MY SPOUSE IS IN A NURSING HOME... WHAT WILL I LOSE?

Trust & Estate Lawyers Jennifer & Jeff Hawkins

The State of Indiana published that Indiana nursing home care cost an average of $61,668 per year in 2011. Fortunately, federal law protects for spouses of nursing home residents from impoverishment. An explanation of this protection appears on Indiana’s Long Term Care Partnership website (http://www.in.gov/iltcp/2340.htm) this way:

• The Spousal Impoverishment Protection Law applies for nursing home admissions occurring on or after September 30, 1989. The purpose of the law is to allow the community spouse [spouse at home] to keep some of the couple’s income and assets while still qualifying the nursing home spouse for Medicaid.
• A snapshot of the couple’s assets is taken in order to determine the community spouse’s share. The snapshot reflects the couple’s assets at the time of the Medicaid applicant’s FIRST continuous (minimum 30 days) institutionalization (nursing facility or hospital).
• When a nursing home spouse is applying for Medicaid, the couple will need to complete a resource assessment tool based upon the resources (assets) owned at the snapshot date AND an application for Medicaid (which asks for information about current resources). The community spouse’s share is calculated from the resource assessment tool. The nursing home spouse’s eligibility is determined from the application. Assets of a married couple are generally considered to be jointly owned, no matter in whose name they have been placed.
• ASSETS: The community spouse is allowed to keep a maximum of 1/2 of the non-exempt assets up to a total of $113,640 (1/2012) or at least a minimum of $22,728 (1/2012).
• The nursing home spouse is allowed only $1,500 in non-exempt assets to be eligible for Medicaid.
• INCOME: The community spouse is allowed to keep all income that is solely in his/her name, plus 1/2 of all jointly owned income. If his/her income does not equal at least $1,839 per month (7/2011), he/she may keep some of the nursing home spouse’s income to get up to the minimum level of $1,839 (7/2011) each month. If the community spouse has high living expenses, he/she may appeal to keep more of the nursing home spouse’s income – bringing his/her total minimum monthly income up to $2,841 (1/2012).
• The nursing home spouse must contribute all of his/her income towards the nursing home cost except for $52 per month for personal needs and any dollar amounts for health insurance, premiums, taxes, and medical expenses not covered by Medicaid. This contribution of income towards his/her care is called his/her “liability.”

This protection requires some careful planning. The State of Indiana prohibits its employees from giving Medicaid eligibility advice and nursing homes can only give employees very basic Medicaid training. Only experienced elder law attorneys offer solid and up to date advice and representation. Experience and expertise really make all the difference!

© Copyright 2012 Hawkins Law PC.

Published with permission.