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I would encourage you to see a certified elder law attorney and ask them what needs to be done to protect you.
If you do not handle it correctly, before placement, yes, your husband being in a facility could bankrupt you. Medicaid will require spend down of personal assets before they step in to help.
That is why having a professional help you is so vital.
Bankruptcy is generally a pathway out of debt. If you are not in deep debt now, it will not be your husband's need for Medicaid that bankrupts you.
As others have said, good time to consult an Elder Law Attorney. In my state (MN) Medicaid permits me to keep the house and one automobile as well as $135K in assets. My husband's assets are already depleted. He is not on Medicaid yet and I have about 4-6 months worth of LTC money in liquid assets to manage his placement. After that he'd need Medicaid.
Medicaid would take all of his Social Security check to put against his on-going expenses at the memory care facility. This would NOT leave me bankrupt, it would leave me in a condition where I would either need to supplement my own Social Security (get a job) or down-size my way of living (live completely below my means). Either way, I am confident I could manage.
I hope this is helpful information -- again, each state managed Medicaid a bit differently. Finding an attorney who understands YOUR state's requirements would be a good first step.
To clarify, in MN when your SS income is combined with Medicaid to pay for the custodial portion of the care, the recipient is now allowed to keep $128 per month, every month. This is up from $90 for my MIL in MN who was in LTC on Medicaid for 7 years. The amount one is permitted to keep varies widely by state and can change every year. FYI my MIL hardly had anything to spend $128 on every month. She got 2 covid payments from the govt that she was also allowed to keep and we used that to buy a pre-paid cremation policy for her, also allowed by Medicaid.
Time to see an attorney to get questions about "division of finances" answered. Take all financial info including who is on titles of any properties. This isn't really Do-It-Yourself any more. You need the best most solid advice you can get from an Elder Law Attorney. Good luck.
Not at all in my family’s experience. When my mother required Medicaid to continue payment in her NH, she remained in the same room, same everything as when she was private pay. My dad remained in their home. Mom’s small SS check went directly to the NH. Dad kept all of his SS, all of his retirement pension, all of the money in their checking and savings accounts, and a car. He was required to sell the second car. His lifestyle financially changed none. Using Medicaid does not have to mean a nightmare. The business manager at my mom’s NH walked our family through the application process in expert fashion at no cost (yes, I realize not every place has someone like this) I wish you well in finding the best place and plan for your husband
No, but doing LTC Medicaid application if it’s a couple is complex.
Please realize that LTC Medicaid is both a medical and financial “at need” program. Folks get all fixated on the $ aspect, but they also have to be “at need” medically for skilled nursing care in a NH/SNF. Unless your State does LTC waiver programs to pay for AL/MC. The vast majority of entry into a NH is that they come in as a post hospitalization rehab patient and then it is determined they cannot return home so segueway from a rehab patient (paid by health insurance) to a custodial care resident (private pay, LTC insurance or LTC Medicaid). It is possible to enter a NH directly and file for LTC Medicaid on day of entry, but is not the norm.
On the financial, ONLY the spouse “at need” for a facilty has to be impoverished to meet whatever $ amount your State has for LTC Medicaid. Most States in 2025 have financial “at need” at $2901 income max and nonexempt assets max at 2K. A home and a (one) car are exempt assets. And for the NH spouse their mo income (like SSA retirement income) less a small personal needs allowance will go to the NH every mo as the required Share of Cost (SOC). The PNA varies by State…. some do a laughable $40 while others do $130. HOWEVER You as the still living in the home / apt are considered the “Community Spouse” and your income usually is not a factor for his eligibility but your & his assets are a factor for his eligibility. And if you realistically require some of his monthly income to keep your household afloat, you file for a CSRA waiver (Community Spouse Resource Allowance, think of it as kinda like old school alimony). CRSA varies by State.
But segregating assets and incomes of a couple are complicated and imho is never ever a DIY, it’s more CELA level of elder law attorney work. Plus y’all will need to probably do some beneficiary and will / codicil changes. It’s a lot to wade through with strict regulations, tight timeframes and terms that you are not at all familiar with. It’s atty work.
Personally I do think that for a widow or widower LTC application, who’s has a kid who is their POA can DIY the application if that kid has been rather involved on their parent’s life, are a signature on all banking and financials; & parent isn’t too crazy & controlling. And if the kid absolutely has their own $ to cover all those lil costs for their parent that arise without needing to be reimbursed. Even if the parent has a home, they can DIY it. Otherwise get an atty.
So say Don has $2800 a mo SSA and Ann has 2700 a mo SSA plus they have 162K in savings. But they have a mortgage & a car note. Don is in rehab at the NH, cannot return home as he needs 24/7 oversight. This Nh private pay monthly cost is 10K. Now their State allows the CS to retain 130K in assets. They lower their assets by each doing an allowed by their State preneed funeral of 10K. Don pays for 1 month 10K private pay. Don files for LTC Medicaid during his private pay stay at the NH as Ann now has moved 130K remaining into an in her name savings account that POD to her daughter. They leave the 2K balance in old joint but move it to his name with Ann as a signatory as 2K is the max for nonexempt assets Don can have. Assets all good! But Ann needs his income to cover her household costs. Ann’s atty does paperwork to establish this and files for CRSA $2500 a month. CRSA gets approved. Dons State has PNA at $75 a month. So all Don has to pay the Nh as his SOC is $225 (2700 - 2500 - 75).
All these steps are pretty specific + on a narrow timeline. It’s realistically done by an attorney experienced with LTC Medicaid in your State work. If y’all have a lot of savings often even those can be dealt with a CS can maybe do a SPiA for excess $ over whatever amount her State allows CS to retain. But this is imho more high cotton type of actions that an attorney and a financial advisor together work on for you. Not a DIY.
The short answer is NO with legal eldercare counsel. Ensure that NONE of your husband's hidden assets, gifting nor his non-exempt cash funds are kept from his care. Please also follow other readers' advice.
Seek professional legal advice from an experienced attorney with expertise in Medicaid placement and educate yourself too, by reading everything you can from legal sources. My non-attorney answer is that yes, it will put an enormous financial strain on your savings and assets. But, at least it is a care option (for now) that takes that burden off you. The entire system is outdated and a joke. The spend down requirements for married couples are unrealistic in today’s economy where housing and food costs are soaring and transportation assistance is nonexistent or hugely expensive. There is also a shortage of available Medicaid beds in facilities and many facilities are not even taking Medicaid patients at all. The public perception of Medicaid is that it is only for the extremely poor and so many middle class people don’t think it matters to them. That is, until they live long enough to realize that at an average of $10,000/month, most people will run out of money to pay for facility care in three years or less - even if they saved and lived within their means. As I have said before, how many middle class people would go out and buy a house or rent an apartment where the monthly cost is $10,000/month - give or take a few thousand?! The present day care situation/predicament/trap is set up to quickly take people’s savings. Leaving them “bankrupt” is just collateral damage.
The move of $ to become purely the nonNH spouse’s would not be “gifting” subject transfer penalty as their State allows the non NH spouse (the Community Spouse) to retain their own assets up to a certain level. In my example it’s 130K, which is high but some States do CS at this level. She - as a Community Spouse- does not herself have to become impoverished.
Don & Ann are married. He’s going to do a spend down to become LTC Medicaid eligible and stay in the NH. He cannot return home. She’s staying living in their home as the Community Spouse (CS). As a CS she is allowed to retain her own assets & income. She does not have to impoverish herself for his eligibility. The exact amount varies by State. Her State allows a CS to retain up to 130K of her own assets to be exempt from counting towards his spend down. It is not gifting, it’s an allowed segregation of what was joint assets. They have 162K. As a CS she can move 130K to her own, in her name only bank account. It’s a segregating assets; it’s allowed but it has to be done just right to be ok for Medicaid regulations.
Now if she wanted to spend down all that 130K to private pay for Don, she can but then she has no fall back / emergency funds of her own. That would be foolish. She could also decide to keep only 100K and private pay for him for longer. She could be in a State that only allows 50% (65K) retained for a CS. Whatever $ amount it is, she as a CS takes advantage of her ability to legitimately retain assets as the Community Spouse.
She does the 130k max. Now they have 32K left. They each do an eligible for their State preneed funeral of 10K. So now only 12K left. So they use 10K to pay for a full month private pay at the NH. Leaving their old joint account with a mere 2K. Which is the maximum assets Don can have under his States LTC Medicaid. Ann & Don uses BOTH the time that Don is in rehabilitation at the NH (covered mainly by his health insurance) and then 1 month private pay to work with a Medicaid experienced CELA level of attorney to do all the paperwork and changes need to get Don ready to file a LTC Medicaid application AND do whatever changes to provide for the CS to be able to have financial security so she can stay living in their home. Attorney shepherds the application.
If they gave 50K to their son, that would be gifting and an issue for Dons eligibility. If they paid their grandkids tuition of 40K, that would be gifting and an issue for eligibility. If they did a title transfer of 1 of their 2 cars to a nephew, that would be an issue for eligibility. None of these are marital joint assets so Don would have a transfer penalty placed onto his application based on the value gifted; he would be ineligible till the transfer penalty period is over.
Transfer penalty are based on the daily room&board custodial care rate your State pays a facility. If your State pays $250 a day, a 50K bad transfer is about 200 days of ineligibility and a 200K bad transfer is 800 days so over 2 years ineligibility.
Couples stuff pretty complicated. 5 yr lookback on all the possible actions and spends of not 1 but 2. It’s very much savvy attorney work, imho.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
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APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
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If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
If you do not handle it correctly, before placement, yes, your husband being in a facility could bankrupt you. Medicaid will require spend down of personal assets before they step in to help.
That is why having a professional help you is so vital.
As others have said, good time to consult an Elder Law Attorney. In my state (MN) Medicaid permits me to keep the house and one automobile as well as $135K in assets. My husband's assets are already depleted. He is not on Medicaid yet and I have about 4-6 months worth of LTC money in liquid assets to manage his placement. After that he'd need Medicaid.
Medicaid would take all of his Social Security check to put against his on-going expenses at the memory care facility. This would NOT leave me bankrupt, it would leave me in a condition where I would either need to supplement my own Social Security (get a job) or down-size my way of living (live completely below my means). Either way, I am confident I could manage.
I hope this is helpful information -- again, each state managed Medicaid a bit differently. Finding an attorney who understands YOUR state's requirements would be a good first step.
This isn't really Do-It-Yourself any more. You need the best most solid advice you can get from an Elder Law Attorney.
Good luck.
Please realize that LTC Medicaid is both a medical and financial “at need” program. Folks get all fixated on the $ aspect, but they also have to be “at need” medically for skilled nursing care in a NH/SNF. Unless your State does LTC waiver programs to pay for AL/MC. The vast majority of entry into a NH is that they come in as a post hospitalization rehab patient and then it is determined they cannot return home so segueway from a rehab patient (paid by health insurance) to a custodial care resident (private pay, LTC insurance or LTC Medicaid). It is possible to enter a NH directly and file for LTC Medicaid on day of entry, but is not the norm.
On the financial, ONLY the spouse “at need” for a facilty has to be impoverished to meet whatever $ amount your State has for LTC Medicaid. Most States in 2025 have financial “at need” at $2901 income max and nonexempt assets max at 2K. A home and a (one) car are exempt assets. And for the NH spouse their mo income (like SSA retirement income) less a small personal needs allowance will go to the NH every mo as the required Share of Cost (SOC). The PNA varies by State…. some do a laughable $40 while others do $130.
HOWEVER
You as the still living in the home / apt are considered the “Community Spouse” and your income usually is not a factor for his eligibility but your & his assets are a factor for his eligibility. And if you realistically require some of his monthly income to keep your household afloat, you file for a CSRA waiver (Community Spouse Resource Allowance, think of it as kinda like old school alimony). CRSA varies by State.
But segregating assets and incomes of a couple are complicated and imho is never ever a DIY, it’s more CELA level of elder law attorney work. Plus y’all will need to probably do some beneficiary and will / codicil changes. It’s a lot to wade through with strict regulations, tight timeframes and terms that you are not at all familiar with. It’s atty work.
Personally I do think that for a widow or widower LTC application, who’s has a kid who is their POA can DIY the application if that kid has been rather involved on their parent’s life, are a signature on all banking and financials; & parent isn’t too crazy & controlling. And if the kid absolutely has their own $ to cover all those lil costs for their parent that arise without needing to be reimbursed. Even if the parent has a home, they can DIY it. Otherwise get an atty.
So say Don has $2800 a mo SSA and Ann has 2700 a mo SSA plus they have 162K in savings. But they have a mortgage & a car note. Don is in rehab at the NH, cannot return home as he needs 24/7 oversight. This Nh private pay monthly cost is 10K. Now their State allows the CS to retain 130K in assets. They lower their assets by each doing an allowed by their State preneed funeral of 10K. Don pays for 1 month 10K private pay. Don files for LTC Medicaid during his private pay stay at the NH as Ann now has moved 130K remaining into an in her name savings account that POD to her daughter. They leave the 2K balance in old joint but move it to his name with Ann as a signatory as 2K is the max for nonexempt assets Don can have. Assets all good!
But Ann needs his income to cover her household costs. Ann’s atty does paperwork to establish this and files for CRSA $2500 a month. CRSA gets approved. Dons State has PNA at $75 a month. So all Don has to pay the Nh as his SOC is $225 (2700 - 2500 - 75).
All these steps are pretty specific + on a narrow timeline. It’s realistically done by an attorney experienced with LTC Medicaid in your State work. If y’all have a lot of savings often even those can be dealt with a CS can maybe do a SPiA for excess $ over whatever amount her State allows CS to retain. But this is imho more high cotton type of actions that an attorney and a financial advisor together work on for you. Not a DIY.
No need to bankrupt you!
Thank you!
Patathome01
Don & Ann are married. He’s going to do a spend down to become LTC Medicaid eligible and stay in the NH. He cannot return home. She’s staying living in their home as the Community Spouse (CS). As a CS she is allowed to retain her own assets & income. She does not have to impoverish herself for his eligibility. The exact amount varies by State. Her State allows a CS to retain up to 130K of her own assets to be exempt from counting towards his spend down. It is not gifting, it’s an allowed segregation of what was joint assets. They have 162K. As a CS she can move 130K to her own, in her name only bank account. It’s a segregating assets; it’s allowed but it has to be done just right to be ok for Medicaid regulations.
Now if she wanted to spend down all that 130K to private pay for Don, she can but then she has no fall back / emergency funds of her own. That would be foolish. She could also decide to keep only 100K and private pay for him for longer. She could be in a State that only allows 50% (65K) retained for a CS. Whatever $ amount it is, she as a CS takes advantage of her ability to legitimately retain assets as the Community Spouse.
She does the 130k max. Now they have 32K left. They each do an eligible for their State preneed funeral of 10K. So now only 12K left. So they use 10K to pay for a full month private pay at the NH. Leaving their old joint account with a mere 2K. Which is the maximum assets Don can have under his States LTC Medicaid. Ann & Don uses BOTH the time that Don is in rehabilitation at the NH (covered mainly by his health insurance) and then 1 month private pay to work with a Medicaid experienced CELA level of attorney to do all the paperwork and changes need to get Don ready to file a LTC Medicaid application AND do whatever changes to provide for the CS to be able to have financial security so she can stay living in their home. Attorney shepherds the application.
If they gave 50K to their son, that would be gifting and an issue for Dons eligibility. If they paid their grandkids tuition of 40K, that would be gifting and an issue for eligibility. If they did a title transfer of 1 of their 2 cars to a nephew, that would be an issue for eligibility. None of these are marital joint assets so Don would have a transfer penalty placed onto his application based on the value gifted; he would be ineligible till the transfer penalty period is over.
Transfer penalty are based on the daily room&board custodial care rate your State pays a facility. If your State pays $250 a day, a 50K bad transfer is about 200 days of ineligibility and a 200K bad transfer is 800 days so over 2 years ineligibility.
Couples stuff pretty complicated. 5 yr lookback on all the possible actions and spends of not 1 but 2. It’s very much savvy attorney work, imho.