My Family Member Needs Assisted Living Now… What Do I Do?
The cost for nursing home care in the State of Wyoming averages $7,635 per month private pay rate, with some homes costing as much as $10,000 per month. While some families may be able to afford these payments for a little while, it doesn’t take long to spend a life’s work on medical care. Once an individual qualifies for Medicaid, that rate drops down significantly, for example $1,500 per month. This is because Medicaid sets the rate it will pay for nursing home care.
In the State of Wyoming, in order to qualify for nursing home care, the institutionalized individual (the one in the home) can only have non-exempt assets (we will get to this) of $2,000 or less. That is basically nothing. They can also have monthly income of up to $2,742 per month. If the institutionalized individual is married, the Community Spouse (spouse of the Institutionalized individual) can have up to $148,620 of non-exempt assets and a monthly income of up to $3,715.50.
Medicaid exempts from the calculations above the following Exempt Assets: primary residence up to $688,000 (under certain conditions), funeral expense trust up to $15,000, a vehicle, household furnishings and appliances, personal effects and clothing, and cash value life insurance up to $1,500. A qualified account of the Community Spouse (IRA, 401k, etc.) are exempt, but the Institutionalized Spouse’s qualified account is not an exempt asset.
The nursing home often advises people wanting to qualify for Medicaid to spend their assets on care until they meet these impoverishment rules (basically go broke) and then apply for Medicaid. By this point, there isn’t much left. This results in more income to the nursing home, while spending your family’s inheritance.
Clients often ask us why they can’t just give their assets away to qualify for Medicaid. Under the Medicaid rules, any gift made within 60 months of applying for Medicaid benefits (Lookback Period) will be added back into the client’s assets. This creates a Penalty Period, meaning the client has to pay out-of-pocket at the private pay rates for the number of months to pay back what was given away. For example, if our client Joe gave his son Ted $50,000 and the private pay rate at Joe’s nursing home is $10,000 per month, Joe would have to pay out-of-pocket at the private pay rate for 5 months before Medicaid would start paying for his care. If the client no longer has those assets, they still have to find a way to pay for care. If Ted spent all that money, Joe has to find a way to pay for his care until the penalty period is over. It can be a real mess.
Our team works with families to find ways to qualify clients for Medicaid earlier, while maintaining as much of their assets as possible. If you are considering nursing home care for yourself or a loved one, it's important to understand the costs involved and the options for paying for this care. Come visit with us and we will work with you to help you understand your options for care and qualifying for Medicaid benefits.
We can also help your family create a plan to protect assets long before you need to qualify for Medicaid. Planning early is best, but even if you are about to go into the nursing home, there are steps you can take to preserve your family legacy. Call Lubnau Law at (307) 682-1313 to see how we can help your family.