Paying for MC

Lgb35

we are in the earlier stages but I see so many of you talking about placing your LO in MC. How are you affording it?

I am 55 and I can’t see spending all of our investments (which are not huge amounts) on MC because I will need that money to live on for the rest of my life. That sounds cold but I have potentially many years ahead of me.

We make too much money for Medicaid.
When you are in the can’t afford to pay out of pocket but not poor enough for Medicaid how are you doing it?

Thanks

cdgbdr

My eldercare attorney has given me advice on how to spend down to qualify for Medicaid for MC if needed. I have $ to pay privately for a while. She seemed to think I was making a poor decision doing that. Some places will take Medicaid after 2 years private pay.

harshedbuzz

@Lgb35

You are not being cold. The reality is that you've been handed an especially crappy hand given that you likely need to work to secure the here and now as well as plan for what could be years of significant care expenses while setting aside a portion for your own needs down the road.

If you haven't seen a certified elder law attorney, please invest in that. All states have institutional Medicaid as a safety net and there are ways to structure assets to qualify. Don't rely on hearsay— even form lawyers who aren't specialists in this field.

HB

Cat K

I read that in order for me to protect assets from Medicaid I would have to place everything into an irrevocable trust. I really don't want to do that, put everything in someone else's name. I also don't want to wipe out everything I've worked hard to save to pay for MC. I'm 69 years old and need savings for the future. When I think about this, I feel so utterly hopeless.

mrahope

FWIW, I also heard that I needed to place assets in such a trust, but decided against it. I did this partially because the fees to set up such a trust were very high, and partly because I didn't want to place that burden (of being the trustee) on my DS. So, now that he's been in MC for a year, we're doing OK. We use his pension and SS to pay for most of the costs, but I'm drawing down slightly more than $2K from our investments. When the MC suddenly raised the rates by about $850/month last January, it became clear that I needed to downsize, so I'm moving to a smaller house where the rent is a good bit cheaper. That said, I never feel free to spend much on myself now, since I never know when the MC might raise the rates again (or by how much) and also how long my DH may live there. He's 86 now and despite having survived both heart issues and cancer, in relatively good health. So many imponderables. TBH, glad I sold our last house, because it makes downsizing easier now, since we shed some large items. Just my experience. YMMV

Timmyd

I had similar concerns and met with a CELA. It was not cheap ($400 for a consultation), but I felt much better when it was over. In my situation, there was no immediate action required. Depending upon what you decide, you may be looking at additional attorney fees to implement the plan you decide upon.

If you do meet with a CELA, try to have all your questions in writing ready to go. Take good notes, and see if you are allowed to record the consultation. These attorneys are not cheap and you want to make the best use of their time.

Timmyd

@Cat K I used to have the same concerns, but after meeting with a CELA, there were options beside the medicaid trust I was not aware of. Laws vary by state, and are always changing. There are additional complexity with regard to "gray" areas of the law and how laws are enforced. This is really a subject area in which it is crucial to have a qualified CELA guide you through all the options.

PlentyQuiet

The medicaid rules were NOT set up for early onset. I'm in the same boat. If I spend down to qualify how do I pay for the next 30 years for myself? I had to give up a professional license to do 24/7 care for DH, so to go back to work will mean an unskilled job at a lower wage. I can survive on that but not rebuild the savings I would have spent. We will care for DH at home as long as possible. But nothing good awaits my financial situation

BPS

Talk to a elder care attorney. In the state I live in Washington a trust is subject to a 5 year look back rule but there is a medicaid approved annuity that can protect most of your assets if it is done at the right time, and timing is critical. It has its down side too, but is an option

H1235

Like the others I recommend a CELA. Before the appointment educate yourself on things as much as you can. Get an idea how much mc costs in your area, look up some of the terms others here have mentioned above. The lawyer will probably throw a lot at you. You want to at least have a rough idea what he is talking about so you can ask appropriate questions and not leave more confused then before. Or have to come back for another visit because things weren’t clear. It is expensive.

JulietteBee

@CatK

Obviously, I do not know what state you are in. However, my state law does NOT require your assets be put in an IRREVOCABLE Trust. By the way, irrevocable does not mean you put it in somebody else's name.

My mom paid $1500 fifteen years ago to put her house and pension in a REVOCABLE Trust. It simply allows her some legal protection from having her house be considered a part of a settlement should she be sued.

Now that she has a dementia diagnosis, I have consulted with a Elder Law firm. The lawyer reviewed mom's documents and assured me that all was done perfectly & then advised me how not to run afoul of Medicaid 5 year look-back period, when the time comes.

Because of what my mom now faces, we thought we needed to do something to protect our house for our child, as both hubby & I have parents with Dementia.

We saw an attorney and told her our concerns. She advised that we put our house in a REVOCABLE Trust which simply allows us to act on each others behalf if/when incapacitation arises. Our son becomes the Trust executor upon our death, tasked with keeping or dispersing of whatever assets we still have in our trust.

Please do not go by what you read. Make an appointment to see an certified Elder Law attorney & get all your legal paperwork done sooner rather than later.

JulietteBee

@Lgb35

I know exactly how you feel, but there is no need to feel hopeless. There are tons of resources out there that you will need to locate, then tap into.

As far as the spend-down requirement, again, in my state, the community spouse is allowed to have assets of their own. You do not have to impoverish yourself totally.

The absolute worse case scenario is that you will have to file for a divorce. I was shocked and appalled when I learned that a family member of mine did that. She divorced her husband which then allowed him the opportunity to get the coverage he needed without wiping her out.

I am not saying I agree with it. Neither am I suggesting anyone else do it. However,as we have talked about off-ramps from this disease, that seems to be an off-ramp chosen by some. My relative never left her marital home. She never left her dying husband. What she did was legally divorce him so as not to have their joint finances used against him.🫂

annie51

Another thing to note…in Florida, Medicaid will pay for a nursing home but only pays a small portion of a memory care facility. 😞 Hopefully your state won’t have this distinction.

Cat K

I'm in North Carolina and a spouse's assets are not protected, like my IRA, poof, gone. And according to what I read, the trust is subjected to the five year look back. I think it's too late for me because my husband is in stage 6. Will he last another five years? Nobody knows, of course. I need to research the laws for NC again.

cdgbdr

DH is Stage 5-6. In OH, you can draw the least amount possible from the 401ks and it's then considered income vs asset. At least for now, she tells me I'm going to be ok because everything is in 401ks. Of course, that could change before this is over.

trottingalong

https://alzconnected.org/discussion/73389/paying-for-mc

Even though I’m older I am in the same position. I am 68, my husband 81. We would basically have to use up our life savings. That would put me in a very bad situation. Even going to a Cela didn’t change the fact that this illness would affect me financially for the rest of my life. Not everyone can realistically place a spouse in a facility.

Denise1847

https://alzconnected.org/discussion/73389/paying-for-mc

Please go to a certified Elder Care attorney who will know how to navigate through the system. Do so quickly as depending upon the state, the laws are different. Also, do so quickly so that your spouse may still be able to sign for a POA and any other legal documents needed going forward.

sandwichone123

My spouse and I have separate retirement accounts. His Federal retirement, military retirement, and social security pay for about half of his care, and the rest comes from his savings. He has enough savings for another year, and I am hopeful that will be enough.

When he was diagnosed I realized that I would have to either place him or quit my job. If I quit my job I would be full-time caregiver and we would have no money to do the things he wanted to do (go out for coffee, out for lunch, etc.). I would not enjoy being a full-time caregiver, but I do love my job. Then when caregiving was over, I would be in my mid-60s with no current experience or references. It would be unlikely that I could get a similar job at that point.

For me, it was worth spending down his retirement assets to have him somewhere that he could interact with people, walk around, and be cared for.

Bluebird

Not having any money for myself after paying for nursing home care for my DH was my biggest fear. I met with an Elder Law Attorney. It cost me $5,000 which is a lot but I figure it’s only 2-3 weeks of nursing home cost. Where I live Medicaid will not cover the cost of memory care unless it’s attached to a nursing home. It will not cover the cost of assisted living at all.
Here is a link that explains what a spouse is allowed to keep -

https://www.medicaidplanningassistance.org/medicaid-eligibility-florida/

Each state is different so check your state.

Bailey's Mom

https://alzconnected.org/discussion/comment/246870#Comment_246870

Bluebird, I live in Florida also and have been to an Elder Law Atty. I have no children or heirs, so elected to not set up any trusts. I was wondering if your atty suggested using 'spousal refusal' to protect your assets should your DH need a medicaid paid facility? This is only available in a few states, Florida being one of them.

Bluebird

https://alzconnected.org/discussion/comment/246955#Comment_246955

The state where I live does not have spousal refusal. It would be great if it did.

Joyful Heart

https://alzconnected.org/discussion/comment/246817#Comment_246817

I'm also in WA and we did do a trust many years ago. We're both on Social Security. He's on early retirement and I'm on disability. He only has a small pension. We cashed out all investments around the same time as we put the trust together. We purposely paid off our home and any other debt so we basically are living check to check/month to month on Social Security. We did not opt for any healthcare as we don't believe in the current healthcare system and so we don't have an official diagnosis either but my DH is mid to late stage 5 by my own estimation and that of a trusted friend who spent a couple of weeks living with us. I myself have multiple health issues and am struggling to keep us afloat with no help.

If you have other information regarding WA, I'd be so grateful if you can point me in the right direction. Finances are a mess this month with several repairs needed to critical things at our home. :-( When it rains, it pours!

BPS

Joyful Heart

The elder law attorney I talked to charged $300 for the first visit. She said there are medicaid approved annuities if you have assets that you want to shield. It makes a difference if it is a revocable trust or an irrevocable trust. The MC my wife is in ask for 2 years of private pay before Medicaid but they are not strict on that that, they will except Medicaid before the two years. For specifics to you, I think you should see an elder law attorney, the one I talked to is Nancy Lee in Puyallup. I don't know if she is the best, but she answered the questions I had.

easy23

My CELA also said that I could protect assets with Medicaid compliant annuities. There is no max amount.

tboard

https://alzconnected.org/discussion/73389/paying-for-mc

I am in the same boat. My DH is a decade older than I am and we can not afford to pay for his care without spending the money that was earmarked for my retirement to "spend down". That means that I provide all of his care 24 X 7 X 365 for free. If I die first he will be able to use retirement money for his care.If he dies first I will be able to retire.