A Six Figure Medicaid Mistake (Part 3)
In this week’s post I continue with the story about a recent call we received in our office from a family concerning a Medicaid denial. The nursing home employee processing Dad’s Medicaid application misunderstood the rules with respect to married couples. As I explained last week, Mom was told she did not need to provide statements for assets in her name, just ones for assets owned by her husband, the Medicaid applicant. This was incorrect.
But, what was also missed by the facility’s employee was the fact that the non-Medicaid spouse has an asset limit to meet in addition to the $2000 limit for the Medicaid spouse. That limit is 1/2 of the combined assets owned by either or both spouses but only up to a limit of $157,920. (There is a common misconception that this is actually the amount the spouse can automatically keep but it’s just the maximum amount. You still have to do the math which can result in a lower number.)
So we needed to do 2 things – determine what that number is and then spend down below that number. Every month this doesn’t happen means that Mom must spend another $12,000 towards Dad’s care because he is not yet Medicaid eligible.
But what is that number and how is it calculated? We know that at any point in time the amount of assets we have changes. Income comes in and expenses go out of our accounts. So calculating 1/2 depends on what date you use. That date is known as the snapshot date – the first moment of the first day of the first month of continuous institutionalization. That would be based on when Dad entered the nursing facility if directly from home or the hospital from which he then was transferred to the facility never having returned home.
In our case, Dad had last been home 16 months ago. He then was admitted to the hospital and from there entered the nursing facility. So, we needed to know the value of all assets owned by both Mom and Dad as of the close of business on the last day of the month before Dad entered the hospital. That was their “snapshot date”.
Next week I’ll tell you what we needed from Mom to calculate this number.