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I pay for his monthly care out or our social security checks and a small pension that I have. The facility recently raised his daily care fee to $150 a day. I fear that rate is going to be increased eventually. I cannot apply for Medicaid at this time, we have too much in assets. I read about the pay down to qualify for Medicaid, but what about my living expenses. I also need income to pay for all the bills that I have to pay and money for his other expenses. This has me worried and is on my mind all the time.

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Because you have some assets, Medicaid for either of you will require a dramatic spend down of those assets until a person qualifies for assistance. Each state has its own rules about spend down and asset levels.

I certainly understand your dilemma! I would love a better answer myself.
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JoAnn29 Aug 2023
Medicaid allows for splitting of assets. The Community spouse is not to become impoverished if spouse is on Medicaid LTC.
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Roofie: Retain an elder care attorney well versed in Medicaid.
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See an eldercare attorney who is an expert in Medicaid.
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Do see an elder law attorney to find the facts for your own state and how to manage this. Division of assets is very important, and the state allows you to keep a portion of assets. Unfortunately often not more than 150,000, which by today's standards is little indeed, but you need to protect what you can for your own living expenses and your own future care.

For expert advice you need to go to an expert and I don't mean a "Forum Expert". I mean one for your own area who has a Fiduciary responsibility to protect you. See an attorney in elder care.
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If you can access Elder Law Attorney support, please do so to help you get best options to navigate this ; both for your own protection and, the well being of patients involved.
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I’ll be following this question, thanks for asking it as this will be my situation in a big hurry.
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This is a common but complicated situation. You need a certified eldercare attorney to guide you. Not just any lawyer, but a CERTIFIED eldercare attorney. They specialize in this kind of problems.

Good luck.
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See a lawyer. It is very complicated for us to understand. A lawyer told me that when you are applying for medicaid, they will have a division of assets, and if you have your assets correctly assigned, you can keep all of yours and most of the patients! But you must see a eldercare lawyer. Normally your first visit is free. It is worth your time!
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AlvaDeer Aug 2023
Before buying a "medicaid annuity, please do research, pass it by both your CPA and your elder law attorney. This vehicle is sold by insurance companies often, and the sales person makes profit from it. It needs to be fully understood. Often it is MEDICAID itself that becomes the beneficiary in such an annuity.

There are many options. Be certain you UNDERSTAND fully any vehicle sold to you. And understand that when you are told the sales people or company has no fiduciary responsibility to you (which your CPA and your Elder Attorney DOES have under that law), just understand what that means.
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Does the facility currently accept Medicaid? And if they do, does Medicaid cover room and board or just certain portions of the care?

Assuming they accept Medicaid, and Medicaid can cover the totality of his care, then I would explore a medicaid annuity. When set up properly medicaid annuities convert your collective countable assets and convert them into a non-countable income stream for you (the community spouse). These cost several thousand dollars to set up, but likely could have your husband qualified for Medicaid as soon as it is set up, and Medicaid would then cover the cost of his care (after taking his co-pay) for as long as he stays in the facility.

To answer your question more specifically, when you are not using a medicaid annuity, most states take the totality of your assets as a couple on the first day of the first month he entered a medicaid facility. From there, they divide that number of assets in half and so long as the half falls between roughly 29k and 148k you get to keep that as the "community spouse". The other half must be spent down. The states I just described are called "50% states". Some other states just have a specific amount you're allowed to keep as the community spouse (like Florida).

Regardless, a medicaid annuity, is probably something you should look into, for it avoids all of this mess by converting all of your assets into income that is not countable by Medicaid when done properly. **This only makes sense as a technique if you're in a facility that accepts Medicaid.**

Not specific financial or legal advice!
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When my mother was in a nursing home and the time quickly came that the expenses were overwhelming the business manager recommended and walked our family through the Medicaid application process. The nursing home received my mom’s entire SS check, hers was far less than my dad’s, and Medicaid kicked in for the rest of the cost. My dad remained in their home. He kept his entire SS check and his entire pension as a retired teacher. He had to sell one car and kept the other one. He cashed out a life insurance policy and immediately used the money on expenses related to them both. My dad’s life changed very little in relation to his finances. Medicaid does not cause the spouse remaining in the community to live without resources and money. Please start looking into this now. I wish you the best
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JeanLouise Aug 2023
Was this NYS?
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Does this Memory care take Medicaid, if not then he will need to go to one that does or go into LTC.

You should have had you assets split before he started care. See and Elder lawyer. His split would go for his care and when almost gone Medicaid applied for.
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