What Protections are Available for the Healthy Spouses of Medicaid Recipients?

If you are a community spouse for purposes of Medicaid, then you may be entitled to certain protections when your spouse becomes a nursing home resident so discuss your options with our Florence Medicaid lawyer.

A community spouse is the healthy spouse of a Medicaid recipient who still lives at home while the recipient is in a nursing home. In light of the income and asset limitations imposed by Medicaid, there are some protections in place for the community spouse who remains in the home, such as the monthly maintenance needs allowance. Under the rules of the Medicaid program, most of the income that is due to the institutionalized spouse must be used to help defray the long-term care costs.

Our Florence Medicaid Lawyer Explains the Basics

First, the Kentucky Medicaid program is a health insurance program that is jointly administered by the federal government along with each respective state government. Most people are aware of the fact that Medicaid is in place to help people who have very limited resources.  As you work throughout your lifetime, you will earn retirement credits that will qualify you for Medicare when you reach the age of 65. This fact causes many people to believe that all of their health care needs will ultimately be covered by Medicare. However, that may not be the case, as our Florence Medicaid lawyer can explain.

Medicare Alone May Not Cover Nursing Home Costs

It is a common misconception that Medicare benefits will cover all of your long-term health care needs when the time comes. However, it is more likely that the expense of nursing home care will not be adequately covered by Medicare benefits. The Medicare program only covers up to 100 days of convalescent care after surgery. It does not cover custodial care such as nursing homes and other long-term care facilities. Since this is the type of care that you would receive from a nursing home, Medicare will not cover the long-term costs.

Having a Nursing Home Plan is a Wise Move

When you are budgeting for the future, you should certainly be aware of potential long-term care costs. It can be hard to imagine the possibility that you will no longer be able to handle all of your own day-to-day needs. However, studies show that most seniors in the United States will eventually require assistance with their daily living. Long-term care is very expensive and, for many, Medicaid is the solution.

As our Florence Medicaid lawyer can explain to you, everything that you own does not count when Medicaid is evaluating your eligibility. People typically qualify for Medicaid through a Medicaid spend down. You intentionally divest yourself of assets in advance of applying for the program.

The Medicaid Community Spouse Resource Allowance

Since Medicaid is intended for people with financial need, there is a $2000 limit on countable assets. However, if you are married, your spouse is entitled to a Community Spouse Resource Allowance. This allowance is equal to half of the countable assets that are shared by the couple in question. A minimum Community Spouse Resource Allowance is also available. This is the amount that the healthy spouse can keep, even if it is more than half of the shared countable assets.  But with proper planning, a community spouse may be entitled to keep other assets in addition to this allowance.

The Medicaid Monthly Maintenance Needs Allowance

If the community spouse is relying on this income to maintain a minimal standard of living, the community spouse may be entitled to a monthly maintenance needs allowance. Income that would have otherwise gone toward the cost of care can be retained by the healthy spouse.

When you recognize the fact that it is likely that you will need long-term care at some point in time, you will invariably have concerns. Do not hesitate to discuss these concerns with our Florence Medicaid lawyer. Nursing home expenses can easily exhaust your life savings if you do not have some type of plan in place — don’t assume that you have no options. Medicaid pays for most of the long-term care that is received by seniors so it is a viable solution for many.

Join us for a free seminar today! If you have questions regarding various Medicaid benefits or any other Medicaid planning matters, please contact the experienced attorneys at The Potter Law Firm for a consultation. You can contact us either online or for individuals in Kentucky at (606) 324-5516 (Ashland, KY) or at (859) 372-6655 (Florence, KY) or for those in the Charlotte and Huntersville, North Carolina area by calling (704) 944-3245.