Omg you both are still so young! Really dealing with Medicaid when it's 1 spouse who needs care and the other considered to be the "community spouse" needs a really good elder law atty. & IMO needs to be be who is NAELA. Your overwhelmed with day to day care and that needs to be your priority instead of trying to figure out how to do a spia or even determine just wtf a spia is.
The important part financially is that ONLY hubs needs to be improverished not you. Doing things to safeguard & move assets so that you do whatever to have funds for your own aging is complex. That's where the NAELA atty comes in. And whatever needs to happen has to be done BEFORE ever doing the medicaid application as Medicaid tends to set couples finances based on a "snapshot" day .... Usually it's the date of application. So if you need to sell a car as you all have two but Medicaid only allows for 1 to be an exempt asset, it needs to be done before the application.
Really couples Medicaid is not a DIY, you need a NAELA atty.
So what's a SPIA?.... A single premium immediate annuity. Personally I hate annuities as so often they are sold to elderly under conditions that likely isn't realistic for the elder but a SPIA is a very special situation annuity great for couples when 1 needs medicaid now & the CS could live for a long long time and they have a good bit of assets. Like say, hubs in his late 60's, still working has a major car crash and needs 24/7 NH care and his insurance is running out. Hubs has second wife in her 40's who works and they have kids under 18. Their assets over the allowed 119k for the CS will get moved into a SPIA in wife's name with Medicaid as the beneficiary. SPIA pays wife an income each month but her income is not included for hubs Medicaid eligibility only his is. If timing right the CS will outlive the SPIA so there will never ever be a payout to the state. If she's in her 40's or 50's and does it as a 20 yr annuity, she's gonna outlive it more than likely. SPIA are not DIYs. For a somewhat younger CS in their 40's - or even early 70's, they can really be a way to keep themselves from becoming impoverished but still enabling the ill spouse to qualify for Medicaid.
Are you thinking about applying him for Medicaid, so he can get nursing home care covered? I assume that he is disabled, and that's why is receiving Medicare at age 59. Has he been told that he needs skilled nursing care? I'd explore what is available in your state to meet his level of need. Then, I'd consult with an attorney who knows Medicaid law and can explain what you can expect. There are some on this site who may be able to provide more info. There are guidelines as to what is counted for the two of you and also how much the non-recipient can keep. I'd try to get this information before you apply and before there is a snapshot date, which is the day they view and value your assets.
Oh my goodness... my heart goes out to you. No, they can't take your home. You need it. But they can take some of his assets. Depending on the state, that varies and I'd advise you consult your equivalent of ADRC or Agency on Aging. Ours in Broward county, south FL for example, is ADRCBroward.org - I'm sure you have such an agency, but state laws differ a lot, so consult them asap. I know I join others here online to pray for you. You can do this, I'm sure you have done it for a while. Wondering if he can go to AL instead of NH, to maintain a bit more quality of life in the interim... Best of luck in finding the answers and the strength you need. Doreen from Angel House ALF in south FL
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The important part financially is that ONLY hubs needs to be improverished not you. Doing things to safeguard & move assets so that you do whatever to have funds for your own aging is complex. That's where the NAELA atty comes in. And whatever needs to happen has to be done BEFORE ever doing the medicaid application as Medicaid tends to set couples finances based on a "snapshot" day .... Usually it's the date of application. So if you need to sell a car as you all have two but Medicaid only allows for 1 to be an exempt asset, it needs to be done before the application.
Really couples Medicaid is not a DIY, you need a NAELA atty.
So what's a SPIA?.... A single premium immediate annuity. Personally I hate annuities as so often they are sold to elderly under conditions that likely isn't realistic for the elder but a SPIA is a very special situation annuity great for couples when 1 needs medicaid now & the CS could live for a long long time and they have a good bit of assets. Like say, hubs in his late 60's, still working has a major car crash and needs 24/7 NH care and his insurance is running out. Hubs has second wife in her 40's who works and they have kids under 18. Their assets over the allowed 119k for the CS will get moved into a SPIA in wife's name with Medicaid as the beneficiary. SPIA pays wife an income each month but her income is not included for hubs Medicaid eligibility only his is. If timing right the CS will outlive the SPIA so there will never ever be a payout to the state. If she's in her 40's or 50's and does it as a 20 yr annuity, she's gonna outlive it more than likely. SPIA are not DIYs. For a somewhat younger CS in their 40's - or even early 70's, they can really be a way to keep themselves from becoming impoverished but still enabling the ill spouse to qualify for Medicaid.
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Doreen from Angel House ALF in south FL