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He’s suffering from a chronic illness and has dementia.

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Wait so you have money but want to use Medicaid which is meant for those without money?

Math is not adding up.
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Reply to WTFchoice
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igloo572 Dec 6, 2024
Imho that is so NOT what the OP is asking. It’s more a situation of being “over resourced” for income so what to do type of ?.

Being on LTC Medicaid does not require healthy spouse still themselves living in their home / living in their community to themselves become impoverished. Only NH spouse has to become impoverished to whatever $ their State has set.

Most States LTC Medicaid do $2829 mo income max & 2K nonexempt asset max. There’s a ton of folks who make the FRA SSA max of $3822 and “wait till 70” SSA max of $4873; and every day more boomers at higher lifetime income who need a NH/SNF. For folks like this, without being able to do something creative with their over resourced situation, they would never ever be able to pay for needed care in a NH/SNF. A Nh isn’t going to say “well we charge 10K a mo but you only get $3822 so we will ignore the $6,178 difference”. This person has get with an attorney to do a Miller Trust or pooled income or whatever exists in their State to deal with being “over resourced” and do whatever to not impoverish the community spouse.

Community spouse/ NH spouse stuff is way complex. That CS does not and should not ever impoverish themselves. The “math” has to work for both.
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Gabbysue: Retain an attorney.
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Reply to Llamalover47
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You can ask when applying for Medicaid. If the answer is not favorable, stop with the application process and consult with a Certified Elder Law Attorney, who can give you guidance.

I understand you want to try and protect your assets, but honestly, Medicaid is for those of us who do not have incoming income from a business we sold.

Your husband may qualify now, if that income is expected in the future. Then, you will have to disclose when the money is received.

Your money and assets are to be used for your care. When your money is depleted (less an allowance for the spouse, such as the home you live in, the car you drive and a certain amount of money) then you qualify for Medicaid assistance.

You don't mention his age. Maybe you are thinking of Medicare? If he is younger than 65, and not already on Medicare, and is now disabled, then you would apply for SS Disability Income, and once approved, he will automatically be put on Medicare. There is a waiting period, I don't recall how long it is.

I wish you and your husband well as you navigate this new challenge in your life.
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Reply to CaringWifeAZ
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Someone on this site recently suggested MILLER TRUST.
Contact an attorney and see if this is an option. (Good luck. Gena).

We hired an elder lawyer and they said we had to create a Miller Trust. All of moms income gets put into the Miller Trust except for $52 dollars. The $52 is used for haircuts, and clothing. Then Medicaid pays the difference in the $8500 mon bill to the memory care facility.
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igloo572 Dec 6, 2024
That $52 is her Personal Needs Allowance. PNA happens in all States for their LTC Medicaid program as it’s required to be done as per the initial Public Laws that created Medicare and Medicaid and within this has dedicated funding for Long Term Care Medicaid. Amt. varies by State with some at a mere $35 a mo and some higher, like FL is abt $130, TX is $75.

A lil’ missive on PNA that is rarely - in my experience- mentioned is that the PNA $ is 100% restricted spending. So it cannot be used for anything that obstensibly is covered by LTC Medicaid. So cannot be used to pay any costs on a home they are allowed to keep under LTC Medicaid; ditto for a car costs; for extra aide’s; for anything “custodial”. A State can ask for an accounting. I would not be at all surprised if some States start to do this as it’s an easy way to jettison folks off of LTC Medicaid.
AND
if the PNA stays at the NH as they are now the residents SSA rep payee so their mo SSA income goes directly to the NH, the PNA $ gets placed into an in-house trust account (like for beauty shoppe to draw payment from), the PNA $ and any funds in their old checking account COMBINED must not exceed their States asset limit. Most do 2K asset limit, so over it, ineligible. POA / you have to pay attention to the balance. The NH are supposed to provide an every 90 days statement on the in house trust account. My mom’s 1st NH did not ever send a statement; her 2nd and eons better Nh did and with a teeeny tiny interest.

I will suggest you ask for a statement if they are not sending one. And ask how the in house account is settled upon mom’s death. Like if it can be done as a POD account so it’s a check to you and outside of any probate requirements, aka would not be an asset of her Estate.
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Consult with an elder care attorney. You should get 1 hour free. Even if you go to pay, it will be worth it.
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Reply to darts1975
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I agree question for an Elder Law attorney. But if I’m understanding correctly this income hasn’t materialized yet so if he qualifies based on your current income yes but when the funds do come in he will likely be over the income and asset limit so it will stop at that point. This is based on my experience with my mom so one particular state and the rules will vary state to state so once again consulting an attorney is wise.
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Reply to Lymie61
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My short answer would be that his share of the income is to be used for his care, and Medicaid applied for when that runs out. As others have said, you need an attorney to accomplish this.
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Reply to iameli
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Sorry to say, but unless you have long term insurance, it's out of pocket. All of your assets must be spent down for Medicaid coverage.
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Reply to Onlychild2024
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This is attorney work. It’s way way too complicated to ever attempt to DIY. Start by looking for a CELA level of elder law attorney. Does not have to be in your city; Just as long as in your State. Medicaid is run by each State uniquely.

Be sure to mention that a regular income source is residual business income. The issue - in my understanding - on $ like this is that it tends to get viewed as an annuitant type of income. And anything “annuitant” has to be within IRS approved actuarial tables for your hubs age to be ok for LTC Medicaid (the program that will pay for custodial care in a facility) with the $ affixed for the incoming year. A good elder law practice will have a CPA that evaluates stuff like this, so you will need to bring in all the paperwork on the old biz along with other financials and tax filings. And if the biz $ takes hubs over the allowed monthly income max, the atty probably can figure out how to suss out one of his income sources to go into a Miller Trust or a pooled income trust. Jusy what options exists vary by State. Really none of this stuff is DIY.

Heres how it could work: hubs fully assessed to be “at need” medically for custodial care in a SNF, so ok for that aspect of LTC Medicaid. Now your State has “at need” financial at $2,829 income and 2K asset max. And you as the community spouse can retain up to 130K. Y’all have only 52K in savings, so 50K is yours alone in a new bank account and hubs has 2K placed into his. So ok on assets. But income that’s over the $2829 as he gets $3,100 in SSA and then $2500 in an actuarially sound residual biz earrings a mo. He’s $5,600 a mo income so over the $2829 max, but in no way covers the private pay rate of f 9K a mo for a NH in your State. So what might can be done is to have his SSA go into a Miller Trust which kinda becomes its “owner” and it’s $3100 is paid to the NH via the Miller. Now he has only $2500 a mo so under $2829. HOWEVER you have a mortgage and a car note and you really need some of his income to keep your household afloat as your own income is not enough. The atty then does documentation to establish that you kinda really need $1500 of his income each month to be able to cover mortgage and your own living costs in the community. You need Community Spouse Resource Allowance of $1500 waived over to you from his $2500 a mo old biz income. Medicaid approves your CSRA so that his Share of Cost he’s required to pay the NH is only 1K less his States personal needs allowance. Voila! You as a CS with CSRA now are better off financially + he’s fully eligible for LTC Medicaid. Plus via that attorney, you are better prepared for dealing with however LTC Medicaid does Estate Recovery once hubs passes.
Realistically imo couples and LTC Medicaid is atty work as all sorts of issues to be evaluated and perhaps tweaked. And you want to start on this before he ever enters a facility and files for LTC Medicaid as it usually “sets” income and assets to the day of application filing. (It’s called the snapshot day). Basically you need to get on this sooner rather than later. Good luck and let us know what happens. We do learn from each other!
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ShirleyDot Dec 5, 2024
Impressive and great demonstration of how complicated this is and why an expert is worth the $$.
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You need to talk to an Elder lawyer. Your assets can be split. You receiving money monthly from a sale ofva business could effect his monthly income which could put youbover the income cap set by your State.
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Reply to JoAnn29
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Best to ask an eldercare attorney in your state. Each state has certain regulations. And, you need to follow laws specifically for your state. It will be money worth spending for sure.
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Reply to AMZebbC
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Gabby,
For me, this is both a legal and moral question. The legal question is so VERY complex that even Igloo, on this Forum--who is a master at knowledge in this wise--recommends that when there is marriage, marital assets, and so on it is NOT DIY. That is to say very dangerous to do it yourself; you need legal guidance by a GOOD CELA certified Elder Law Attorney. Expensive? Yes, but crucial.
First of all you are dealing with marital assets here, and how things are documented and licensed for tax purposes and secondly you are dealing with Medicaid which is a joint federal and State program, and each state has different rules.

While a Forum of caregiving strangers is great for which is best incontinent wear for night, who should be POA and what do they do, and etc. For LEGAL questions, and MEDICAL questions and FINANCIAL questions it is off you go to the experts.

I leave moral questions to you; and leave legal guidance and options to your attorney, and I wish you the very best of luck in protecting your own assets so well as you are able.

Take care.
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