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Should I Spend Assets, so Spouse’s Nursing Home Stay Is Covered by Medicaid?

McNair Dallas Law

Older woman in a wheel chair with her husband and daughter.

My spouse is going to have to move to a nursing home. When spending down assets for the sick spouse to qualify for Medicaid, does it have to be done before sick spouse is sent to a nursing home or can it be done even after the sick spouse is admitted to a nursing home?

MarketWatch’s recent article entitled “Do I have to spend my assets before Medicaid will pay for my spouse’s nursing home?” cautions that the rules for Medicaid coverage of nursing home care are very complicated. Medicaid is the federal-state safety net program for healthcare, and it pays for nursing home care.

However, to qualify, nursing home residents must prove that they’re impoverished under Medicaid’s rules. These rules are different in each state.

In Texas, to be eligible, a single applicant must have “countable” assets of fewer than $2,000. Almost all assets are counted against this limit except for the resident’s home, which isn’t countable provided its fair market value (less any mortgage) is less than $688,000 (in 2023).

If the nursing home resident is married, their spouse — known as the “community spouse” — may keep up to $148,620 (in 2023) of the couple’s combined countable assets. This is known as the community spouse resource allowance or “CSRA.”

There are other safeguards in place to help ensure the “community spouse” retains assets to pay for their own future care.  It is essential to meet with an Elder Law Attorney who can help the couple plan for the future.

Texas Medicaid will look back over the 60 months prior to the application.  If the applicant or his or her spouse violates Medicaid’s spend-down rules, a penalty will be assessed, delaying approval for Nursing Home Medicaid benefits.

Contact our office today to ensure that your planning is done properly.

Reference: MarketWatch (Oct. 22, 2022) “Do I have to spend my assets before Medicaid will pay for my spouse’s nursing home?”

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