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15 year difference. Husband is 72, wife is healthy and longevity in the family.

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She goes to a qualified elder care attorney.
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I agree with BarbBrooklyn above. Both need to make an appointment to see an Elder Law Attorney who is familiar with Medicaid [which is different from Medicare] to give advice on what is required in their State, as each State has somewhat different Medicaid rules. And while there, update their Power of Attorney, Wills, Medical Directives, etc.
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At some point - which you may already be at - having hubs become eligible for Medicaid will become an option for you & him. Dealing with Medicaid for an individual is IMO cumbersome but can totally be done by a child as a DIY for their parent if they've been involved in their parents lives. But for couples with 1 of them being younger & a likely "community spouse" for decades, Medicaid & Medicaid planning is complex & you need an atty. I'd look to find a NAELA level elder law atty.

Medicaid does NOT require the community spouse (you) to themselves become impoverished; only hubs would need to be elgible. But just how to spend down & shift assets & move $ to income streams for you is NOT ever a DIY project realistically. It's just way way too complex both in knowing what your states laws are, what options are and how Medicaid is run for your state & evaluating financial planning. Plus as you are a caregiver, you days are pretty filled in dealing with hubs to get still have time, energy to think about too much else. Also for couples, Medicaid does a "snapshot" day to which all assets & income are fixed to. So if you need to shift $ to do things like pay off a mortgage; turn in 2 cars & get 1 newer more dependable one; change designated beneficiaries, do a SPIA, etc,.... Stuff needs to be done way in advance.

If you & hubs have a family, it is critical that planning is done so that $ is there both for you as a community spouse & for your kids. If kids below 18 or still in HS, they need to be getting a SS benefit from his SS eligibility. We had this as when my hubs turned 66 /full retirement, our son was still in HS, so hubs applied for SS (instead of waiting till 70 to get his max SS) & son got SS for most of his high school years. It is a pretty nice little known benefit for some SS retirees & it made sense for the break-even.

For may-dec couples, what is likely to be suggested is for assets beyond whatever is the allowed exempt amount (in most states is 119k) to be moved into a SPIA (single premium immediate annuity) for you. You not hubs. Now personally I hate hate hate annuities as they are so often sold to fearful gullible elders with terrible terms & high commission. But a SPIA is a very special type of annuity which provides income to you. Again income to you, which doesn't enter into income level for hubs Medicaid. So say hubs is best off getting care in a facility; you all have 500k in savings/investments; 119k is allowd to be an exempt asset; so what to do with the 381K??? Things could be paid off (like a mortgage). But what could be done is have the 381k go into a SPIA for you. It will be monthly income for you; your income doesnt matter for his medicaid. Your what 56?,57?. The actuarial tables for white female late 50's is going to be a 20/25 yr payout (I'm slightly older than you & my hubs is 70). You are likely to totally outlive the SPIA. One sticky with this type of SPIA is that it needs to be Medicaid compliant & not done by just some guy holding an insurance license (annuities are insurance products). A good NAELA atty will have FAs they work with who do Medicaid compliant products. An added plus is that the SPIA income could be enough that you won't need to draw your SS till 70 so you get max a decade plus from now.

Also for couples planning needs to be done for the possibility that you predecease him. Most couples have each other as their life insurance beneficiary. But if hubs is on Medicaid, bad idea as that $ will make him ineligible. And who will deal with all this for him??? Your gone, so who? All beneficiary designations need to get changed. Really the atty will know what options to suggest.

What is good is that you recognize that something needs to be done. call around to get an appt with a NAELA elder law atty. good luck!
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Do you have an IRA or some type of Retirement Fund? That cannot be touched by anyone but you.
If you don't have one, you really should start one.
We have a 30 year age difference but I started my IRA when I was 33 and no one can touch that until and unless I am dead.
It is my understanding that any joint accounts, Medicaid can only take half - but this is why you go to an Elder Attorney. Some are free consultations.
My DH is 95 and at home and I am planning to keep him here since I do not work and he's really not all that much trouble. His memory is going but he still knows who I am so I can live with the memory problems. Lately he thinks it is morning every time he gets up from a nap :)
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I'm pretty sure that an IRA is a countable asset, unless it is in payout status and then the amount paid is considered income.

But this kind of complication is exactly why you need advice from an attorney.
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Long term care insurance is out of the question of him because he already has alzheimer's / dementia, but it is not out of the question for you.
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Definitely get long term care insurance. There are different levels, but well worth it if you can afford it. Minimum assisted Living per month is probably $3000+. Nursing care even more.
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Depending on the state...Medicaid can take all but approx $100,000. Or half of the total assets.   If you live in a community property state..all assets are considered belonging to both husband and wife.   Your husband would lose all of his term life policies, pension, social security. If that puts you below about $1800 per month..you might get a spousal support waiver...depending on the State you live in. 

You need a lawyer to create accounts and separate your finances in a manner that will pass muster.
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Thank you for all the info and help. I am getting in touch with elder care lawyers. We do have long term care insurance but that only last for a brief time with a $10K/month for memory care that I have heard it costs. Scary stuff. I hope that AD progression is very slow and we have many more years together at home but this is a scary future and I trying to get us prepared. We don't know what that future holds but will try to live each day well and cherish it.
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