How can my father qualify for Medicaid in order to get the in-home care he needs?

A fellow caregiver asked...

My parents are 88 and 89 with limited resources. Dad needs homecare; he is unable to walk, bathe, care for his meals, etc. but the resources aren't there. They have approximately $125,000 and they live off of the dividends and dad's Social Security. We have thought of spousal refusal where my dad transfers all assets to Mom and can now qualify for Medicaid; however, Mom receives his Social Security and does not receive much of her own. I understand that by refusing to care for him she loses his Social Security and without that she will not be able to support herself. Any suggestions, as they want to remain in their rental apartment? They do not own their home.

Expert Answer

Steve Weisman hosts the nationally syndicated radio show A Touch of Grey, heard on more than 50 stations, including WABC in New York City and KRLA in Los Angeles. He is a practicing lawyer specializing in estate planning and is admitted to practice before the United States Supreme Court. He's a public speaker and commentator who has appeared on many radio and television shows throughout the country, and he's the legal editor of Talkers magazine, the preeminent trade publication of talk radio. His latest book is The Truth About Avoiding Scams.

Medicaid is a joint state-federal program. Although the general eligibility requirements are determined by federal law and regulations, the states are permitted to vary these eligibility requirements to some degree. The use of spousal refusal as a Medicaid planning technique varies greatly from state to state. However, The law also permits a "community spouse" who is not receiving Medicaid benefits to retain as much as $109,560 of their assets, not including the value of a home and still be eligible for Medicaid. You should consult an elder law attorney for more specific advice for your own particular state.

Unfortunately, although it is actually more cost effective to keep elders in their homes instead of paying for nursing home care, few states have very effective Medicaid programs that incorporate significant at-home care.

Fortunately, a Medicaid sponsored program that may be available in your parents' area that can be of help is PACE which is an acronym for Program of All-Inclusive Care for the Elderly. Pace provides care that elders require in order to remain in their homes. I suggest that you look into whether PACE services are being offered in your parents' area. You can go on the internet to see if there are any PACE providers near them.