If a couple own a house together and 1 needs to go to a nursing home, can the spouse that is going into the nursing home turn over their half to the other spouse and still be eligible for Medicaid without consequences?

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The home is an exempt asset under Medicaid as long as it's within whatever your state has as a maximum assessed value (500K - 750K range). If you sell your 50% to another - even your spouse - that causes a Medicaid transfer penalty on an asset. The well spouse is considered the "community spouse" and is expected to be able to continue to live in the home; be able to have about 114K in assets and get MMNA or CRSA (these are kinda like alimony for the NH set) if need be. Only the needing a NH spouse needs to impoverish themselves to qualify for Medicaid. Couples planning is really NOT a DIY project.

For couples the whole Medicaid application is somewhat more complex than for an individual and really to best position the CS to be able to have as much assets and income they need to see an elder law attorney (and financial advisors they work with that too understand Medicaid compliance). For couples, Medicaid tends to do a "snapshot" day (usually the date of application) that the couples finances are fixed at. It's really important that couples if they want to do something creative financially get things done BEFORE the Medicaid application. For example, Medicaid allows for 1 car, now most couples have 2 cars, what is often best is to trade in both to get 1 newer & more reliable car. If they give a car to favorite nephew, it will cause a transfer penalty. If there is a mortgage (horrors!) and the CS is likely to be able to continue to live in the house for years more, it often is good to spend some of whatever is in excess of the 114K CS assets to pay down or payoff the mortgage, and this takes time to do but you need it done BEFORE the application. There's all sorts of other issues related to CS planning.

Really often the CS is totally focused on the day to day caregiving of their spouse and overwhelmed and stressed by that alone. Much less trying to figure out how to maximize their long term finances under Medicaid. You need to work with an elder law attorney to get it done so that it's compliant for Medicaid review for your state. If your family or a family friend of the couple, you can really help them by assisting them to find documents to take to the atty and working up a "face sheet" on them. Face sheet is kinda a 1 or 2 page list of who they are, dates on marriages, divorces, all birthrates of all kids, info on their insurance policies and SS/retirement awards letters, property ownership details. Help them get organized their financial items. Good luck. None of this is simple & try to keep a sense of humor going…..
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