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SpokaneInnovaging2014

CHAPTER ONE n TAKING CHARGE Navigating the Complexities Medicaid Eligibility: Know the Facts By Richard L. Sayre, Sayre & Sayre PS A good estate plan allowed $75,000. If you have $300,000 or her name, or $1,939 from all sources. involves preparing for in non exempt resources, the well spouse This figure may be increased if you have the potential of disabil- will be allowed $117,240. A spousal household expenses exceeding certain ity and long-term care. transfer to the well spouse must be done, standards. For instance, if the well spouse and the well spouse must spend down or earns $2,000 per month and the ill Very few families have acquire exempt assets to qualify. If you spouse earns $600, the well spouse will sufficient resources are single, you are allowed a maximum of keep all $2,000, but the ill spouse must to pay for more than $2,000, excluding exempt resources. The contribute his or her income towards the a short period of Department of Social and Health Services cost of living (if at home) and health care nursing home or in-home health care; (DSHS) adjusts these figures annually. expenses. This is called “participation”. and spouses and children of individuals who have suffered from a stroke, or who Exempt resources (assets) that do not If the well spouse earns $1,000 and the develop Parkinson’s, Alzheimer’s disease, “count” towards these figures include the ill spouse earns $1,000, the ill spouse Huntington’s or similar disabling condi- family home (unlimited value if you are will contribute $939 per month to the tions may quickly find themselves facing married, $543,000 maximum if you are well spouse, bringing the well spouse’s devastating expenses. These expenses can single), one automobile, burial insurance, income to $1,939 per month. The ill be minimized with proper planning. burial plots, some income producing spouse will then contribute the balance properties (such as a small business), towards care costs and may retain some Medicare provides very limited long-term certain Medicaid exempt annuities and income if they are in a nursing home or care benefits, only for a short duration for retirement funds, and assets in very spe- the COPES home care program to cover disabled seniors. When limited Medicare cialized trusts. living expenses. benefits end, you must cover these costs yourself. Such expenses can exceed Long-term care insurance policies are If the person is living in an adult family $8,500 per month. Under appropriate not resources (although their income will home or assisted living, they must pay all circumstances, the state and federal reimburse DSHS in a Medicaid case), and remaining income to the living facility government will provide long-term care will be especially helpful when a law is after spousal allocation, if any. DSHS assistance for you or your spouse in your finally enacted which will increase the pays the balance of the costs. There is no home, in an adult family home or congre- exempt cash set aside by the value of penalty connected with transferring funds gate care facility, or in a skilled nursing coverage. from one spouse to another, but if you home under the Medicaid program. For planning purposes, a couple may transfer assets to a child, draconian pen- To be eligible for long-term care be able to transfer assets into the name alties await both spouses. Medicaid assistance, a couple must of the well spouse without penalty, Today, the gift penalty period is no lon- “spend down” to amounts established by acquire an exempt resource (such as ger imposed at the time of the gift, but federal law. To be eligible for Medicaid paying down a mortgage, buying a new at the time of institutionalization, which assistance with home care, assisted liv- car, or purchasing a Medicaid exempt could be years later. There are ways to ing, an adult family home or a congre- annuity), then qualify the ill spouse for minimize penalties in respect of transfers gate care facility, the well spouse may Medicaid services. to children, but because of the horrible have no more than $53,016, and the ill Currently, the well spouse is allowed an consequences of a carelessly planned spouse no more than $2,000, excluding income stream equal to all income in his transfer, no one should consider doing exempt resources. If you need assistance for nursing home care, the well spouse is allowed half of all “ A good estate plan involves preparing “available” resources, with a minimum of $53,016, up to a maximum of $117,240, excluding exempt resources. The ill for the potential of disability and spouse is allowed $2,000. For example, if you have a total of $150,000 in non long-term care.” exempt resources and a spouse is in a nursing home, the well spouse will be 28


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