Medicaid When Both Spouses Need A Nursing Home

Hurley Elder Care Law often discusses the protections for married couples when one spouse enters the nursing home and the other resides at home or in a community. But what happens when both spouses require nursing home level care? This occurs more often than you may think, and the Medicaid rules are quite different when a couple enters a facility at the same time.


The Asset Limit is different for Married Couples when both spouses apply for Medicaid

Medicaid eligibility can be like putting a puzzle together. There are some nuances when applying jointly, the combined resources of both husband and wife are compared to the couple’s resource limit of $3,000. However, this limit is applied only during the month both spouses enter the facility. After the admission month, each spouse is treated as an individual with an asset limit of $2,000.


All income is attributed to the Individual Recipient

Another puzzle piece is income. Income belongs solely to the individual who receives it and is not considered jointly. If one spouse’s total gross income exceeds the Medicaid limit of $2,829 (as of Jan. 1, 2024) then this individual may need a Qualified Income Trust (QIT) to qualify. It could be possible that one, both, or neither of the spouses require a QIT to obtain Medicaid eligibility. Each source of income should be carefully reviewed. The name on the check matters!


The level of care determines if they are considered a Medicaid couple

As we further fill in our puzzle, there are some circumstances where both spouses may live in a facility with spousal impoverishment rules still in play. Personal care homes, assisted living facilities, and nursing homes are not treated equally. The care coordination team at Hurley Elder Care Law can help guide you as you decide which facility may be appropriate based on your loved one’s care needs. Our care coordinators also work alongside our attorneys to determine what public benefits may be available based on the facilities chosen.


The good news! Asset protection is still possible.

We can help you work through your long-term care puzzle. There are options to preserve and protect assets when a married couple needs a higher level of care. Contact Hurley Elder Care Law at 404-843-0121 to schedule a consultation. Our experienced team can discuss the couple’s specific scenario and find ways to help them utilize their resources to achieve their care needs and the best quality of life possible.

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