Married Couple - One Spouse Needs Nursing Home Care

If your spouse needs nursing home care,
here's how to be sure you're both protected.


Most people would like to receive care in the comfort of their own homes when they need it. Sometimes though a spouse is too ill or disabled for that to be a safe option. That's when a professional facility can give you the peace of mind of knowing that his or her needs are properly cared for.

If your spouse needs to enter a nursing home, you ideally want all the money and assets you've accumulated over a lifetime of hard work to be preserved. That way you can continue on with a secure lifestyle, and use your financial resources as necessary to make your husband or wife as comfortable as possible. It's all achievable with good planning. Lamson & Cutner Elder Law attorneys do it everyday.

  • David Cutner and Carole Lamson explain how to obtain full Medicaid payment when a spouse needs nursing home care. Medicaid can seek to collect the cost of care from the well spouse, when assets are transferred between marital partners without the proper legal structures in place.

    Click here to watch video!

The financial challenge a married couple will face
when one partner needs nursing home care.

Many married couples may have built up a net worth of several hundred thousand dollars or more over the course of their lives. With the cost of living today, many find that they're just meeting expenses with what they have. The problem is that Medicaid sets a "Minimum Monthly Maintenance Needs Allowance," limiting income for a spouse who remains at home, when his or her partner enters a nursing facility. That amount is $2,931 of income per month in 2014. For the well spouse, Medicaid expects 25% of any income above $2,931 to be contributed to the cost of the nursing home care.

Similarly, the value of assets cannot exceed a certain amount, because Medicaid will require you to contribute any excess to the cost of care. Effective asset protection planning involves transferring assets to the "community" spouse, meaning the one who'll continue to live at home. However, Medicaid sets a maximum value for the assets the community spouse can have. This is called the "Community Spouse Resource Allowance," and can be no more than $117,249 in 2014.

Of course, losing the income and assets above these Medicaid thresholds can leave many healthy spouses in dire financial straits. The cost of supplementing your spouse's nursing home care, along with your own living expenses, could quickly exhaust most of your monetary reserves.

Following is how a Lamson & Cutner Medicaid lawyer can protect you from a financial crisis.

What a couple can do
for each other and their family.

With proper planning, you can retain the benefit of all your money and assets. That way the nursing home is paid for, and you can maintain your lifestyle. Here's a three-step plan to accomplish that result for you.

Step 1: If you own a home, it's transferred to the "community" spouse, who does not need nursing home care. Medicaid classifies this as an exempt transfer, and it is not subject to a penalty.

Step 2: Transfer liquid assets such as savings and securities to the "community" spouse also. This too is an exempt transfer, and protects your cash and other assets from having to be used to pay for nursing home care.

Step 3: Once your spouse is settled into the nursing home, and Medicaid benefits are approved, estate planning is initiated for you. Assets with value that exceeds the Community Spouse Resource Allowance are transferred to a special protective trust. The trust is structured so that when your spouse qualifies for Medicaid, the assets will be protected from Medicaid contribution requirements, which would demand that any excess amount be paid toward the cost of your spouse's care.

Learn more about qualifying for full Medicaid payment of nursing home care and asset protection strategies in Lamson & Cutner's recently published Special Report, 25 Strategies to Prevent Financial Ruin from Long-Term Health Care Costs .
Click here to download it free.

The benefits you receive with this approach.

This sequence of strategies provides the opportunity to keep your home, income and other assets intact for your use, and still receive full Medicaid funding for the nursing home care your spouse needs. As the healthy "community" spouse, you can continue to live in dignity with the same lifestyle. You'll have funds to supplement the care provided to your spouse by the nursing facility, and make his or her stay there more pleasant.

Additionally, your home and other assets can be preserved for transfer to family members or heirs when you both pass on, and will be subject to favorable tax treatment through the protective trust.

Another excellent advantage of these strategies is that if you eventually need either home or nursing facility care, the legal and planning steps will already have been taken to facilitate your eligibility for Medicaid benefits. These methods will also put you in the best possible position to preserve the greatest amount of your money and other assets. These can be used to maintain your lifestyle at home, or to make life more comfortable for you in the nursing facility. Any assets left after you've both passed on can be transferred to your children or heirs.

Here's an example of a case in which Lamson & Cutner helped a couple protect their significant liquid assets:

The client was in her 80's, and suffered from Parkinson's Disease. After several strokes, seizures and other serious medical complications, she became uncommunicative. Since all assets were held jointly with her husband, L & C lawyers arranged to transfer them all to him. That protected the money from loss under Medicaid eligibility requirements. The firm then filed an application for nursing home benefits, which was approved. The end result was that the couple's money was shielded against loss, and is now available for the husband to use on behalf of his wife, and to maintain the lifestyle he's been used to.

You can learn more about having Medicaid pay for your home or nursing facility care, and still preserving your cash and assets, simply by clicking on these links:

Call the law firm of Lamson & Cutner today to speak to an Elder Law attorney about getting Medicaid approval for your spouse's nursing home care, and about protecting your income, assets and lifestyle. Get the facts on your particular situation. The toll free number is 1 (212) 447-8690.