Making The Complex

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Medicaid Spend-Down for the Nursing Home for Married Couple

The term “spend-down” involves someone who resides in a nursing home and does not qualify for Medicaid because they exceed the allowed assets. The excess assets are spent down to the amount allowed by Medicaid. Unfortunately, a full spend-down results in depleting countable assets down to $2,000. Families are often told that they are required to spend all of the applicant’s money on nursing home bills to qualify for Medicaid. Fortunately, there are other options available to preserve assets. In reality, the ability to avoid a full spend-down is most important for a Medicaid applicant who has a spouse at home.

An applicant who is single is allowed to have a maximum of $2,000 of countable assets. A common misconception is an unmarried applicant must spend-down to $2,000 to qualify for Medicaid long-term care. There are strategies available to preserve a significant amount of assets from spend-down.

The spousal spend-down rules for Louisiana Medicaid long-term care provide an additional exemption for the spouse at home. This additional exemption is called the Community Spouse Resource Allowance. In 2021, the Community Spouse Resource Allowance is $130,380.00. Assets in the name of the spouse at home (the community spouse) qualify for the Community Spouse Resource Allowance. In a nutshell, a Louisiana Medicaid applicant with a spouse at home has a total exemption from spend-down of $132,380.00 ($2,000.00 plus $130,380.00). If the couple’s countable assets exceed this amount, they are typically advised to spend-down to this level. Married couples have additional options available to avoid spending-down their assets and ethically qualify for Louisiana Medicaid. These strategies do not involve the five-year look-back for transfers. Alternate planning is a viable option.

If you have any questions call J. Douglas Sunseri, Nicaud & Sunseri Law Firm, LLC — 504-837-1304 or 504-957-5734 — [email protected] for a consultation.


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