Medicaid can be a very helpful plan for the elderly. However, it gets complicated, when it comes to financial eligibility. This is especially true if the applicant is married, according to the Delco Times in “Medicaid–Protecting Assets for a Spouse.”
Generally speaking, to be eligible for Medicaid long-term care, the applicant may not have more than $2,400 in countable assets in their name if their gross monthly income is $2,313 or more. That’s the 2019 income limit.
There are Federal laws that mandate certain protections for a spouse, so they do not become impoverished when their spouse enters a nursing home and applies for Medicaid. This is where advance planning with an experienced elder law attorney is needed. The spouse of a Medicaid recipient living in a nursing home, who is referred to as the Community Spouse, is permitted to keep as much as $126,420 and a minimum of $25,284, known as the “Community Spouse Resource Allowance,” without putting the Medicaid eligibility of the spouse who needs long-term care at risk.
Determining the Community Spouse Resource Allowance requires totaling the countable assets of both the community spouse and the spouse in the long-term care facility, as of the date of admission to the nursing home. The date of admission is referred to as the “snapshot” date. The community spouse is also permitted to keep one-half of the couple’s total countable assets up to a maximum of $126,420 in 2019 and no less than the minimum of $25,284. The rest of the assets must be spent down.
Countable assets for Medicaid include all belongings. However, there are a few exceptions. These are personal possessions, including jewelry, clothing and furniture, one car, the applicant’s principal residence (if the equity in the home does not exceed $585,500 in 2019), and assets that are considered inaccessible, such as a spouse’s retirement accounts.
Unless an asset is specifically excluded, it is countable.
There are also Federal rules regarding how much the spouse is permitted to earn. This varies by state. In Pennsylvania, the spouse is permitted to keep all their own income, regardless of the amount.
The rules regarding requests for additional income are also very complicated, so help from an elder law attorney will be needed to ensure that the spouse’s income aligns with their state’s requirements.
An estate planning attorney can advise you on creating an estate plan that fits your unique circumstances, as well as guide you through the process of applications for programs, such as Medicaid.
Reference: Delco Times (June 26, 2019) “Medicaid–Protecting Assets for a Spouse”