Can Medicare take Dad's properties to pay for Mom's care?

A fellow caregiver asked...

My mother was just diagnosed with cancer and her Dr. gave her information on a prescription assistance program she might qualify due to her low income. My parents keep their finances separate, and have for years. Neither one of them owns any stocks, but my father has several properties and a savings. Will that affect my mother's chance to qualify for assistance? And if she does qualify, will that mean that Medicare will be able to take my father's properties since they are legally married and the properties still have both names on the tiles?

Expert Answer

Medicare's coverage of prescription drugs is operated through Medicare Part D prescription drug plans sold by private insurance companies. These plan charge a monthly premium, only pay for a portion of covered drugs, and leave many drug costs uncovered. However, there is a program to help with these uncovered costs for people with low income and few assets, which is probably what your mother's doctor was referring to. Unfortunately, the assets your father has may turn out to disqualify your mother from qualifying for this program. Here's how it works.

If your mother's income is low (up to 150 percent of the federal poverty level) and she has few assets (up to roughly $12,000 for an individual, or $25,000 for a couple) other than the home she lives in, she might be eligible for a low-income subsidy (LIS) that provides significant help with the costs of drugs under a Medicare Part D plan. Depending on exactly how much income and assets she has, the plan's deductible, coverage gap, and copayments could all be eliminated or reduced. Applying for an LIS is done with the Social Security Administration, not directly with the plan or with Medicare. To get information on enrolling in the LIS subsidy, visit the Social Security Administration website, or call them toll-free at (800) 772-1213. Your mother can also simply make an appointment with any local Social Security office.

The problem is that the LIS program will probably consider your father's assets as also belonging to your mother, and would therefore make your mother ineligible for LIS assistance. If your parents were divorced or legally separated, and the property and savings were solely in your father's name, they might not be counted among your mother's assets. However, if your parents are not divorced or legally separated, in most states the law considers property owned by either spouse to also belong to the other, even if it's only in the name of one spouse. An exception would be if the property in question was already separate (belonged solely to your father) before they got married, or was given or bequeathed to your father as separate property during the marriage and has always been kept separate.

These questions of separate or joint property can be complicated, and may depend on the particular laws of the state your parents live in. It may be worth their while to consult with a family law attorney in their state who can advise them about your mother's relationship to these properties and other assets of your father's. The answers may affect your mother's eligibility not only for the LIS program but also for help with other Medicare premiums, deductibles, and copayments in the future, and with eligibility for Medicaid coverage for long-term care if she should need it in the future.