Many spouses are confronted with the sudden realization that their other half will remain indefinitely in a long term care facility. Overwhelmed by guilt and grief, they are propelled through a harsh system of Medicaid rules regarding long term care and with little guidance on their options. To not fault of their own, spouse’s rely on the nursing home to protect their interests and explain long term care planning and options, without understanding the long term financial implications of a decision. Unfortunately, conversations about long term care planning are difficult and often take the back seat, until the need arises.

The basic rules surrounding long term care as paid by Medicaid, or Medical Assistance in Pennsylvania, focus on two parts: medical requirements and financial requirements. The doctors at the hospital or nursing home will certify whether an individual is in need of 24/7 continuous care to satisfy the medical requirements.

To financially qualify for Medicaid in a spousal situation, certain assets are included, while others are excluded. For example: a house, the retirement accounts of the healthy spouse, and car are excluded. The available individual resources and joint resources are then added together. From the “total available resources” the healthy spouse can keep half of the assets up to about $120,000.00. Therefore if a family has $210,000 in assets, the healthy spouse can keep approximately $105,000.00. The other $105,000.00 could be spent on a spouse’s care, but it doesn’t have to!

The remaining $105,000.00 can be transferred to the healthy spouse without interrupting Medicaid benefits! The healthy spouse can use those assets on himself or herself without limitation. However a nursing home is not permitted to explain this to a spouse because it involves significant legal and financial planning. But, we can and we will.

If you or your loved one is confronted with these challenges and you want to avoid paying the nursing home unnecessarily, you know you can Count on Mooney. We can help guide you through the complexities of long term care planning. With 16 office spread throughout Central Pennsylvania and Northern Maryland, I can meet with you to discuss your options at an office location most convenient for you. Call today at 717-200-HELP.