It is scary if your spouse is in need of Texas Medicaid nursing home benefits. Nursing homes cost a lot of money that most people do not have available to spend in their retirement years. Fortunately, with good advice many couples are eligible to qualify for Texas Medicaid nursing home benefits without losing everything. Some couples can even keep all of their assets. Let’s look at the story of Tom and Helen:
Tom and Helen have lived in Houston their entire adult lives. Two weeks ago, Tom and Helen celebrated their 50th wedding anniversary. Yesterday, Tom, who has Alzheimer’s, wandered away from home while Helen was grocery shopping. The police found Tom wandering the neighborhood hours later and took him to a hospital. Tom’s doctor has just told Helen that she needs to place Tom in a nursing home where he can receive the level of care that he needs. Concerned about nursing home expenses, Helen together a list of their assets:
$ 5,000.00 – Checking Account
$ 50,000.00 – Savings Account
$ 50,000.00 – CDs/IRAs
$150,000.00 – Residence
In addition to their assets, Tom receives a Social Security check for $800 each month and Helen receives Social Security of $400 each month. Helen begins to research nursing homes to find the best one for Tom and soon discovers that the average cost of a nursing home is over $4,500 every month! Helen’s afraid that everything they have worked for their entire lives will be consumed by nursing home expenses and, even worse, she will be left penniless to pay for her own monthly bills in less than three years.
There is good news for Helen. Texas offers the Medicaid program to help pay for nursing home care expenses. It is possible that Tom and Helen will not have to lose everything they have worked for to pay for nursing home expenses. The process may take some time, but the results are usually worth it.
To apply for Medicaid, Helen will have to go through the Health and Human Services Commission (HHSC). If she does things strictly according to the way HHSC tells her, she may only be able to keep approximately one-half of their assets. The rest of their assets would have to be “spent down” before Tom would qualify for Medicaid benefits.
In most cases there is an alternative to the traditional “spend down.” That is because federal law protects Helen so that she does not have to impoverish herself before Tom can receive Medicaid benefits. The challenge is that Helen cannot take advantage of this protection at the case worker level.
In order to ensure that she keeps as many assets as she is entitled to, Helen must go through the fair hearing process. She must proceed properly and she should have an attorney advising her of her rights throughout the process because the fair hearing carries significant legal ramifications with respect to Tom’s eligibility for Medicaid benefits and the amount of assets Helen can keep. But with proper advice, Helen can avoid such a large spend down.
This is an example where knowledge of the rules and how to apply them can make a substantial difference in the outcome. Consult a Texas Medicaid Attorney regarding your rights if your spouse has applied or is expected to apply for Medicaid benefits.
Need a name of a Medicaid Attorney in Bexar County.
Dear Mr. Shea, My landlady is disabled and is currently in a type of residential/hospice setting and not expected to live more than a few months. Her daughter has asked me for some info about the Miller Trust. My landlady owns a home which I currently rent from her for $600 per month plus utilities. I am also disabled under SSA guidelines and I cannot afford to move. My landlady’s expenses for her care exceed her income substantially and her children currently have to pay the difference. Will a Miller Trust for her SSA retirement, annuity and my rent payments give her protections under the Miller Trust provisions? Her family is considering selling the home to me if I can afford it on my SSA disability check. Any help would be greatly appreciated. Many thanks. Chris
My mom has no property of anything of value. She does have retirement income (civil service $1302 and military reserves $545) and divorce property income (her 1/2 of my dad’s military retirement check $727.50) and her social security check is $117 per month. Can her divorce settlement be excluded from the eligibility? If so, I think she could qualify for Texas Medicaid benefits for nursing home.
I have her in a private non-licensed facility and she desperately wants a better place. She has stage IV colon cancer that has spread to her liver and lungs. She is currently under Hospice care.
Please advise.
Maggie
My son Joseph M. suffered a stroke on June 26, 2009 and all indicati;ons are that he is headed for long term care in a month or two is 30k gross short term care stops in Dec. then long term kicks in at about athe same rate. I don’t see how a Miller Trust can help since he is single. He is totally incapacitated and improving slowing – going home with him would be most difficult. Social Sec. is determining his disablity staus which should come athrough in a month or so…is reducing his income through legal means possible to qualify him for Medicaid?-
A Miller Trust can work if the Medicaid applicant is single or married. The key issue is if the Medicaid applicant receives too much income to be eligible for Medicaid benefits.
Every asset and source of income that is available to the Medicaid applicant is considered available. From the perspective of Medicaid eligibility, if an applicant’s income exceeds the limit the fastest way to fix it is with a Miller Trust which can be completed within a couple weeks generally. With income from a divorce, a long term option may be to modify it through the divorce court, but that will probably take longer and may cost more.
A Miller Trust does not “protect” assets or income. It is a tool to re-characterize income so that it is within the strict eligibility limits. A Miller Trust in no way increases the income or assets that a Medicaid recipient can keep, its only purpose is to restructure a person’s income to fit within the eligibility standards.
Responded to via email.
am looking for the DOWNLOAD of the application form! Where is it?
The Medicaid application can be downloaded on the following page as described above: http://texastitle19.com/texas-medicaid-application/