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I just read your answer to Lea. If your child is on any assistance, like Medicaid, leaving them money means the loss of that assistance until the money is spent down. My nephew has a Special needs trust, the downfall is it can not be used for housing, food or utilities all of which you can get help for. I would talk to an elder lawyer to see how your childs inheritance can be protected.

I know a couple the husband needed care. The assets were split and he was able to go on Medicaid. She never touched her split and she died before him. Her split went towards his care. There was no inheritance.
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Reply to JoAnn29
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THIS is an attorney question.
I have seen spouses file for divorce and keep the divorce hidden from family in order to separate finances. Often you cannot save more than 100,000. That won't help you much when you need care.

Time to visit an attorney, get options, weigh them carefully. Opinions of a Forum is about as good as asking "The Man on the Street".
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Reply to AlvaDeer
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https://www.ricafortelaw.com/library/one-spouse-needs-medicaid-nursing-home-benefits-in-new-york.cfm#:~:text=Fortunately%2C%20Medicaid%20eligibility%20rules%20allow,the%20healthy%20spouse%20may%20retain.
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Reply to CaregiverL
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Please see an elder law attorney asap. They can do an action plan..& also see if “Medicaid eligible “. Everyone not the same.. Not a black/white answer. I don’t believe anyone can get long term care insurance when they need it. They have to start paying premiums when healthy
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Reply to CaregiverL
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Want, I want to emphasize what some are saying here--you really need to see a Trusts and Estates attorney who also understands Medicaid regs in your state

You want to set up a "special needs trust" for your child so that an inheritance doesn't disqualify them from government aid.

This is NOT a DIY situation. Seek the best legal counsel you can find.
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Reply to BarbBrooklyn
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Want - you say you also have a daughter who needs help due to a chronic illness. I think your situation requires what's called a Trust & Estates attorney, and not an elder law attorney. A T&E attorney will look at your situation and advise you on what vehicles allow for assets to be protected for you, your daughter, and your husband.
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Reply to NYDaughterInLaw
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If you're of "financial means" why are you trying to get your spouse on Medicaid?

Medicaid is for people who aren't of "financial means". Why not get Long Term Care insurance for your spouse? This way you can place him in residential care if you need to.

If you need to place your husband, the nursing home will take half of his income while you cash-pay. Even if he does not qualify for Medicaid for a long time or ever, they can only ever take half.

If you are looking for a way to preserve assets and get the state to pay for him through Medicaid, he will have to get any assets he has taken out of his name, then be kept out of a facility for five years for the Medicaid look-back period.
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Reply to BurntCaregiver
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NYDaughterInLaw Apr 1, 2024
Long Term Care insurance gets more and more expensive with age. OP's husband is 82, has had a stroke, and has dementia. I doubt anyone would sell him LTC insurance for less than what it would cost to put him in a luxury nursing home.
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You need to consult an eldercare attorney.
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Reply to Hothouseflower
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This isn't a do-it-yourself thing. You should see an elder law attorney in your state who will know your Medicaid rules and regulations.

Sadly there are times when a division of finances won't work and where, in the case of a spouse, all assets excepting a home, a car, and about 100,000 can be used for the care of the spouse in facility. Let us assume, in these times, a couple has over a lifetime been able to tuck away a million. This means the spouse who must enter care will quickly, at about 12,000 on average for memory care, go through all the money leaving only 100,000 for the surviving spouse.

I would see an elder law attorney to decide how best to protect yourself.
I have actually seen cases, my CPA being one, where a spouse has got a divorce and division of assets. This was done quietly and no one knew the divorce existed, but his finances were protected in the instance of a long and protracted coma for his own spouse before her death. She was young at the time of her injury, never recovered and was in care for a long time.

See an attorney. The advise of a Forum is great, but this is a case where you need expert advice and you cannot afford to be wrong. You will get all your options in a one hour visit.
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Reply to AlvaDeer
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BurntCaregiver Apr 1, 2024
@Alva

That's the way. Get a quiet divoce before putting someone into care. That way the other spouse at least keeps a 50/50 division of assets.
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You need to see an Elder Lawyer and have your assets split. Your husbands split goes towards his care and when almost gone you apply for Medicaid. Once he is on Medicaid you remain in the home, have a car and get enough of your monthly income to live on. I am just giving you basics an Elder Lawyer will get into more.
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Reply to JoAnn29
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I am in the process of finishing this with my parents. Their elder care attorney in Massachusetts has changed my father's will to leave his assets (house) to me as the personal representative, so my mother does not have the house as an asset. She is also not his POA or HCP. We have submitted the 18 page Mass Health application.

The attorney also advised changing the names/account owners on large savings accounts, brokerage accounts, etc. The goal is that my mother's (who needs LTC) only assets are her pension and social security, about $2K. My father I believe will still need to pay her Medicare insurance.

Being new to this, I was surprised, but as a married couple they are considered a "unit" and assets can be transferred from the spouse to himself only, then me. My mother signed paperwork acknowledging that she was giving permission to make this change to their savings account. I still need to update the ownership on their brokerage accounts and CD, but my father unfortunately is exhausted by the whole process, so I hope to work with him when I am in Boston this week to make changes, otherwise the state of MA will take half of their other joint assets?

I am not an expert at this and have learned a lot. My understanding is that the LTC/skilled nursing wants to know if the application for Medicare assistance has been filed. If so, they will proceed and consider her on Medicaid.

The rest of the money will be used for my father's AL. He can sell the house and have access to 100% of the proceeds. The REALLY good news in this process is I found a place nearby that offers both AL and LTC. They will be on different floors, but in the same place.

If anyone has experience in this area, I really welcome you advice/counsel.

Thank you
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Reply to Logan1964
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MACinCT Mar 18, 2024
Logan, Double check on that house title. A will shows where money goes but who has the title? When Medicaid or MASS Health is filed the house may have to be an asset. When I was executor to someone in MA in 201: First, if the estate is one penny above 1 million, there will be at least a 4% estate tax. If there is life insurance, that is counted in the estate. MASS Health DOES send a bill for the MERP. They did not care how it was paid by the executor. I had to pay this bill upon sale of a house including the estate taxes. Probate oversaw my payments.
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Didn't your husband acquire "financial means" precisely so he could be well cared for in his old age rather than placed in a Medicaid facility with a roommate, separated by a curtain, who's blasting his tv set 24/7? Memory Care Assisted Living is a much better, more comfortable, environment for a man of means! You may want your life, yes, but I'm sure he wants what's left of his life to be the best it can be too!
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Reply to lealonnie1
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wantmylife Apr 1, 2024
Hello Lealonnie,

We have an adult child with a chronic illness. We are both hoping to leave a considerable part of our estate to her, to cover her living and medical expenses. I have cared for my stroke victim husband for 3 years. We live in a rural area where it is extremely difficult to find caregiver help. I have someone who comes in one day a week. I have back issues, and would like to find an in home, full time caregiver. As for wanting my life, I'm sure many spousal caregivers would agree with me, I'm tired. Don't judge me.
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In your state of residence (CO) Medicaid only covers LTC, which means the person is basically bedbound or so profoundly ill that they need 24/7 care.

Needing LTC is an assessment usually made by a physician. This is one of 2 things an applicant needs to qualify for. The other is financial need. Then there is a 5-year "look-back" period for the financial application.

I would discuss this with an elder law attorney, or estate planner or Medicaid Planner for your state.
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Reply to Geaton777
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With an elder law attorney advising how to protect what assets for the well spouse that CAN be protected you proceed.
However, do understand that your assets stand to pay for your care, not the taxpayer.

After your assets are gone, is the time for Medicaid.
You WILL need an attorney to protect what assets are allowed the well spouse for her own future care.

Attend with a full set of assets and get options from an attorney. While a Forum may be well meaning, this isn't something you can afford to do wrong.
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Reply to AlvaDeer
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See an elder lawyer in separation of assetts
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Reply to MACinCT
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You go to am Elder Law attorney in your state who can advise you about local Medicaid regs.

In most places, when one spouse needs Nursing Home level care, their assets are split and the institutionalized spouse spends down their part of the assets private paying for care.

The spouse who remains at home, termed the Community Spouse, does not need to become impoverished.
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Reply to BarbBrooklyn
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