The simple answer: No. In fact, there are couples who together have over $117,000 in assets (not including their home) and qualify for Medicaid without any spend down. How can this be? What about the “division of assets” and “spend down” people are always talking about? Medicaid law is quite complex and everyone’s situation is different.

The following example is just one of the many ways in which some of our clients are able to qualify their spouse for Medicaid without spending a penny: Carol’s husband, Bob, entered a Mississippi nursing home in October of 2012. At that time, their assets totaled approximately $200,000 (not including their home and one car, both of which are “exempt” for Medicaid purposes). Carol and her daughter immediately went to the Division of Medicaid to apply for benefits. The caseworker explained to Carol that, upon application for Medicaid benefits, the state will only allow Bob to retain $4,000 of assets in his name, and will require the transfer of their joint assets into Carol’s name up to a maximum of $113,600. Bob will qualify for Medicaid once their joint assets are spent down to $117,600. When Carol came to our office in January of 2009, it was because the social worker at Bob’s nursing home had told her she should contact an elder law attorney to see if there were ways she and Bob could preserve more than $113,560 their assets. We explained to Carol that she may be able to keep additional assets, but it would depend on her income and the interest their assets were earning.

Basically, every community spouse is entitled to a minimum monthly maintenance needs allowance of $2,841 per month. If Carol’s income, including the interest from her assets is less than $2,841, she can keep enough of Bob’s income to bring her income up to this level. Carol informed us she has $900 in income and all of her and Bob’s assets are in CD’s and bank accounts earning no more than 5%. We told Carol that her $100,000 earning 5% will be considered by the state as an asset, and the income of $416.33 per month will be counted as income, giving her a total income of $1,315.33 ($900 + 416.33). Her income, because it is less than the minimum monthly maintenance needs allowance of $2,841.00, entitles Carol to retain some of Bob’s income up to the monthly needs allowance. In this case, she can retain some of Bob’s income. Because her assets exceed the asset limits, Carol may be able to purchase a special type of annuity, or make a loan, of any excess money, in order to qualify Bob for Medicaid. However, the income from this special annuity or promissory note will reduce the amount of Bob’s monthly income that she will be permitted to keep. Bob’s monthly income is only $1,000, so the monthly income from the annuity or note will not likely decrease the amount that she is entitled to keep of his income, and all of their assets will be saved.

In order to accomplish this, special planning will be required, and it is likely that, due to the complexity of the Medicaid rules, that a fair hearing will be necessary to get the plan approved. Again, this scenario is fact-specific to Carol and Bob. It is unlikely to be accomplished at the case worker level as the state is not able to give legal advice on this type of planning. The bottom line: before you start spending down, seek advice from someone who knows Medicaid laws.  For more information, click here or email contact@mortonlaw.com.

Tags: medicaid planning