I went to an Eldercare lawyer who wanted to charge me exorbitant fees to rewrite my healthcare papers as well as rewrite my will which he had just done two years prior. He said they needed to be updated. I know he was just trying to get more money! So my question is now that I know it will be 5 years or less until I have to place my husband in a NH, what papers should I be saving? Do I have to save ALL receipts for 5 years? (seems impossible to keep it organized.) Or exactly what should I be saving and what should I not be spending money on in order to be eligible for Medicaid? I do know that I cannot give money gifts to my grandchildren, and I assume my children also. That is about all he could tell me besides I COULD spend money on house repairs and improvements. He said I could even take a vacation and it would be OK? I am so confused about this. Can anyone help me?
For couples, the car(s) are often a problem. Medicaid for NH allows for 1 (one) car. Most couples have 2 cars. If you gift the car to a grandkid, that triggers a Medicaid penalty issue. What seems to work best is for couples to take both cars, trade them in and then get 1 newer and more dependable car and pay in full for it.
If you still have a mortgage, often what is good is to take any excess $ and pay off the mortgage entirely. Although Medicaid does allow for their monthly income to be diverted to pay for maintenance for the community spouse if need be, the maintenance (MMNA) is usually pitifully low. If it's a May-December marriage, often the community spouse has to go to court to get the MMNA increased (kinda like going to court to get more alimony).
What is kinda critically important for couples is that Medicaid does a "snapshot" day on their finances in which whatever their assets are is set on & fixed to that specific day. The day can be the date of application or the date of admission, you need to find out what's what for your state's Medicaid program. So whatever you do financially needs to clear through your bank accounts before the snapshot day. If you are paying off a mortgage, this can take time and you need to get this cleared out & cancelled before the snapshot day. Often for couples, they need to keep them at home a couple of months to get everything done financially so that the community spouse can retain as much assets and spend-down and clear through before the "snapshot". Good luck and try to stay calm & organized.
OK how Miller works is:
each state sets the exact "income" that Medicaid allows. Like for Texas when I applied for my mom, the income ceiling was $ 2,094.00. Now my mom's monthly income was $ 1,800 a month so she was under so no Miller.
But say my mom's monthly income instead was $ 3,500.00 as dad was a railroad retiree. RR retirement is extraordinarily high. Each month guaranteed $ 3,500, is quite a lot for living @ home but not enough to private pay for a NH. Now mom qualifies in all other ways for Medicaid, except that income is $ 1,406.00 too high every month. A Miller Trust is done to divert her income to the trust so that the trust gets the excess income of $ 1,406.00 and then mom gets $ 2,094.00. Presto! Voila! Mom now qualifies for Medicaid. The excess $ each month into the trust is the property of the state and upon mom's death reverts to the state 100%. There is no MERP action on it as the trust beneficary is the state .
Now for Miller the income has to be from a guaranteed source of funding but most larger pay retirements do that anyways. Miller does need to be established by an elder law attorney so that it is flexible (for changes in income) and adaptable for your state laws on trusts, banking, etc. You have to have it legally set up Miller. It's really not a DIY project imho.
Regarding legal fees if you are able to get a consultation from an elder law attorney and the main paperwork done (DPOA, MPOA, will or codicil to an old will, an AD) for under 1K that is a pretty good price. For my mom, we did this ages ago with an estate attorney (as elder law was not the speciality it is now) and it was a % of the estate (kinda like what probate attorneys do) and it was much more. Also if your state allows a "Guardianship in case of Incapacity" ask about doing that too.
I agree with pstegman, call your state department of aging for specific help in your state.
Assets are cash, money in checking or savings accounts, credit union accounts, stocks, savings bonds, trusts, annuities, or any other money that you have saved or invested. Assets also include things like boats, trailers, real estate, and life insurance policies or other expensive items you may own. Medicaid does not count as assets the home you live in or personal property (e.g., clothing, furnishings, car). So make a list of those assets with account numbers and dollar value. Call your MD office of the aging for help 1-800-243-3425.