Medicaid Case Study - Asset Protection for Spouses
Tom and Helen have lived in Middletown their entire adult lives. Two weeks ago, Tom and Helen celebrated their 50th wedding anniversary. Yesterday, Tom, who has Alzheimer’s, wandered away from home while Helen was grocery shopping. The police found Tom wandering the neighborhood hours later and took him to a hospital. Tom’s doctor has just told Helen that she needs to place Tom in a nursing home where he can receive the level of care that he needs. Concerned about nursing home expenses, Helen together a list of their assets:
$ 5,000.00 - Checking Account
$ 60,000.00 - Savings Account
$ 50,000.00 - Money Market Account
$100,000.00 - CD’s/IRAs
$150,000.00 - Residence
In addition to their assets, Tom receives a Social Security check for $800 each month and Helen receives Social Security of $400 each month. Helen begins to research nursing homes using the Connecticut Nursing Home Guide to find the best one for Tom and soon discovers that the average cost of a nursing home is over $7,000 every month! Helen’s afraid that everything they have worked for their entire lives will be consumed by nursing home expenses and, even worse, she will be left penniless to pay for her own monthly bills in less than three years.
There is good news for Helen. Connecticut offers the Medicaid program to help pay for nursing home care expenses. It is possible that Tom and Helen will not have to lose everything they have worked for to pay for nursing home expenses. The process may take some time, but the results are usually worth it.
To apply for Medicaid, Helen will have to go through the Department of Social Services (DSS). If she does things strictly according to the way DSS tells her, she will only be able to keep approximately one-half of their assets. However, Helen would only be allowed to keep $101,640.00 in assets due to certain restrictions imposed by DSS. Exempt assets, such as their home, are excluded from the $101,640.00. The rest of their assets (approximately $113,360) would have to be “spent down” before Tom would qualify for Medicaid benefits.
In most cases there is an alternative to the traditional “spend down.” That is because federal law protects Helen so that she does not have to impoverish herself before Tom can receive Medicaid benefits. The challenge is that Helen cannot take advantage of this protection at the case worker level.
In order to ensure that she keeps as many assets as she is entitled to, Helen must go through the fair hearing process. She must proceed properly and she should have an attorney advising her of her rights throughout the process because the fair hearing carries significant legal ramifications with respect to Tom’s eligibility for Medicaid benefits and the amount of assets Helen can keep. But with proper advice, Helen can avoid such a large spend down.
This is an example where knowledge of the rules and how to apply them can make a substantial difference in the outcome. Consult an attorney regarding your rights if your spouse has applied or is expected to apply for Medicaid benefits.
Please note that proper Medicaid planning differs according to the relevant facts and the circumstances of each situation. If you need Medicaid benefits and want to protect your rights and your property, call (860) 593-0404 to schedule a consultation.
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Index Tags: asset protection, nursing home, social security, title 19 medicaid
[...] A lot of people are denied for Connecticut Medicaid benefits after their initial application. The reason why their application is denied could be any number of reasons. In some cases the application is incomplete or inaccurate. In some cases assets may be attributed to the applicant when they should not be. In some cases you may be entitled to Connecticut Medicaid benefits but the way the system is set up, it is just not within the power of the case worker to approve your application. This last case is very common with married couples. [...]
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