Nebraska Department of Insurance
THE NEBRASKA SENIOR HEALTH INSURANCE INFORMATION PROGRAM (SHIIP) NURSING HOME RESIDENT WITH A SPOUSE AT HOME BROCHURE
NURSING HOME RESIDENT WITH A SPOUSE AT HOME
Spousal Impoverishment Protection Law (1989)
This federal law protects spouses of nursing home residents from losing all of their income and assets to pay for the nursing home (NH) spouse's care.A couple's assets and income will be divided according to the Spousal Impoverishment Protection Law. To get Medicaid help for NH care, the assets of the person needing this help must be $4,000 or less. Medicaid is handled by the Nebraska Department of Health and Human Services and there is an office in most counties.
What would happen if your spouse was not able to live at home due to poor health or confusion? Would we have to spend all of our resources to pay for the nursing home (NH) care?
Let's look inside the home of Ward and June.
Ward is not able to take care of June at home any more, due to her health. He is thinking about admitting her in the long-term care facility (nursing home) down the street.
- They own about $100,000 in resources (assets).
- Their total income is $1,800 per month.
Q: Does Ward have to spend all of their money before the State helps pay for June's care?
A: NO, because of the Spousal Impoverishment Protection Law.
INCOME
Under Spousal ImpoverishmentAt-Home Spouse Income in your name remains your own (Social Security, pensions, interest, dividends, etc.)
The spouse at home will keep all of his/her personal income.
Nursing Home Spouse The spouse in the nursing home (NH) may be required to use most of his/her income to pay for his/her care, except for a personal allowance of $50 per month ($90/mo. for veterans).
Spouse may be able to keep more:
After the income has been split, if the spouse at home gets less than $1,605 every month, he/she may keep part of the NH spouse's income, giving them at least a monthly income of $1,605.
If the spouse at home has to pay high rent, mortgate or utilities, he/she may be able to keep more of the NH spuse's income. Example: (from Ward and June) Ward will keep all of his income. Remember, if Ward's income was lower than $1,605 per month, then he could keep part of June's income.
Checks made out in June's name would be considered hers and would go to the NH to pay for her care, unless a portion is needed for Ward. (June may have $50 from her income each month, as her allowance for personal needs.) June will also continue to pay her Medicare Supplement insurance premium with her income.
ASSETS
Under the Spousal Impoverishment Protection LawMost assets (such as bank accounts, stocks, bonds, etc.) are considered as joint assets between husband and wife. (It doesn't matter in whose name they are placed.)
What amount of assets the spouse at home is able to keep?
- Maximum: - at least half of all countable assets, up to a total of $95,100 in 2005.
- Minimum: - at least $19,020 in 2005.
Example: Total assets owned by Ward and June are $100,000. Half of Ward and June's assets are $50,000. This gives Ward a reserved asset amount of $50,000.
The couple would need to spend their income and assets down to the reserved $50,000, plus $4,000 that is allowed by Medicaid (a total of $54,000), before Medicaid would begin to help pay for June's nursing home costs.
In addition to 1/2 of the countable assets, the couple may also keep the home that is owned and occupied by Ward (the community spouse), one automobile and their household furnishings. The couple may also pre-pay for their funeral expenses.
Assessment of Resources
The Department of Health and Human Services will complete an assessment form to find out the total value of the couple's combined finances in the month of admission to the nursing home.
This assessment will help decide the amount of assets the spouse at home may keep. One must be able to show proof of assets owned.
The spouse at home should contact their nearest Department of Health and Human Services office to fill out the assessment form.
Transferring of Assets - CAUTION
Persons who give away or transfer assets in order to get Medicaid
help may end up waiting longer before Medicaid will help them.
For additional information, contact your nearest office of the
Nebraska Department of Health and Human Services
or the toll free number:
1-800-685-5456
Your nearest Area Agency on Aging may also be able to assist.
For questions on Medicare contact:
SHIIP
Nebraska Senior Health Insurance Information Program
Terminal Building
941 "O" Street, Suite 400
Lincoln, NE 68508-3639
(402) 471-2201
1-800-234-7119
TDD: 1-800-833-7352
nica@doi.state.ne.us
www.nol.org/home/ndoi
This publication has been created or produced by the State of Nebraska SHIIP Program with financial assistance
through a grant from the Centers for Medicare & Medicaid Services, the Federal Medicare Agency.
Reprinted 02/05
OUT95079