If it appears as though you, or a spouse, will need nursing home care in the near future you need to start thinking about how you will cover the cost of that care. The high cost of nursing home care results in almost half of all seniors to turn to Medicaid for help with their nursing home expenses. You may be considering Medicaid as a source for help with your future nursing home costs; however, you have heard one too many horror stories about how turning to Medicaid for help leads to a loss of assets and/or leaves the at-home spouse without income or resources. There was a time when those stories had a basis in fact. That was before the Medicaid spousal impoverishment rules were implemented. To help you understand those rules, the Affton Medicaid attorneys at Amen, Gantner & Capriano explain Medicaid eligibility and the spousal impoverishment rules.
How Much Will Nursing Home Care Cost?
You are probably aware that quality nursing home care is not cheap nor are the other various Home and Community-Based (HCB) services offered to seniors who need assistance. To give you an idea what to expect in the State of Missouri, the average monthly cost of long-term care (LTC) is around $5,000 per month as of 2017. With an average length of stay of 2.5 years, you can expect to spend over $150,000 on an average nursing home bill.
Who Will Pay for Your Nursing Home Expenses?
Like many people, you may be wondering why Medicaid is always associated with nursing home expenses. What about Medicare or private health insurance? While you can count on Medicare to cover most of your healthcare expenses during your retirement years, it will not cover your nursing home expenses. Likewise, most basic health insurance policies also exclude LTC expenses unless you purchased a stand-alone LTC policy at an additional expense. Because Medicaid does offer LTC coverage, eligibility for Medicaid is often brought up when nursing home expenses are discussed.
Medicaid Eligibility
The fact that Medicaid covers nursing home expenses is great news – as long as you qualify for benefits. As you may have heard, Medicaid eligibility is based, in part, on an applicant’s income and “countable resources.” Both limits are relatively low. As a senior on a fixed income, your income may not be an issue; however, your countable resources (assets) could be given that the limit for an individual is only $999 assets such as your home and a vehicle are exempt from consideration; however, you could still find yourself over the limit. Of even greater concern is the impact your efforts to qualify for Medicaid will have on your community spouse (a spouse that is not in LTC).
Spousal Impoverishment Rules
Before the spousal impoverishment rules were implemented, one spouse was often left without income or resources when the other spouse needed nursing home care. Why? Because the couples’ income and assets were combined for the purpose of determining Medicaid eligibility. If a couple’s assets exceeded the program limit, those assets had to be “spent-down” (sold or transferred) until their value dropped below the limit. This left the community spouse with virtually no resources. Fortunately, the spousal impoverishment rules now prevent that from occurring.
The rules now call for a “division of assets.” All assets belonging to either spouse are added together, except for exempt assets. One-half of the total (but not less than $24,180.00 or more than $120,900 as of January 2017) is considered as the “spousal share” for the community spouse. The spousal share is protected from the Medicaid spend-down requirements, ensuring that those assets remain available for the community spouse to use.
A similar provision also allows the community spouse to keep some of the nursing home spouse’s monthly income if the community spouse’s income is below the Minimum Monthly Maintenance Needs Allowance (MMMNA). The amount of the MMMNA is set by law and will vary each year depending on factors such as geographic area and household size. For a community spouse with no dependents, the MMMNA can vary between $2,003.00 and $3,023.00 as of January 2017.
Contact Affton Elder Law Attorneys
For more information, please join us for an upcoming FREE seminar. If you have additional questions or concerns about the Medicaid spousal impoverishment rules, contact the experienced Affton Elder Law attorneys at Amen, Gantner & Capriano, Your Estate Matters, LLC by calling (314) 966-8077 to schedule an appointment.
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