Medicaid for Married Couples
If one spouse needs to enter a skilled nursing facility and apply for Nursing Home Medicaid, families are afraid that the assets they have accumulated over a lifetime will quickly be depleted due to the high cost of care. Working with a Certified Elder Law Attorney at HECL, a well spouse can confidently preserve all of their hard earned savings while still receiving the Medicaid benefit for the un-well spouse.
Income and Asset Requirments
If you are a spouse in the community, the great news is that you can keep all of your monthly income! In fact, if your income is below $3,160.50 you can receive some of your unwell spouse’s income too! I’ve got more good news, you can keep $126,420 of your assets. If you have assets above and beyond that, the Certified Elder Law Attorneys (CELA) at Hurley Elder Care law can devise a plan to save all of your hard earned money. Click here for a discussion on countable and exempt assets as well as income diversion.
In Georgia, the community spouse is allowed to keep all countable assets up to $126,420 (as of 2019). this is called the Community Spouse Resource Allowance (CSRA). Each state also establishes a monthly income floor for the at‐home spouse. This is called the Community Spouse Maintenance Needs Standard (CSMNS). This permits the community spouse to keep a minimum monthly income of up to $3,160.50 (as of 2019).
Ralph and Alice were high school sweethearts who lived in Smyrna, Georgia their entire adult lives. Two weeks ago Ralph and Alice celebrated their 51st Anniversary. Yesterday Ralph, who has Alzheimer’s disease, wandered away from home. Hours later he was found sitting on a street curb, talking incoherently. He was taken to a hospital where he is being treated for dehydration. The family doctor tells Alice she needs to place Ralph in a nursing home. They both grew up during the Depression and have always tried to save something each month. Their assets, totaling $182,000 not including their house, are as follows:
1| Will I have to spend down all my money before I can receive Medicaid?
No, this is simply not true and even though some families do spend virtually all of their savings on nursing home care, Medicaid does not require it. There are a number of strategies that can be used to protect your family’s financial security. In addition, there are also many assets that are considered exempt for Medicaid eligibility purposes.
2| Is Medicaid is going to take my home?
In most cases your home is an exempt asset for eligibility purposes. You can own your home and receive Medicaid benefits! However, the State of Georgia has a Medicaid Estate Recovery Program. Fortunately, there are ways to protect your property and minimize your exposure to Estate Recovery.
3| Can I transfer all of my cash and assets right away to be sure I am eligible for Medicaid?
The law has severe penalties for people who simply give away their assets to create Medicaid eligibility. There is a look-back period of five years. Gifting may be possible; however, it is critically important that you have the advice of an elder law attorney well versed in Medicaid rules.
4| Isn’t Medicaid is only for extremely poor people?
No! As life expectancies and long-term care costs continue to rise, the challenge quickly becomes how to pay for these services. Many people cannot afford to pay $5,000–9,000 per month or more for the cost of a nursing home. Even those who can pay for a while may find their life savings wiped out in a ma er of months, rather than years. Fortunately, the Medicaid Program is there to help. In fact, in our lifetime, Medicaid has become the long-term care insurance of the middle class.
5| Help! My spouse is in a Nursing Home and our combined income seems too high for Medicaid. What do I do?
Only the income of the Medicaid recipient is considered when determining eligibility criteria. The income of the well spouse is not considered and will never increase the amount a Medicaid recipient is responsible for paying the facility.
In cases where a potential Medicaid recipient’s income exceeds the income cap ($2,313 for 2019) funding a Qualified Income Trust is necessary.
6| If my spouse is living in the Nursing Home and on Medicaid, will I no longer will have the money to pay my bills?
Not necessarily. You may be eligible to receive a portion or all of your spouse’s income even if Medicaid is paying for the cost of their care. This can avoid the necessity for the community spouse to dip into savings each month, which would result in gradual impoverishment.
7| If I receive Medicaid assistance, will I be able to put money aside to pay for my final expenses?
Good News! Medicaid recipients are allowed to set money aside to take care of their final arrangements. Currently, you can set aside up to $10,000 in a burial fund and still qualify for Medicaid.
8| Won’t the Nursing Home apply for Medicaid for me and make sure that my insurance covers everything?
It is your responsibility to be sure you plan to pay for your Nursing Home expenses. If you find yourself or a loved one in a situation where long-term care is imminent, it is wise to be sure you seek the advice of a professional to be sure you have a plan in place right away. While many Nursing Homes process Medicaid applications as a courtesy for their residents, the responsibility of supplying the State Agency with the application, the required documentation, and the information ultimately falls on the resident and their families.
Receiving a denial after enduring the long and tedious Medicaid Application process can be scary and frustrating. Depending on the situation, there are many different strategies for overturning an initial denial. Our attorneys will review your specific situation and can not only assist with handling the appeal but may also be able to protect your original application date. Timing is of the essence in this situation so don’t delay. Contact us so that we can review your specific situation and find ways we can help!
When dealing with a Medicaid denial knowledge is power. For more information on Medicaid Eligibility please click here.