How do I spend down assets for Medicaid?

• December 14, 2021
• CLLB Law
• Estate Planning

Many older adults find in their later years that they need long-term care, whether in-home, in the community or in a nursing home. To be eligible for Medicaid long-term care benefits, a person must meet certain state income and asset guidelines. Much like the tax laws, the Medicaid laws are filled with exceptions to the rules. On average in Kentucky and Indiana, with the help of a Medicaid planning attorney, married couples will save 95% to 100% of their assets and obtain long term care benefits for the incapacitated spouse. For a single person, families can often save at least 50% of their aging parent’s assets and obtain long term care benefits. With advanced planning, a single person can often save even more.

To protect your hard-earned assets, it’s extremely important to employ an attorney who regularly files for Medicaid benefits for those aged 65 and older. The laws and local customs are complicated and can be overwhelming for a novice. Mistakes are costly in both time and money. It’s critical that you follow the rules exactly, otherwise you risk being denied Medicaid. With facilities in Southern Indiana and the Louisville Metro Area costing on average $7,500 to $9,000 per month, a denial of Medicaid benefits is not an option.

One of the most important Medicaid rules is that you cannot spend down your financial resources by “gifting” – giving away your money and assets to children, grandchildren, or others simply to reduce your balance sheet to come in under Medicaid eligibility cut-off levels. Spend-down rules are complicated and precise, and the best way to make sure you navigate the rules successfully is to hire a skilled Medicaid lawyer. The estate planning attorneys at Church, Langdon, Lopp, Banet Law are highly experienced in Medicaid and in preserving your hard-earned assets. We would be glad to help you.

It’s important to remember the difference between Medicare and Medicaid. Medicare is a program administered by the federal government that provides health insurance to older and disabled Americans. Medicaid is a program administered by the states and provides healthcare benefits to low-income Americans. Most older adults already have Medicare, but this blog focuses on qualifying for Medicaid benefits in Indiana and Kentucky, to preserving your assets, and to covering the cost of a nursing home.

What expenses qualify for a Medicaid spend-down?

An attorney explains nursing home spend-down.

A skilled estate planning attorney can evaluate your financial situation and guide you through a strategy to preserve your assets and qualify for long term care benefits based on Medicaid guidelines. For a married couple, a skilled Medicaid attorney can often preserve 95% to 100% of your assets. For a single person who has not completed the proper estate planning, that savings is often reduced to 50% of the assets. If there is a “spend-down” component to a single person’s Medicaid plan, the “spend down” can include the purchase of the following items:

• Pay off a mortgage, credit card debt, or car loans
• Buy a new house
• Update and repair your existing home
• Buy a new vehicle to replace an older one
• Prepay funeral and burial expenses
• Spend on medical equipment and care not covered by Medicare or Medicaid
• Buy new household and personal items like furniture and clothing
• Increase in-home caregiver services.

As stated above, you cannot gift assets to family members or others as a way to get around Medicaid qualifying limits.

The American Council on Aging (ACA) offers a wealth of information about all the things older adults may grapple with.  The ACA provides Indiana and Kentucky Medicaid Income & Asset Limits here and here that can be helpful to older residents wanting a primer on Medicaid eligibility guidelines, including definitions of “income” and “assets.”

Medicaid’s Approach

Medicaid is the payor of last resort – it pays when there is no one else left to pay. Medicaid is a needs-based program; if you meet the financial and other requirements, you are entitled to the benefits of the program.

There are certain preliminary requirements to obtain Medicaid eligibility for some or all of nursing home monthly charges. In Kentucky, you need to be in a nursing home, not in assisted living or independent living or personal care. In Indiana, the Medicaid Waiver program may provide you Medicaid benefits for home based or assisted living care. If your loved one is in a nursing home, both states require the Medicaid applicant to reach a level of care called “skilled nursing care.” The applicant must also be in a Medicaid bed.

The State allows each nursing home to have a certain number of Medicaid-eligible beds. If the nursing home already has its quota of Medicaid residents, you will not get Medicaid coverage at that facility. Thankfully, the Louisville Metro and Southern Indiana areas are filled with superb nursing homes with highly trained staff.

Medicaid’s basic philosophy is that the nursing home resident, and his or her spouse, should pay for that resident’s nursing home care before the taxpayers are required to assist. Unless you know the rules and know how to use them to your advantage, then the common result is that if you have worked your entire life, lived carefully, paid your taxes, saved for retirement, and played by the rules, you will go broke in a nursing home before Medicaid will agree to help.

Federal law does not require such a punishing outcome. State administrators, however, often enforce local customs not found in the federal Medicaid law that results in families losing their life savings to the nursing home.

Choosing the Right Estate Planning Attorney

If you or your loved one is in a long-term care crisis or in need of long-term healthcare and financial planning, our estate planning attorneys are some of the finest in the region. We help families find solutions to preserve their assets and to manage their elder care needs. We regularly apply for Medicaid benefits in Indiana and Kentucky using legal and financial strategies to preserve your assets and to gain you and your loved ones the healthcare they deserve. The goal of Church, Langdon, Lopp, Banet Law is to allow families to remain focused on the most important aspect of aging: enjoying their lives together.

We maintain offices throughout the Kentuckiana area, offering the necessary guidance to older adults with our estate planning lawyers in Louisville and estate planning attorneys in Jeffersonville. Likewise, our New Albany, Corydon and Clarksville elder law attorneys have also helped their neighbors with the challenges faced by aging siblings, spouses, parents and grandparents. When it’s time for you or your loved one to enter a nursing home, you want to make sure that as many of your assets as possible are protected. You can do this by qualifying for Medicaid and following the appropriate rules. We can help you with that.

To learn more about our estate planning lawyers, you can read their attorney bios here. You can also read testimonials from our highly satisfied clients. We pride ourselves on providing the highest level of client service and are committed to open and frequent communication.

Contact an Elder Law Estate Planning Attorney Today

If you want to learn more about spending down assets for Medicaid, the skilled elder law estate planning attorneys at Church, Langdon, Lopp, Banet Law would be glad to help. We have first-hand experience with the challenges and obstacles to preserving finances when faced with entering a nursing home. A lifetime of savings and assets can disappear within months. There are legal ways you can prevent this through informed estate planning. To find out more about how we can help, call us at 812-725-8224.