Show #354 Airing Sunday 8/27/06
Nursing homes are extremely expensive. Most folks end up spending their life savings paying the costs before becoming eligible for Medicaid. But what happens to the streams of income, like Social Security and pension? Must those funds also go to the nursing home? Here to help you make sure you'll have enough to live on is my law partner, Laurie Steiner.
Question: Before Medicaid will pay for nursing home care, a person or couple must have very little savings. But what happens to the income, social security and pension checks that continue to arrive?
Answer: In general, when a person enters a nursing home, his or her income goes to the nursing home. It's the name on the check rule. If you're married, the income, the Social Security and pension checks of the institutionalized spouse go to the nursing home. Your only separate income, if you're in the community, is yours.
Question: Isn't that a big problem for women?
Yes. For most married couples, the husband goes to the nursing home first and the wife's at home. The husband, for most older people, has the higher income from Social Security and pension. And that can present a terrible problem for the wife.
For example, let's say the husband's in the nursing home, and his income is $2,000/month, from Social Security and a small pension. That money typically must be paid to the nursing home, and Medicaid pays the rest. The wife keeps her Social Security check that's in her name of $500/month, but that's not enough income to cover her basic needs.
Question: Is there any solution?
Answer: Yes, although the law recently changed to make it harder for a spouse to protect income. There are two techniques that can be used to increase the income for the spouse at home.
First, you can apply with the Department of Job and Family Services to get some or even all of your spouse's income shifted over to you. The law says you're allowed a minimum of $1,650/month to live on. So if your income is only $500/month, you can get $1,150/month from your spouse's income, instead of paying that to the nursing home.
But you have to apply for this added income-it won't come automatically.
And depending on your living expenses, you may even be allowed to increase your minimum income to as much as $2,489/month, shifting even more from your spouse.
The second technique is to take some of your assets that would have to be "spent down" to pay the nursing home, and instead use those assets to buy a Medicaid qualified annuity paying income monthly to you, the spouse at home. With this strategy, the spouse at home can increase her or his income to any amount.
Question: This all sounds complicated. Where can viewers get more information?
Answer: You can go to the federal Medicaid website, at www.cms.hhs.gov/home/medicaid.asp. Even the web address is complicated.
You can go to Ohio's Medicaid website, http://jfs.ohio.gov/ohp. These will give you some basic Medicaid information, but they're not particularly user-friendly.
There's a lot of good information on the Golden Opportunities website, www.golden.tv.
The Medicaid rules are tough to navigate. But Laurie's message is important: the law allows a spouse at home to preserve sufficient income to pay your bills. For more information, give Laurie Steiner a call.
