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Issue 6, September/October, 2007 Maximizing Income and Assets for the Spouse at Home Many of our clients in a nursing hom have a spouse who is still healthy and independent with many years ahead of them. Our goal in those cases is to obtain Medicaid eligibility for the nursing home spouse on the earliest possible date and maximize the income and assets available for the healthy spouse, called the "community spouse". When there is a community spouse, Medicaid looks at the value of the couple's countable assets on the date of nursing home admission. Certain assets are not countable, such as, the primary residence, one car, and the community spouse's IRAs. Most assets are countable including bank accounts, money markets, CDs, bonds, brokerage accounts, annutities, life insurance with cash surrender value, IRAs of the nursing home spouse and second homes. Assets are countable whether they are titled in the name of one spouse or both spouses and even if a child is also named on the account. After determining the value of the couple's countable assets, Medicaid allows the community spouse to keep one-half, up to a maximum of $101,640. The nursing home spouse keeps $2,400 or $8,000, depending on their income. Everything else is considered "excess" and must be spent down before the nursing home spouse can receive Medicaid benefits. So, if a couple's countable assets are $100,000 and the nursing home spouse is entitled to keep $2,400, the community spouse keeps $50,000, and $47,600 is considered "excess" and must be spent before Medicaid can start. Once the couple spends their excess assets and Medicaid begins, the nursing home spouse's income goes to the nursing home; the community spouse keeps their own income and, possibly, some portion of the nursing home spouse's income. Medicaid determines this by looking at certain of the community spouse's expenses and applying a standard formula to determine how much money they need; however, in Medicaid's view of the world the maximum amount anyone needs is $2,541 per month. This is as much as Medicaid will tell you Here is what Medicaid will not tell you:
1. There are ways in which the couple's "countable" assets can be increased, before the date of the nursing home admission, in order to increase the one-half share of the community spouse. 2. If the community spouse needs more of the nursing home spouse's income than indicated by Medicaid's standard formula, they can ask for and be granted additional income, even an amount in excess of the $2,541 monthly maximum. 3. If the community spouse's needs are still not met by their income and their spouse's income, they may invest excess assets in order to secure additional monthly income for themselves for the rest of their life. 4. If excess assets still remain, they can be spent on things that will most benefit the community spouse, for example, burial accounts and home repairs but it does not end there; for example, income tax can be pre-paid on the nursing home spouse's IRA, which will have to be liquidated before they qualify for Medicaid. The bottom line is that Medicaid will not tell you how to maximize the income and assets of the community spouse, but we will. LET US HELP YOU! |
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