Married Couple - One Spouse Needs Home Care
How to provide home care for your spouse
and still protect your money and assets.
If your spouse's medical problems have reached the point of being too much to handle, home care is available and it can be fully paid for by Medicaid. The nice thing is that as a married couple you can retain the comfort and dignity of living in your own home, get the assistance you need there, and preserve the income and assets you've built together over a lifetime. The key to getting these benefits is proper planning.
However, there are a few stumbling blocks to be overcome, which Lamson & Cutner's Elder Law attorneys have highly effective ways to handle. Here's what they are.
The obstacles you face in getting
home care for your spouse.
Home care is expensive and Medicaid only approves applications that meet strict criteria. Daily care of eight to twelve hours currently runs about $3,600 to $5,400 a month. Around-the-clock assistance increases to $10,000 a month or more.
The problem most couples have is ownership of a home and other assets, along with income that exceeds Medicaid limits for qualification. With a married couple, when one spouse needs home care assistance, New York Medicaid eligibility requirements permit no more than $787 in monthly income, and total assets cannot exceed $13,800, for the spouse who needs care. Yet few couples living in New York could survive with these finances.
Many couples have homes that were purchased decades ago, and have either paid off the mortgage or have substantial equity. They have some investments, and perhaps a 401K or pension plan. Most are also receiving monthly Social Security income.
It would seem impossible to become Medicaid eligible under these circumstances, yet it can be done. This is how a Lamson & Cutner lawyer achieves that result for you.
A solution that protects both of you.
The following three-step plan can attain Medicaid eligibility and protect your home, income, investments and other assets.
Step 1: Transfer all assets to the well spouse, who does not need assistance. Transfers to a spouse or to a minor, blind or disabled child are exempt from Medicaid penalties.
Step 2: While your spouse is receiving Medicaid home care, you maintain your spouse's assets in your name, or in a protective trust. If your spouse's health status suggests that he or she may eventually need to enter a nursing home, putting the assets in a trust may facilitate subsequent planning.
Step 3: Excess income goes into a pooled income trust. This is a special type of trust, run by certain charities, which functions almost like a bill paying service and preserves your income. For example, let's say you have Social Security income of $1,730 a month. The Medicaid limit is $787. You simply write a check every month for the difference of $943 to your pooled income trust account, which has been set up specifically for you. The trust will pay your bills according to your instructions. There's a small monthly administrative fee. When you pass on, whatever is left over in your account goes to the other beneficiaries of the pooled income trust. In this way the charity can continue to provide services to those in need.
You can learn more about these income and asset protection strategies in Lamson & Cutner's new Special Report, 25 Strategies to Prevent Financial Ruin from Long-Term Health Care Costs.. It's free. Just click here to download it.
The benefits you both receive with this approach.
Your spouse will receive home care, fully paid for by Medicaid. Your home, income, investments and other assets you've accumulated together as a couple will be preserved, instead of being dissipated to pay the cost of care. This means you both can continue to maintain your lifestyle, and have your money available to use as needed. Here's an actual situation.
In a case involving a married couple, a man needed 24-hour care at home, which his wife was no longer able to handle. Elder Law attorney Carole Lamson protected his income with a pooled income trust, and transferred all of his assets to his wife. A Medicaid application was then filed for home care assistance, which was approved. L & C recently handled his recertification. He continues to receive the around-the-clock care he needs, completely paid for by Medicaid. He and his wife have been able to comfortably maintain their way of life and dignity.
Medicaid will also cover any of your spouse's medical expenses that Medicare or other medical insurance doesn't. Additionally, there's a wide range of community programs that will become available, such as adult day care. All these costs and services will be paid for by Medicaid.
Yet another benefit is that if you ultimately need either home or nursing facility care, the planning steps will already have been taken to facilitate your own eligibility for Medicaid coverage. The trust arrangement will also put you in the strongest legal position to preserve the maximum amount of your cash and other assets possible. These can then be used to keep your lifestyle intact at home, or to make your stay in the nursing facility more pleasant. Any assets remaining after you have both passed on can be left to your children or heirs.
You can learn more about protecting your money and assets, and still having Medicaid pay for your home or nursing facility care by clicking on these links:
Call the law firm of Lamson & Cutner today to find out about the home care benefits your spouse can receive, and learn how to protect your money and assets. You can speak to an Elder Law attorney toll free at 1 (877) 303-1414.