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If you are a married couple and it’s that 1 of you is medically “at need” for a NH and you are hoping that Medicaid will pay for this but you are totally ok on remaining in your home / apt and going on with your life, then you would be considered a “community spouse” aka a CS for LTC Medicaid, and it’s not at all straightforward filing and eligibility.

This situation is complicated. Imho it is never ever a DIY. It’s elder law work, especially an CELA level of attorney. There’s a segregation of income and assets that has to happen and done in a way that is not an issue for that future filed LTC Medicaid application. (Like new bank accounts to be opened). And each State administers its Medicaid programs uniquely, so what works for me in Louisiana probably not accurate for whatever State you’re in.

for examples:
- if there is a CS, they can seek a waiver to have some of their NH spouses monthly (eg SSA retirement) income “waived” over to them rather than their NH spouse having it all paid to the NH as LTC Medicaid Share of Cost (less sm Personal Needs Allowance) requirement. This is called CRSA or MMNA and imo kinda like old school alimony paid to the CS to help them bolster their own income to cover their costs of living in the community. Like there is a mortgage, or a car note, or they have extraordinary drug or utilities costs which the CS’s SSA & other income alone can’t cover….. this CS very definitely has always needed their spouses income to make their household run, so this CS file for CSRA or MMNA.
- Or the Couple has too much in savings over the 2K usual nonexempt asset max for a NH resident in your State and 130K in nonexempt assets your State allows a CS to retain…. so under atty advice, this CS liquidates all $ above 132K and puts it into a SPIA in CS name only that pays the CS as low as possible mo amount so that the CS income btween the SPIA $ and their regular SSA retirement income is still not quite enough to live in their community, so their atty files for CSRA.

The facility or Medicaid caseworker tend not to proffer info on stuff like this as it’s financial advice, which they are not supposed to give.

CS / NH can be a minefield. Not a DIY. You as the CS are not - again for those in the back - ARE NOT expected to become impoverished. Only the NH spouse has to be impoverished for LTC Medicaid.
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AlvaDeer 15 hours ago
Wow, so glad you're here to answer this one, and it is indeed so complicated. Expensive as they are there are times it just has to go to the Elder Law Attorney.
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Yes, they look at the marital assets of the couple.
Now if, for instance, YOU have written a check to your darling grandson for his college education, and your husband did not agree with it or sign the check, but you insisted this was your 1/2 of marital assets to gift as you chose?
I haven't a CLUE how that works.

In the case of a married couple I unfortunately for their pocketbook ALWAYS send them to an elder law attorney to speak about marital assets, division of assets and anything else that they need to know regarding applications for Medicaid.

It is so important that you get EXPERT advice to walk through this, because you are trying not only to have a good "lookback" of five years, but you are going to have to protect marital assets for yourself that you may need for your own aging care.

Do seek qualified help. A Forum of strangers is just that. We aren't experts at anything, and whatever our experience it is unique to us. When you need expert legal, financial or medical advice you must see an attorney, a CPA or an MD.
Good luck.
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