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I’m aware that if someone doesn’t qualify for Medicaid, they can open a Miller Trust and also that that money is untouchable by anyone but Medicaid when the person passes. What happens when a person needs to be on Medicaid but doesn’t qualify financially, and the Community Spouse needs every penny from both SS checks (and more) to pay bills? We need Medicaid but don’t qualify. Are there any other options besides a Miller Trust?

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This is an especially difficult problem to deal with. LTC NH Medicaid is all about income & assets. In my experience it doesn’t seem to factor in debt or other costs for eligibility except for certain exemptions like a mortgage or Community Spouse Resource Allowance or the very rare dependent.

For individual NH Medicaid, if they have debts, they basically end up defaulting on all debt & either just letting it fall to debt collection/write off process or filing bankruptcy or family pays on debts. In some states, if there’s a home with mortgage, they can file for a diversion of part of the copay for a set period of time if house has a valid Listing Agreement with a Realtor to pay the monthly mortgage for a few months. 

For couples the CS can file for CSResource Allowance from the NH spouses monthly income. CSRA amount varies by state. But if even with CSRA & your own income, living costs and debts can’t be met, it’s pretty dire. You might want to meet with a bankruptcy atty before filing hubs Medicaid application to see what the best option might be. Bankruptcy might be better than just walking on debt as those can produce 1099-Cs which are taxable income due to IRS. Spouse cannot have IRS issues as IRS as a supercreditor can attach SS income which morphs into problems for the required copay to the NH each mo. under Medicaid rules. 

Miller Trust is only for his monthly income. Not yours. 

One of the bigger reasons for bankruptcy in the US is medical debt. If no amounts of cutting expenses or taking another job or selling stuff can make a difference, then perhaps bankruptcy is best as it is a fresh start. President has done maybe 6?
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Are you aware of the Community spouse provisions?

Is your husband over on liquid assets, income or both?
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Hi, Barb. Yes, I am aware of Community Spouse. We have no liquid assets, even the car is leased. I would be applying for Medicaid just for him, but they consider both our SS incomes. Right now, we owe more than we “make”,so there is no money for a MT. I was just wondering how that would be handled.
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Are you talking about community or NH Medicaid?
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Thanks, Igloo. You said pretty much what I already knew. There is no help out there for people on the edge like us. We don’t qualify for anything except $15 a month in SNAP. I’ve explored the bankruptcy option. Debt relief programs are also an option. As long as I can keep Hubby at home, I will. Medicaid is our only option for payment and they consider the household income, not just his. It’s not fun to have worked hard all your life and this is the reward.
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