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Medicaid
- Paying the Nursing Home: A Married Couple's Concerns, and What To Expect in the Medicaid Planning Process
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Paying the Nursing Home: A Married Couple's Concerns, and What To Expect in the Medicaid Planning Process
It is difficult for all of us to think of a time when we will need long-term nursing care. In addition to needing the care, it is necessary to consider the economic consequences that result. In this article, I will discuss the process facing a married couple where one spouse is in need of long-term care, and the other spouse will remain in the couple's home. Failure to consider these consequences now, can lead to catastrophic results in the future. We will discuss specific planning tips in later articles to help you aviod these and many other potential pitfalls.
Unless an individual has purchased private long-term care insurance, he or she will be faced with depleting the married couple's resources in order to pay the nursing home costs. Presently, these costs can range from $4,000 to $10,000 per month. Only after a married couple's assets are spent to a stautorily determined level will the government's Medicaid program begin to pay the expenses.
Resource Assessment and Retained Assets
If one spouse is expected to be in the nursing home for at least 30 days, the couple will submit a resource assessment form to the medical assistance office in the county in which they reside. Often times the form can be submitted to the nursing home which will in turn forward the document to the county office. The resource assesment form will set forth a list of assets owned by the husband and wife on the date the one spouse was admitted to the nursing home. Certain assets are excluded such as the couple's home, household goods, an automobile and the community spouse's IRA's, 401K's, and pension plans.
Through the use of the assessment form, the couple will be notified of the amount of assets that the community spouse is permitted to keep. Contrary to the understanding, it is best to have this resource assessment made as soon as possible after entering a nursing home and at a time when the couple's assets are at their highest point. This will help insure the community spouse will keep the greatest portion of the estate possible.
Retained Income
In addition to the assets the community spouse may preserve, he or she is also permitted to keep a portion or all of the couple's income. Some possible sources of income are social security, pensions, interest, dividends, annuity distributions, and other periodic payments. The community spouse may keep all of the income that comes in his or her name. If the community spouse's income is below the statutory minimum, he or she may also retain a portion or all of the institutionalized spouse income as well. The minimum monthly maintenance allowance is determined for each community spouse based on his or her housing costs.
Conclusion
This article has only served to outline the basic issues and rules facing a married couple when one spouse must enter a nursing home. Protection methods, such as the use of Irrevocable Trusts, will help to ensure that individuals may preserve assets for themselves and their future beneficiaries. Contact an experienced attorney who specializes in Pennsylvania Elder Law and Estate Planning, for the right guidance to your matters.
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The information provided in this article relates only to Federal and Pennsylvania laws presently in effect as of the writing of the materials.
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Elder Law Offices of Shields and Boris
109 VIP Drive
Suite 200
Wexford, PA 15090
Phone: (724) 934-5044
Toll Free: (800) 879-0984
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Elder Law Offices of Shields and Boris
109 VIP Drive
Suite 102
Wexford, PA 15090
Phone: (724) 934-5044
Toll Free: (800) 879-0984
Get Directions
