If you would like to learn more about nursing home expenses paid by Medicaid, call me for a free initial conference at (405) 842-7590 or click here to E-mail me. Check out this page below to have a general idea of how much money can be kept by the non-institutionalized spouse, or the children. There are limitations on both the income and the assets that the spouse in the nursing home can have each month in which Medicare pays some or all of the nursing home expenses. Check out the diagrams below for a general idea of how your family qualifies. Often changes can be made in family assets to improve your family's situation.        

This is a complex area (some say more complex than the income tax law). It needs professional advice, but many benefits can be obtained in the right circumstances. Before you make application for Medicaid Assistance for a nursing home patient, contact a lawyer, or DHS, or someone who can help you and your family get the benefits that the law allows.        

What follows is only an illustration of how income and asset limitations generally work. This is not legal advice. Every particular case must be individually calculated. The income and asset limitations for 2002 are shown.        

Medicaid Nursing Home Financial Limitations - 2002

INCOME

$1,635 Per Month Maximum
(Includes Social Security)

Single Individual (H)

Married Individual ($1,635 or Less)
Transfer enough from H to bring W up to $2,232/mo.
Medicaid pays the balance due to the nursing home.

Married Individual (Between $1,635 and 2,500)

Single or Married Individual (above $2,500)

Medicaid Nursing Home Financial Limitations

ASSETS

ALLOCATION OF ASSETS BETWEEN HUSBAND AND WIFE
(Form MA-11)
Combine Assets Of Both Into One Pot, Except Exclude House
One Car (Used 4 times a year)

Single Individual (H)

Medicaid Nursing Home Financial Limitations

TRANSFER OF HUSBAND'S AVAILABLE ASSETS
Spend Down (Form MA-12)

GOAL: $2,000 Maximum Property Owned By Husband

1. Invest In Exempt Property
1. House (Pay off mortgage, remodel)
2. Trade For Bigger Car (Equipment For Transporting H)
3. Prepaid Burial Policy
2. GIFTS: Transfers For Less Than Fair Market Value
3. Spend Down (MA-12)
1. Nursing Home Expenses
2. Spend Down To $2,000

Medicaid Nursing Home Financial Limitations

TRANSFER OF HUSBAND'S AVAILABLE ASSETS
For Less Than Fair Market Value (Gifts)

GOAL: $2,000 Maximum Property Owned By Husband

1. Penalty Period ($2,000 per month from Date of Gift)

Can Give $72,000 over 3 year period before Application Date (Date when H is both institutionalized and applies for Medicaid Assistance for nursing home care)        

2. 36 Month Look Back Rule Safe Harbor (Completed Gift With No Possibility Of H Ever Receiving A Benefit From The Gift Outright Or In Trust)

Completed Gifts More Than 36 months before the Application Date are not considered (Except Certain Trust Distributions).        

3. Trust Distribution Exception (60 Month Look Back Rule)

If H Creates An Irrevocable Trust, And Can Receive A Discretionary Or Required Benefit From It, When A Trust Distribution To Another Occurs, (so H can no longer receive that property, because it has been distributed to another) That Is Considered A Gift To The Other On The Date Of Distribution, Which Is Subject To A 60 Month Look Back Period From The Date Of Distribution To The Other. Maximum Gift Over 60 Months Is $120,000 ($2,000 per month). Such Trust Distributions Over 60 Months Are Ignored.        

4. Life Estate In Home

(Two realtors letters of value of life estate in house, or statement that there is no market for a life estate in this property)
H not living there: Not countable for 1st 12 months, or so long as H is making a bona fide attempt to sell life estate.        

5. Testamentary Trust



6. Non-Probate Assets: Probate Estate is only part of deceased individual's estate, as a practical matter, subject to Medicaid repayment claims (Only interested in cash and real estate).



7. Gifts From Others - Trust Distributions To Supplement But Not Replace Available Government Aid.

Gifts From Others Including Trusts Will Count As Income (Limit $1,635 per month)
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If for:      Cash      Food      Clothing      Shelter
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All Other Trust Distributions Will Supplement, But Not Replace Available Government Aid.
Examples: Beauty Salon, Disney World Trip, Television, Chair