it, I’d downsize and pay in full for a new place.
- prepay on all utilities that seems reasonable
- get dental work done. Not really covered by medicaid. This could easily run serious $$$$. I did huge spend down in dental for my mom with her $ and worth every cent.

And all extra $ still left after using on above and taking off the 119k I’d turn into a medicaid compliant SPIA. Normally I hate annuities.... they are often sold to gullible fearful elders who don’t understand just what kind of insurance product they are buying and it’s hefty insurance salesmen commission paid.... but a SPIA is a very narrow type of annuity good for a CS. If you are a younger spouse or a healthy with probable longevity spouse that not too too old, you will likely outlive the SPIA. SPIA pays you income (income to you, not hubs) so not a factor for Medicaid and the $ in the SPIA is not counted as a community asset. It’s outside of spend down too. SPIA not ever a DIY.  It’s speciality underwriting, not to be done by just anyone with state insurance license. A good NAELA or CELA atty will have FAs they work with to do these. Assuming SPIA allowed for your state, I’d suggest you ask either atty about if your TSP totally counts as joint assets if then pulling TSP funds to use for SPIA could make sense. I’d suggest you read federal info on tsp drawdown so you minimize any penalty if they exist. I’m not familiar with tsp, my dad was a fed but retired before tsp required so got both SS & civil service annuity & federal BCBS which passed on to my mom. Most fortunate for her and in turn for me as her dpoa. 
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Why wouldn't your pension be counted. It is taxable income. Being Federal you don't get SS right? To receive Medicaid you can have no assets. What assets you do have are used to offset the cost of your care. Before planning for Medicaid you better check out the rules in your state. There is a cap to what your income can be.
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According to this article, the community spouse's income is not counted unless it is above a certain level. However, I believe this is for Nursing Home Medicaid, not for Community Medicaid or waivers.

Being in a business for decades does NOT mean you know anything. Having NAELA certification does.
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elderlawanswers.com/medicaid-protections-for-the-healthy-spouse-12019
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