Justin, My mom is currently in rehab at a nursing home, and her insurance is covering all the charges. But her care team told us yesterday that she will need to transfer to the long-term care unit soon. My dad still lives at home, and they don’t have enough to cover the nursing home costs and meet his expenses. I was told that Medicaid could help, but they would have to get down below $2,000. My dad will be broke! Do we have any other options? – Steve
I know the situation seems desperate, but I have some good news for you. When one spouse in a married couple needs help from Medicaid to cover long-term care costs, they do not have to spend down to $2,000. Medicaid policy contains certain provisions called “spousal impoverishment rules” that are designed to leave the spouse living at home in better shape than you might have expected.
In general, the spouse living at home is allowed to keep the house, a vehicle, and up to one-half of the couple’s other assets. The one-half rule has certain limitations—if one-half of their assets would be less than $25,000, your father will not be required to spend down below $25,000, and if one-half of their assets would be more than $120,000, your father will not be allowed to keep more than $120,000.
Beyond that, there are some very efficient ways to help your parents spend down without wasting the assets that Medicaid won’t let them keep, and there are protections relating to their monthly income stream, too. The bottom line is this—the situation isn’t as bad as you thought, and there is more to be done than to just spend down to the $2,000 limit you thought they faced. At The Elder Law Practice, we help families in this situation all the time.