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The financial requirements to get Medicaid can be scary. People are always shocked at how little money you can have left before Medicaid will start paying for you to be in the nursing home. Please, don’t let these numbers scare you.

REMEMBER, YOU CAN QUALIFY FOR MEDICAID WITHOUT SPENDING DOWN ALL OF YOUR MONEY, YOU JUST NEED TO PLAN AHEAD!

But, even if you didn’t plan ahead, even if Mom is moving into the nursing home tomorrow, please talk to an Elder Law Attorney. In general, an experienced Elder Law Attorney can save at least a portion of your money, even without pre-planning.

Also, please remember that there are SO many exceptions to these general rules. The Medicaid rule book is about 3 inches thick. For every rule, there is an exception and an exception to the exception. Medicaid makes tax law look like a breeze. So again, please talk to an Elder Law Attorney. I just want this article to give you an idea of what we’re dealing with. PLEASE DO NOT TRY TO DO YOUR OWN PLANNING BASED ON THESE NUMBERS. It will not end well.

So, now that we have established that you should not panic or do your own planning after reading these numbers, here they are:

Single- these are the guidelines for anyone who is not legally married

  • Asset limit- You have to have less than $2,000 in assets before Medicaid will pay. This includes your retirement accounts, most annuities, the cash value of life insurance policies, real property, and your home. Pretty much everything you can think of goes into this $2,000 limit
  • The House- if you own your home when you go apply, Medicaid will force you to put your house up for sale. They will allow you to get Medicaid before your home sells, but, they will place a lien on your house and the proceeds from the sale will be used to reimbursed Medicaid for any money they spent on you.
  • Income- IF YOU ARE OVER THIS INCOME LIMIT, DON’T WORRY! You can still get Medicaid, you just need something called a Qualified Income Trust or a Miller Trust. In theory, the income limit is $2,313 a month. In reality, there is no income limit as long as you have a Miller Trust. Talk to an Elder Law Attorney. They can help you set this up and walk you through how it works.

Married- these are the guidelines for someone who is married

  • Asset Limit- The person in the nursing home is still only allowed $2,000. However, the spouse who is not in the nursing home (called the well-spouse) is allowed to keep ½ of the couple’s assets UP TO $119,000. The couple is viewed as one economic unit. So, generally, it doesn’t matter whether assets are owned by the nursing home spouse or the well-spouse
  • House- if the well-spouse is still living in the home, the home is an exempt asset. The spouse can stay in the home. Unlike a single person, as long as the spouse is living in the home, Medicaid will NOT force the home to be sold and will not put a lien on the home.
  • Income-
    • Nursing home spouse- Just like a single person, IF YOU ARE OVER THIS INCOME LIMIT, DON’T WORRY! You can still get Medicaid, you just need something called a Qualified Income Trust or a Miller Trust. In theory, the income limit is $2,313 a month. In reality, there is no income limit as long as you have a Miller Trust. Talk to an Elder Law Attorney. They can help you set this up and walk you through how it works.
    • Well- spouse- This can get a little complicated. But, the well- spouse is able to keep all of THEIR income. So, they can keep their social security check or pension check each month. AND, if their income is less than $2,030 a month, they will be allowed to keep enough of their spouse’s income to bring them up to $2,030 a month.
      • Here is an Example: John is in the nursing home and Medicaid is paying for him to be there. John’s receives $1,500 a month from social security and $2,500 a month from his pension. His income is $4,000 a month total. Mary, John’s wife, still lives at home. Her income is $1,200 a month from social security. Since Mary’s income is less than $2,030 a month, she is allowed to keep $830 a month from John’s income. ($2,030-$1,200=$830). Now her income is $2,030. The rest of John’s money ($4,000-$830= $3,170) goes to pay the nursing home or to the Qualified Income Trust.

If you are feeling confused or overwhelmed, it is because this is INCREDIBLY COMPLICATED. I cannot emphasize enough how much you should not try to do this on your own. Please contact a local Elder Law Attorney and get them to walk you through this process. AND REMEMBER, YOU CAN GET MEDICAID, YOU JUST NEED TO PLAN AHEAD!