Q&A On Medicaid Rules For Married Couple 12/15/15

Intro: It's your parents' worst nightmare. Dad had a stroke and is now paralyzed. Mom is still living in the family home, but doesn't know how long she will be able to continue to afford to stay at home with a nursing home bill of $9,500 per month for dad. Everyone has told her that Medicaid can pay, but you have to be penniless first. She is in a panic, and doesn't know where to turn.

Q. We know that Medicare will not pay for much of his stay

A. That's correct. It will pay, along with your supplemental insurance, only up to 100 days of care. Since Medicare only pays to help you get better, after 100 days, they assume that you are no longer going to get better, so the insurance won't pay anymore. Plus, it takes planning to qualify for the government benefit for Nursing homes, Medicaid.

Q. So is mom right to be in a panic about paying for dad's care in the nursing home?

A. She should be worried, but not panicked. A spouse living at home is allowed to keep some assets with which to live. It's not too much, but it's far from being penniless.

Q. Well, what can mom keep and still allow dad to qualify for Medicaid?

A. The spouse at home is allowed to keep the house, one car, cemetery plots for both spouses, pre-paid funerals for both spouses and ½ of the remaining assets up to a maximum of $119,220 in 2015 and 2016. The government allows enough for basic living expenses. Even some of dad's income might be allowable for mom to keep.

Q. What about the excess assets? Does everything else need to be spent on nursing home care first?

A. As we discussed before about the single person rules, that's what the nursing homes want you to think, so that they receive as much money as possible in private pay rates before Medicaid is allowed. And, Medicaid doesn't WANT to pay benefits.

Thankfully, there are planning tools you can undertake in order to qualify WITHOUT spending all the other assets first. Ideally, you plan ahead, but even if dad is already in the nursing home, there are still planning opportunities available. See a certified Elder Law attorney to find out what can be done.

Close: Even at the last minute, there is Medicaid eligibility planning available for a married couple to protect some assets. But, you need good legal advice from an Elder law attorney.