Marcus - your situation is that you are the spouse & it's your wife that is in a NH, right? If so, the rules for Medicaid are very different. Personally I would get my Google on and read up on whatever comes up for your state (PA) and then I would go to see an elder law attorney.
I say this because the vast majority of those in a NH and applying for Medicaid to pay for their stay are widows or widowers. For that group (my mom is in a NH on Medicaid since 2011 and she is in her 2nd year of being on hospice too), it's pretty straightforward….about 2K in monthly income (like SS and retirement) and 2K in non-exempt assets (like savings or investments). Basically for individual Medicaid, they need to be impoverished.
BUT for you & your wife, totally different situation. You are considered the "community spouse" and that means you still need to be able to have whatever to continue to live in your "community". You personally DO NOT HAVE TO IMPOVERISH YOURSELF. Only your wife need to meet that criteria to qualify for Medicaid. For a community spouse (CS) the rules vary, for most states you are allowed to have up to 113K in assets, your home & a car. If you need some of her income to make ends meet, then you can file to have her monthly income -which Medicaid expects her to pay to the NH as her required "SOC" (share of cost) - instead diverted to you to provide you with more income to be able to live within your community. It is critical that you understand that you - yourself - do NOT have to become impoverished, just your bride does.
Most states have a formula for all this. It is called the MMNA or CSRA. Minimum monthly needs allowance or Community Spouse Resource Allowance. Think of it as alimony for the NH set. SOme state have the MMNA/CSRA pretty low. But the $ can be appealed. This is when an good elder law attorney will be priceless for you to have. There was a poster on this site, who's dad was in a NH but her mom was the CS & when it was all appealed, his co-pay to the NH was about $ 40.00. All the rest of his monthly income instead was diverted to her mom who was the CS.
Also if you are like most couples, you have each other as your beneficiary. Bad idea once 1 of you go onto Medicaid. Why? - because if something should happened to you and your wife then gets the $ from your life insurance policy, it will disqualify her for Medicaid. And who is going to be there to deal with all this for her if you are gone. Again the attorney can help you change things you need to do once she goes into a NH.
CS situations seem to base the couples finances on a set "snapshot" day in which whatever assets are there that day is what all the MMNA/CRSA is based on. You may need to move things around - perhaps pay off your mortgage or pay for other things BEFORE the application - so that you have less assets in general for Medicaid to evaluate.Also another item for couples is that Medicaid allows for only 1 car - most couples have 2. If you give 1 to your grandchild that incurs a transfer penalty. For most couples, who has 1 as the CS, it's often best to trade in both cars and then get 1 newer & more dependable car. It's little things like this that a good elder law guy can plan out for you.
It's a lot to deal with and really you can't do it all. When you are primarily focused on your wife and her care and all the emotions to her being in a NH, you just can't do it all. See an elder law guy and do this asap. Good Luck, dear!
As mentioned above, Medicaid is a shared federal/state program and there are some aspects that are mandated by federal law and some unique to each state. Having just navigated the Medicaid maze of applying and finally achieving eligibility for my dad, I found that besides the Medicaid.gov website, many attorneys offer excellent advice on their websites, with some offering a free consultation. In particular, it is important to pay attention to whether you are "dual eligible", that is, have Medicare and now seek Medicaid, and if you would be seeking Medicaid for medical assistance and community services or for nursing home coverage. There are different rules that apply to each of the above. For me, the internet was an invaluable resource for obtaining information. (Be sure to type in your state next to your search). Also, there have been changes since the ACA so it is important that any information you may be getting from the internet is current. Good luck.
Go to the top right hand corner of this page and click on "Money and Legal" This will have answers to your questions. You can also do a search on the internet for Medicaid in your state. Good luck
I say this because the vast majority of those in a NH and applying for Medicaid to pay for their stay are widows or widowers. For that group (my mom is in a NH on Medicaid since 2011 and she is in her 2nd year of being on hospice too), it's pretty straightforward….about 2K in monthly income (like SS and retirement) and 2K in non-exempt assets (like savings or investments). Basically for individual Medicaid, they need to be impoverished.
BUT for you & your wife, totally different situation. You are considered the "community spouse" and that means you still need to be able to have whatever to continue to live in your "community". You personally DO NOT HAVE TO IMPOVERISH YOURSELF. Only your wife need to meet that criteria to qualify for Medicaid. For a community spouse (CS) the rules vary, for most states you are allowed to have up to 113K in assets, your home & a car. If you need some of her income to make ends meet, then you can file to have her monthly income -which Medicaid expects her to pay to the NH as her required "SOC" (share of cost) - instead diverted to you to provide you with more income to be able to live within your community. It is critical that you understand that you - yourself - do NOT have to become impoverished, just your bride does.
Most states have a formula for all this. It is called the MMNA or CSRA. Minimum monthly needs allowance or Community Spouse Resource Allowance. Think of it as alimony for the NH set. SOme state have the MMNA/CSRA pretty low. But the $ can be appealed. This is when an good elder law attorney will be priceless for you to have. There was a poster on this site, who's dad was in a NH but her mom was the CS & when it was all appealed, his co-pay to the NH was about $ 40.00. All the rest of his monthly income instead was diverted to her mom who was the CS.
Also if you are like most couples, you have each other as your beneficiary. Bad idea once 1 of you go onto Medicaid. Why? - because if something should happened to you and your wife then gets the $ from your life insurance policy, it will disqualify her for Medicaid. And who is going to be there to deal with all this for her if you are gone. Again the attorney can help you change things you need to do once she goes into a NH.
CS situations seem to base the couples finances on a set "snapshot" day in which whatever assets are there that day is what all the MMNA/CRSA is based on. You may need to move things around - perhaps pay off your mortgage or pay for other things BEFORE the application - so that you have less assets in general for Medicaid to evaluate.Also another item for couples is that Medicaid allows for only 1 car - most couples have 2. If you give 1 to your grandchild that incurs a transfer penalty. For most couples, who has 1 as the CS, it's often best to trade in both cars and then get 1 newer & more dependable car. It's little things like this that a good elder law guy can plan out for you.
It's a lot to deal with and really you can't do it all. When you are primarily focused on your wife and her care and all the emotions to her being in a NH, you just can't do it all. See an elder law guy and do this asap. Good Luck, dear!