My wife has PPA (Primary progressive Aphasia) and may need some in-home care several days a week. She 74 and I am 72 years old. We do not have long term health insurance. This is our second marriage and we maintained separate bank accounts since our marriage. We have our home valued at $350,000 in a joint trust with a 115,000. mortgage. She has $4,000. in saving and $6,000. in a IRA. I have $130,000. in a Individual trust and $60,000.in an IRA.We also have 2 vehicles debt-free valued $$50,000. We presently live on my social security and savings with most of her SS income going towards medicine and personal expenses. Will I have to deplete my savings, IRA , and sell one of the cars before she would qualify for Medicaid? Would our house, which is in our joint trust, need to be sold?
It is CRITICALLY important that you see someone before you apply for Medicaid or other programs for her. For community spouse situations, there is the "snapshot day" - usually the date of application or date of admission and your financials are based and fixed on what i$ there on that date.
One thing you can look into now is the car situation. You are allowed A CAR if you are a couple on Medicaid. If you gift or donate the extra car, there would be a transfer penalty based on the Blue Book value of the car. You don't need to deal with this happening - what works well is to turn in both cars and then get a single new car that works best for your situation (like if there will be a wheelchair or you need a small SUV rather than a sedan) and will be dependable for years & years.
What also works well for the community spouse if they are young (really 72 is young) and in good health and can likely live for a decade more than the ill spouse, is to spend-down their assets to pay off the mortgage completely. 115K legit spend-down done. Now you do have to make sure that all the paperwork on the house is done and filed, etc BEFORE the snapshot day. I bet the attorney will suggest you do this. Another thing that is often done for couples where 1 likely will need a facility soon and the other not, is to sell the current house and then buy a new house that will better suit the needs of the community spouse.
ANother thing to find out about is what services would be made available to her that would be paid for by Medicaid. Most Medicaid $ are spent for skilled nursing services in a NH setting. At home care usually is on some type of Medicaid waiver or Medicaid diversion program. Some states do alot of waivers while other states don't. If your state is narrow in it's approach to at-home care paid by Medicaid waivers, then you are going to have to private pay for the services anyways, so no benefit to applying to Medicaid. It's all lots to think about and realistically it's worth having a good elder law attorney to help. Good luck.
This article may also help clear up some confusion:
Spending Down to Medicaid Doesn't Have to Impoverish Both Spouses: https://www.agingcare.com/articles/medicaid-spend-down-for-spouses-158628.htm
http://medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Eligibility/Eligibility.html
And, regarding spousal impoverishment:
http://medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Financing-and-Reimbursement/Downloads/SSI-SpouseImpovStandards.pdf