| It isn't just the US Government waiting out | | | | furnishings and personal effects. In some |
| there to grab a chunk of your hard earned | | | | states, the remaining spouse's IRAs are |
| estate when you become incapacitated or die. | | | | exempted, as well. The non-ailing spouse is |
| Strangely enough, state coffers are | | | | then entitled to half of any remaining |
| frequently enlarged through the mechanism of | | | | assets, subject to minimum and maximum |
| Medicaid. When someone requires long-term | | | | limits, while the other half must be spent on |
| care in a nursing home, unless he or she has | | | | the nursing home care. |
| a private long-term care insurance policy, | | | | |
| their whole estate may belong to the state | | | | In addition, income like Social Security, |
| when they pass on. | | | | some pensions, and some interest dividends |
| | | | are subject to "maintenance allowance," rules |
| Nursing home care is not free, even in county | | | | designed to allow the healthy spouse enough |
| or state operated facilities. Someone, | | | | money to live on. If, for example, the |
| somewhere, has to foot the bill. If you, or | | | | Social Security Income or other pension |
| your family, does not have resources to pay | | | | income is in the remaining spouse's name, he |
| for the care, Medicaid steps in. While | | | | or she is entitled to keep it for living |
| Medicaid is a federal program, funds are | | | | expenses. In some cases, the spouse at home |
| allocated to the states for administrative | | | | can receive more than half of the marital |
| purposes and are subject to state rules and | | | | assets, particularly if his/her income falls |
| regulations. | | | | below minimum levels. |
| | | | |
| People who apply for Medicare aren't always | | | | If there is no spouse, in many states the |
| aware of exactly how the program works, but | | | | individual requiring nursing home care is |
| even more sadly, most people who are forced | | | | required to sign over his or her home to the |
| to apply for Medicare really have no other | | | | state to reimburse Medicare. When the |
| choice, so it doesn't matter how it works. | | | | nursing home stay is not permanent, the |
| By the same token, Medicaid rules have been | | | | Medicaid recipient is allowed to live in the |
| revised so that if one half of a married | | | | house until death, but cannot pass it on to |
| couple requires nursing home care, the other | | | | children or other heirs, because it actually |
| spouse doesn't have to sell the house and | | | | belongs to the state, not to the individual. |
| live on the street. | | | | |
| | | | Estate planning, particularly if it involves |
| Under the most recent Medicaid rulings, when | | | | some sort of long-term care insurance, can |
| one spouse has to be in a nursing home for 30 | | | | alleviate or eliminate some of the worries |
| days or more, the couple's assets are | | | | associated with the potential for requiring |
| assessed and some assets are excluded by | | | | nursing home care. Talk to your attorney or |
| virtue of "spousal impoverishment" rules. | | | | other estate planner about what can be done |
| The couple's residence is excluded from the | | | | to protect your remaining assets if you have |
| asset evaluation, along with household | | | | to go to a nursing home. |