Listen to Lawrence…Medicaid Eligibility with an Irrevocable Trust

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CLIENT QUESTION:
After spending time in the hospital, my wife was sent to a nursing home for therapy where she suffered a stroke. I don’t know if she will be able to return home. There may be a time that I have to evaluate her assets. Over 20 years ago I established an irrevocable trust with you. I left out of the trust some assets. I have joint bank accounts with her and me, bonds in both my and my son’s names. Are her assets considered all of the value or half? By the end of March, she will spend about 100 days in the hospital and nursing home. Is there any government program to help the cost?
MY RESPONSE:
First, let me say that my heart goes out to you, your wife, and your whole family. This has certainly been a difficult year for everyone and now worse for all of you. UGH!
Okay, first we have to determine if she can come home. If she can, Medicaid may be available to pay for an aide to assist you in taking care of her. Medicaid, will most probably not pay for an aide 24/7 so we need to address the reality that you will need to supplement the cost if you need more hours. On the other hand, if she remains in the nursing home full time, we can get Medicaid to pretty much pay the whole bill.
How is this possible?
To be eligible for Medicaid, your wife has to be poor, that is she cannot have assets of more than $15,900 in her name. Your case is made easier because you set up an IRREVOCABLE MEDICAID ORIENTED TRUST more than 5 years ago. All the assets in the trust are now protected! Good job!
The fact that you still have assets in her name will not be a problem though. The general rule is that jointly held assets between a husband and wife are considered 50% owned by each. However, we will now transfer all of the assets out of your wife’s name into your name. There is no Medicaid transfer penalty between spouses. With all the assets out of your wife’s name, she will now be eligible for nursing home and/or home care (community) Medicaid, subject to what is called, “spousal refusal.” Spousal Refusal is just you saying that you refuse to use your assets to pay for her at this time. Sounds too easy, right, but that is what you will do and she will get Medicaid to pay for her care.
As to the joint bonds with your son, you will only be considered a 50% owner and this amount will also be protected under your spousal refusal declaration. Of course, I will need to see all your financial and other information to really fine-tune this plan, but in general terms, this is how this will all work. We need to move fast here, so call for an appointment ASAP.
I hope all my readers will learn from this real-life fact pattern because this is a typical situation that we deal with every day.
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