Without going into detail, I would suggest that anyone who cannot see the way clear to paying full nursing home costs for a spouse for an extended period... should do some extensive reading on the medicaid rules for your state. Should the patient be in the home for an extended period, @$75K to $90K per year, a nest egg may be quickly depleted.
Eligibility for help from medicaid varies widely by state, to the extent that choice of residence could be a factor. Ownership of a home rather than renting could also be a major factor. Additionally, the value of the home could also have a major effect on the long term assets of the surviving spouse. (Some states allow more than three times as much as others, when exempting assets from qualifying for the medicaid help. )
The amount that the spouse may exempt (and retain) also varies widely, when the approval for aid is involved.
The laws regarding "recovery" of Medicaid costs after death, also varies. Not all states require a lien on the home.
Add to all of this, the "five year lookback", and the entire subject becomes much more important, as the decisions that have to be made, cannot be retroactive.
We don't want, or expect bad things to happen, and it's easy to push hard decisions aside, but without a crystal ball, no one can predict health, for five years in the future.
The individual state laws are nuanced, and not always easy to find, or to interpolate. The Federal website is written in generalities, and gives no clue that the variances by state, could leave the healthy spouse with as much as hundreds of thousands of dollars more or less after the demise of the person receiving healthcare.
Thus, elderlaw... and the suggestion to obtain an elderlaw attorney. Most people who have gone through this with their parents or relatives have seen the ins and outs of the law, but usually only in the context of the state where they were involved.
At this point, it appears to me that some early research on the subject may be in order for those who see a potential need for the services, or maybe haven't settled on a permanent home location. The driving reason for looking now, is the five year lookback.
Am not an expert on this, but at this point, locked in to my original decision. Even if I were to find a potential better financial outcome, the time for change is past.
Eligibility for help from medicaid varies widely by state, to the extent that choice of residence could be a factor. Ownership of a home rather than renting could also be a major factor. Additionally, the value of the home could also have a major effect on the long term assets of the surviving spouse. (Some states allow more than three times as much as others, when exempting assets from qualifying for the medicaid help. )
The amount that the spouse may exempt (and retain) also varies widely, when the approval for aid is involved.
The laws regarding "recovery" of Medicaid costs after death, also varies. Not all states require a lien on the home.
Add to all of this, the "five year lookback", and the entire subject becomes much more important, as the decisions that have to be made, cannot be retroactive.
We don't want, or expect bad things to happen, and it's easy to push hard decisions aside, but without a crystal ball, no one can predict health, for five years in the future.
The individual state laws are nuanced, and not always easy to find, or to interpolate. The Federal website is written in generalities, and gives no clue that the variances by state, could leave the healthy spouse with as much as hundreds of thousands of dollars more or less after the demise of the person receiving healthcare.
Thus, elderlaw... and the suggestion to obtain an elderlaw attorney. Most people who have gone through this with their parents or relatives have seen the ins and outs of the law, but usually only in the context of the state where they were involved.
At this point, it appears to me that some early research on the subject may be in order for those who see a potential need for the services, or maybe haven't settled on a permanent home location. The driving reason for looking now, is the five year lookback.
Am not an expert on this, but at this point, locked in to my original decision. Even if I were to find a potential better financial outcome, the time for change is past.