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I need to have my husband go to a skilled nursing facility. To get Medicaid help, I will have to spend down. My elder lawyer said to buy a house or condo. Buy it outright, no mortgage. I am uncertain how to proceed. I looked at one condo . I also today have a tour of the nursing home. This is all very confusing to me. Christine

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I know I'm a broken record, but you might want an Aging Care Specialist to help you. Ours is a Social Worker with over 30 years of experience and while she is very clear that she does not give legal advice, it is apparent by the questions she asks in the lawyer's office that she knows exactly what needs to be done. She reframed what the lawyer was saying in terms that were easily understood by the elderly person making the decisions.

You might find it helpful to have someone explaining things to you in plain English. My advice: Interview three. Pay by the hour. It will be worth it.
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Christine;
I found an article under "Paying for Care" that explains a lot about Medicaid; this section of it may give you some good information.


Strategy #5: Spousal Transfers and Spousal Refusal
An important feature of the Medicaid laws is that transfers between spouses are permitted, are not subject to the look-back period, and thus do not result in any penalty. In the case of a married couple, one of the basic strategies is to transfer any assets that are in the name of the spouse who needs care to the name of the well spouse. (In cases where the ill spouse is in an institutionalized setting such as a nursing home and the well spouse remains in their home in the community, the well spouse may be referred to as the “community spouse”).
New York and some other states permit something called “spousal refusal.” In these scenarios, the well (or community) spouse will refuse to provide support for the spouse who needs care. As a result, the spouse who needs care will be immediately eligible for Medicaid and receive services.
Once Medicaid provides services, it has the right to seek contributions from the well spouse. In some cases, however, Medicaid does not pursue its rights, and in other cases it is willing to settle at a discount. At a minimum, the well spouse will receive a significant benefit because any reimbursement to Medicaid will be at Medicaid’s discounted rates, rather than at the private pay rates that the providers would have charged. Unfortunately, most of the states are “spousal share” states that do not permit spousal refusal. In these states, the resources of both spouses are counted towards the Medicaid eligibility amounts, and the above strategy is therefore ineffective.
Some specialized elder law attorneys are very familiar with their state’s Medicaid programs and are able to work within the laws to produce favorable outcomes for their clients. Bear in mind that every case has its unique facts, and the strategies discussed here may or may not be a good fit for your family. It is best to find an attorney who specializes in Medicaid planning in your state and seek a consultation.
David Cutner is a former family caregiver and co-founder of Lamson & Cutner, a boutique elder law firm in Manhattan known for its successful strategic planning and insights into the issues of today’s elder law maze.
Asset Protection Elder Law Financial Planning Long Term Care Medicaid Paying for Care
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Epiphanytoo Jul 2018
Great article info but I have one slight complaint and that is you have to read carefully for several lines before you come to the most CRUCIAL point: that is that these rules vary state by state. So in cases of Medicaid, you should always begin with an examination of the STATE laws, because there is no "one answer". Epiphanytoo, former full time caregiver and current in-law of someone in nursing care.
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Christine;

I feel for you! If you are confused by what the lawyer is telling you, please ask him or her to explain it better. Is this lawyer a certified eldercare attorney? Not just someone who claims they know all about Medicaid?

Do you currently own a home?
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