As we or our parents age, we will be forced to confront how to receive quality long-term care. At a certain point, most aging adults will need assistance to meet their daily needs. Many times, this is done in an assisted living or skilled nursing facility. The concern becomes affording such care. Medical insurance rarely covers skilled nursing. Instead, the cost of such a facility may be covered by long-term care insurance, privately funded, or covered by Medicaid.
If you are married, the well spouse does not have to become impoverished to place the disabled spouse in skilled nursing. As a married couple, you do not need to spend all of your assets on care for the sick spouse. It is very poor planning to spend all of your hard earned retirement on the care of one spouse, and then have years or decades left in your own life with no way to pay for your basic necessities like food or housing. Instead, with proper planning, we can shelter assets for the well spouse staying at home while still providing for the sick spouse's care with the assistance of Medicaid.
Nevada Medicaid has specific rules that protect the well spouse staying at home when a sick spouse has to go into a nursing home. These rules make it unnecessary to spend down your liquid assets to poverty levels. Instead, the well spouse staying at home can keep the home, at least one car, and one-half of the couple's assets. In 2012, the well spouse can keep a minimum of $22,728; however, with proper court approval, this amount can be increased to $113,640. This is true even if these amounts are more than one-half of the couple's assets.
Additionally, Nevada Medicaid rules permit the well spouse staying at home to receive up to $2,841 of the parties' joint income by a proper court order, even if that is more than one-half the income. This is important because, even though the sick spouse has been moved to a skilled nursing facility, the well spouse's regular living expenses likely have not decreased. The mortgage and utilities still have to be paid.
These amounts are in addition to assets like the home and car. Nevada Medicaid will not consider your family home so long as the well spouse, or another dependent, resides there. Additionally, Nevada Medicaid will not consider your car, regardless of its value, or a pre-paid burial policy with a face value up to $1,500.
Medicaid rules can be complicated, but they are not impossible to navigate. In taking care of both spouses, it is wise to plan so that you can access the benefits available to you. This type of planning should be done as soon as possible after the sick spouse is diagnosed with a condition that might require an eventual move to skilled nursing - even if that move is months or years away. When properly planning, the well spouse at home can keep resources necessary for his or her own care and quality of life, while still getting long-term care for the sick spouse.
Cassandra Jones is an elder law and family law attorney in Gardnerville. She can be reached at 782-0040.