Spousal Responsibility for Nursing Home Care

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learner15
Posts: 22
Joined: Wed Mar 04, 2015 3:49 pm

Spousal Responsibility for Nursing Home Care

Post by learner15 »

Hi All,

This is my first post of probably several to come. I just read the Bogleheads' Guide to Investing and it really got me thinking. I have often considered Long Term Care Insurance but never "pulled the trigger". It's back on my radar now. One question that I have is how much responsibility the spouse has for paying for any nursing home care. I'm recently married and am wondering if one of us needs care, will the other have to deplete their financial resources to pay for it? Is there any protection for the spouse? Thanks for any insight you can provide.
Last edited by learner15 on Sun Mar 08, 2015 9:53 am, edited 1 time in total.
mhalley
Posts: 8871
Joined: Tue Nov 20, 2007 6:02 am

Re: Spousal Responsibility for Nursing Home Care

Post by mhalley »

So there are three ways to pay for nursing home care. One is self insure, ie, make enough money so that when you or your spouse needs nursing home placement, then you have it covered. I think that is generally about 3 million. The next is long term care insurance, that is say 250k-3million. (Just a guess off the top of my head). The third is medicaid. Basically, you have to spend down all of your assets until you are eligible for medicaid. When you are married, the nh is going to send you the bill. There are ways that people can finagle their finances, but there are strict rules about when you can divest yourself of assets to attempt to qualify for medicaid. There are some provisions to help keep the spouse from becoming impoverished due to nh costs: http://www.medicaid.gov/medicaid-chip-p ... -page.html
In general, you don't want to buy it until you are around the late 50s.
Here is Clark Howards suggestions about ltci: http://www.clarkhoward.com/news/clark-h ... roll/nFb3/
Mike
Note: looks like the monthly income for medicaid in ct is $1743 for family of 2.
barber
Posts: 61
Joined: Sun Feb 25, 2007 12:50 pm

Re: Spousal Responsibility for Nursing Home Care

Post by barber »

Bill M
Posts: 438
Joined: Sun Dec 30, 2012 10:10 pm

Re: Spousal Responsibility for Nursing Home Care

Post by Bill M »

In our case, the top reason for long-term-care insurance was to protect enough of our savings from the Nursing Home, so the health spouse can sill live somewhere. What Medicaid lets you keep isn't much....
Topic Author
learner15
Posts: 22
Joined: Wed Mar 04, 2015 3:49 pm

Re: Spousal Responsibility for Nursing Home Care

Post by learner15 »

Thanks all, for your thoughtful responses. I began looking into it a bit more myself and found these other resources that may be helpful as well.

http://aspe.hhs.gov/daltcp/reports/spouses.htm
http://newoldage.blogs.nytimes.com/2010 ... ed-spouse/

What a difficult decision...
Last edited by learner15 on Sun Mar 08, 2015 9:52 am, edited 1 time in total.
billyt
Posts: 696
Joined: Wed Aug 06, 2008 9:57 am

Re: Spousal Responsibility for Nursing Home Care

Post by billyt »

An elder care attorney in your state can be a valuable resource in sorting out your options.
whomever
Posts: 1071
Joined: Sat Apr 21, 2012 5:21 pm

Re: Spousal Responsibility for Nursing Home Care

Post by whomever »

We consulted with an elder care attorney. This is local to WA.

My takeaway is (but I might be misunderstanding or misremembering, consult your own attorney in your state):

1)Any assets above rather small limits (see the pdf referenced in the medicaid link posted upthread), whether titled in either name or jointly go to pay for care, with an exception for...
2)...some kind of special trust ('Medicaid trust'???). I didn't follow this all that closely, because it wasn't the kind of thing you'd do beforehand, and I figured the rules would probably change by the time one of us might need care (we're young and healthy). But the idea was to preserve a legacy (which we don't care about).
3)Income (above the limits) that comes in the name of the person in the facility or that that comes in joint names goes towards care.
4)Income that comes in the community property spouse's name only (SSA, pension, annuity) stays with the community spouse without limit.

So we plan to arrange for either of us to be able to scrape by on SSA/pensions/annuities, if the worst happens. There is always a risk, of course, that the rules will change.

(as far as the morality of sponging off the taxpayer, we'll be able to pay for several years of care. For us, this is about the rare situation where, say, one of us has a stroke early and is in a facility for 20 years or whatever. LTCI doesn't help a lot there)
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