I know assisted living is not covered by Medicaid or Medicare. Here is the scenario: two married elderly people still live in their house. They get Medicare, and social security and pension money. The husband falls ill, unable to walk, incontinent, has dementia, and the wife can't care for him by herself. They make too much to qualify for Medicaid so he can go into a nursing home, but is this true? Are there ways around it? Just asking, looking ahead for someone, who is worried. (will consult an elder care lawyer eventually, just want some idea what to expect, what to ASK.) Please direct me to the proper pages pertaining to this, on this site? Thank you.
Lassie - omg wife is 70! She could live another 15 years....or more..... They need to get with elder law atty to figure out how to do community spouse planning ahead of the inevitable fall.
If he falls, EMS called, hospitalization happens & she doesn't take him home, then social services at hospital will find placement for him in a facility. But although this sounds fab as now he's not her problem, it cascades into problems for her...... they have assets, there are funds to pay for care, bills for his care will be stacking up cause Medicare & secondary insurers only pay so much. If she ignores the situation, facilities will issue "30 day Notice" & then contact APS or state to get an emergency ward of the state action done. & he will be made a ward with a court appointed guardian or conservator. They can start attaching assets as she's looked to have relinquished rights.
Their not your parents right? So are there kids and where are they in all this?
Will she go & meet with an atty? Or is this in inevitable trainwreck?
Basically what Miller does is it become the payee for monthly income and then Miller pays the individual whatever is your states monthly income limit with the rest staying in miller but reverting to the state in some way. There's a lot of prior answers on Miller on this site you can read. The "in some way" will depend on just how your state needs for this to happen as per state laws & how your state runs its Medicaid programs and how much CSRA / MMNA the CS is able to retain.
CSRA MMNA would be monthly income diverted from NH spouse (instead of all of monthly income going toNH as their required by Medicaid copay or SOC/share of cost) to CS to enable them to stay & pay for living in the community. Think of it kinda like alimony for the Medicaid NH set.
Really couples planning is complex. Get NAELA elder law atty.