I need help finding an attorney who can help me navigate what I need to do to get my husband on Medicaid. What happens to my limited assets if he needs to go to a long term care facility? I've been on the phone all morning with no luck. I do have an appointment in 6 weeks, but I'm afraid to wait that long. I won't be able to pay the bills if I lose his social security check. Thank you.
To me, right now the 2 biggest things you can do is:
- 1. be as much of a cheerleader for hubs placement in rehab in the NH. You want him in rehab as long as possible. So if that means u cheer him on after PT or OT., do it. Or you check in with therapists to tell them what might motive hubs, so that he gets positive on rehab and does what’s asked of him. As others have said, rehab is a MediCARE benefit. It’s a post hospitalization discharge for him to the rehab place, which likely is in a SNF aka skilled nursing facility aka a NH. He can be 20/21 days @ 100% MediCARE paid and then up to 100 days at 50%.
What this does besides getting him better is it buys you time to figure out y’all’s overall financial and legal situation; done by working with the atty so that you can be a CS and be living in pretty much the same standards you were before this happened.
- 2. get yourself organized for all your joint and any separate financial and legal paperwork. Like get 4 binders going: property related, banking/financial, medical, other legal (wills, info on heirs type of stuff). You’re overwhelmed so take time to do this. And why hubs being on rehab for as long as possible /plausible becomes mucho importante as it buys you time.
As a final on this, do not, DO NOT, let the NH do anything to file for a LTC Medicaid application on your hubs yet. Should someone in billing or admissions lean on you for this….. please pls say firmly that as he is a rehab patient until there is a clearer understanding of what his post rehab capabilities are looking like, you are NOT YET filing LTC Medicaid for him. Make that clear. The reason why is that most States LTC Medicaid do a “snap shot” day at which all assets are affixed. So say y’all have 145K in savings & 401K (non exempt joint assets)…. well CS for most States can themselves have their own assets of $120/128K. So under the guidance of that new attorney $120K gets shifted to you & 23K would be it for hubs to “spend down” to get him impoverished to meet State requirements. But by & large the legit asset movement on CS behalf has to be done before application filed. So the snap shot happens after asset moves. It’s imo not a DIY project. It’s savvy to Medicaid atty work.
if your living expenses are beyond what your income is - this happens as maybe a mortgage, or extraordinary medical costs that you personally have, or other HCOA or monthly debts you have to pay - the attorney can file for you to get CSRA or MMNA. They are State specific allowances to CS from NH spouse monthly income. Like if hubs SSA is $2200 a mo & you as a CS mo living costs runs 3K but your income is only $1400. The attorney files CRSA or MMNA for $1600 to be waived from hubs NH copay to instead go to you. Hubs max copay to NH would be $600 and from that he gets to keep whatever your State has a it’s personal needs allowance for a NH LTC residents. Let’s say y’all live in GA, it’s $70 PNA. So hubs copay to NH is $530.00.
CS/NH is not simple & why you need Medicaid savvy atty ahead of LTC Medicaid filing for hubs. Keep the 6 week appointment and try to find an other atty to speak too as well, so comparison shop.
Good luck and remember to get your rest!
Did you the attorney know that this is a bit of an emergency.
Meanwhile I am assuming hubby is in rehab? Get involved now with the Social Worker and discharge planning. Throw yourself on his/her mercy and ask for guidance as to how to begin medicaid application and division of assets.
If you are able to, now and without further ado, I would put some few months expenses away in a lockbox in a bank. Do not take this money out of your accounts in large increments such as 5,000. Take it in several increments a few thousand at a time. This will give you funds for yourself for a few months while everything is in the works.
Try not to panic. If social workers at rehab cannot guide you look up Licensed Social Worker in private practice and ask if they can help you on the phone before making an appointment. There are some in private practice now, hopefully, where you live.
Wishing you the best. I hope that Igloo is looking in on the AgingCare site to offer some immediate guidance; she is very good at this sort of thing.
Medicare (not Medicaid) will pay for rehab in full for up to 20 days and at 50% after that if he is still making progress.
He can be admitted to Long Term Care "Medicaid PENDING".
So the community spouse (the one not in LTC) you are entitled to remain in the house, have a vehicle.
Your marital assets get divided but there is a way for the Community spouse to keep some of HIS income if that will allow you to stay in the home.
Start gathering your bank statements. Ask the secretary to let you know of any cancellations.
There are nuggets of accuracy in all this & a lot of fear factor in it as well.
What she needs to realize imho is that there are regulations in place to allow her as the “community spouse” to retain her own income and if she needs some of NH hubs income she can seek to have some of that waived to go to her instead. But knowing how to do this and other things to protect her interests is not imho ever a DIY. Couples stuff is complicated and needs an atty who understands how to segregate things to protect her self interests. CELA level of elder law atty that’s current on her States approach to LTC Medicaid work.
oh and on the $30 a month….. like 3-4 southern states have $30 pegged as the monthly personal needs allowance. OMFGawd that’s maybe just maybe at best a (1) beauty shoppe visit and inexpensive got on sale at WalMart/Target or bought at Goodwill clothing replacement at best. I can’t imagine….
If it’s an individual LTC Medicaid app, so they r a widow, widower or old bachelor/ette, a POA or good friend of theirs can totally do it or help the applicant do it. PIA to do & will be hiccups but 100% achievable. It’s monthly income for individuals $2754 max by & large and whatever your State has set as max nonexempt assets. Which tends to be 2K-4K. With CA & NY as an outlier to all this. It’s straightforward impoverishment. Nonetheless horrifying but straightforward horror, lol!
But for couples, imho & what I’ve seen with friends of mine in marriages when the older hubs suddenly has to stay in a facility, it’s way different. They have to segregate their income and their assets, probably need to change legal (like beneficiaries of their wills & life insurance to be others than NH spouse cause if the CS gets hit by a bus & dies, the NH spouse gets the $ & ineligible for Medicaid, and then just who is dealing for all this for him?). Figure out debt service so that they legitimately need as much as possible of NH spouses income to them. Plus CS keeps their income and their own assets but have to segregate it. In a lot of ways similar to how ya divvy up stuff in divorce and position yourself as the more “at need” one in & have to find out what assets and debts are. But for NH/CS situation, you’re not infighting with soon to be ex-hubs or ex-wife or ex-whatever. It’s more doing things to position yourself against the State to retain assets and have the $ to maintain those assets for your own lifetime, which could be years if not decades. CS does not to themselves become impoverished.
For individual applications, that they have debts are does not matter. Medicaid does not care abt debts, they are all income & assets. So applicant default on debts as no $ due to required copay/SOC to the NH.
BUT for a CS debt does matter as it positions her to show why she needs her NH hubs income to go to her. The CSRA / MMNA as a resource allowance $ waiver from $ due to NH to instead go to CS are very much like old school alimony. Couples stuff if there are assets - imho - aren’t really DIY. So worthwhile to meet with an attorney to see what options exist for how LTC Medicaid regs run in your State.