What if My Spouse Requires Nursing Home Care in Massachusetts?

This is the second of several case studies designed to give examples of how Massachusetts elder law attorneys protect assets in the event a spouse requires nursing home care.

Mr. and Mrs. Jones are in their late seventies.  Their house is jointly owned and they have no mortgage.  Their life savings total $300,000. Ten years ago, Mr. Jones was diagnosed with Alzheimer’s disease.  Despite the stress of being the primary care giver for her husband, Mrs. Jones is in relatively good health with a family history of longevity.  After a decade of home care, Mr. Jones now requires 24 hour care, more than Mrs. Jones can afford or provide.  After a brief hospitalization covered by the Federal Medicare program, Mr. Jones is discharged to a local nursing home.  He will remain there for the rest of his life.  The Jones’s never met with an elder law attorney to plan for the possibility of Mr. Jones requiring permanent long-term institutional care.

After a month in the nursing home, Mrs. Jones is informed that her husband’s Federal Medicare benefits have expired.  She is told that she now has to pay privately until her husband qualifies for the Commonwealth’s MassHealth program.  In the meantime, she is handed a bill for $13,000 representing next month’s private nursing home cost.

The business office tells Mrs. Jones that her husband will qualify for MassHealth once she has reduced her assets to approximately $117,000.  They correctly inform her that she is over the program’s financial limit by approximately $183,000 ($300,000 – $117,000 = $183,000) and offer to help her for free with the Medicaid application after she spends down $183,000 on private care.  Or, they refer her to a non-attorney “Medicaid specialist” who will help her with the application for a small fee once she exhausts the excess $183,000.

In this example, folks who do not seek the advice of an elder law attorney end up unnecessarily paying $183,000 in private nursing home care.  How’s that “free” or non-attorney reduced fee Medicaid “specialist” sounding now?

People who meet with an attorney specializing in asset protection can often protect everything from a spend down.  Yes, the MassHealth asset protection lawyer is going to charge you to develop an asset protection plan and to qualify for MassHealth, but that fee is going to cost A LOT less than $183,000.

The asset protection lawyers of Oalican Law Group can often protect all of the assets for the at-home spouse despite what she heard from the nursing home, neighbors, or other attorneys who do not specialize in Massachusetts elder law.  MassHealth allows the community spouse to purchase a MassHealth approved annuity with the excess assets.  Properly done, this allows the ill spouse to qualify for benefits the day the annuity is purchased.   The asset protection attorney just protected the couple’s life savings.  However, we’re not done.  We also need to protect the house from a MassHealth lien.  So, part of our plan addresses protecting the house from the placement of a Medicaid lien even if the at-home spouse dies first (this often involves the community spouse changing her will).  Finally, we will prepare new estate planning documents to name someone other than the ill spouse as the new primary health care agent and attorney-in-fact for the community spouse.

In this classic “crisis” case, an experienced elder law attorney can often protect all of the assets even when no advance planning has occurred.   The real challenge is to educate yourself before blindly committing to a financial catastrophe by finding an attorney who truly specializes in this area of the law.

 

Regards,

 

Eric R. Oalican