Measuring Disabled Father’s Income when He Enters Long Term Care

Dear Mr. Premack: My step-father has been diagnosed with Alzheimer’s and may soon need to be put in a nursing home. He currently receives social security and a pension check from the school district where he worked. If it is necessary to put him in a nursing home, I already know his social security check will go to the nursing home. Will the nursing home take his retirement check also? If so, my mother will not have any other source of income besides her $422 social security check to live on. – RSC

If your step-father needs to move to a nursing home, there are only three ways to pay for his care. First, from family savings and income. Second, from special long-term care insurance if they purchased a policy. Finally, from government benefits if he can qualify.

If they had long-term care insurance, you would not have written to me – so we’ll focus on how their money and government benefits interact under the Medicaid program. To qualify for Medicaid, your step-father’s monthly income (checks written to him) must be below $2,094 (increased to $2163 in 2014). Further, his countable resources must not exceed $2000. In this context, “countable resources” means that his wife can set aside various assets, like their home, an automobile, and about half of their savings (but not more than $113,640 [increased to $117,240 in 2014] unless their income is quite low, in which case the ceiling may be set at a higher amount).

In addition to setting aside some assets if he qualifies for Medicaid, his wife can retain up to $2,841 (increased to $2931 in 2014) from their combined monthly income. If his social security and pension together total $2500 and your mother has her $422 social security, and if he qualifies for Medicaid assistance in every other way, then she will keep $2,841 for her own living expenses and will pay $81/month to the nursing home (in 2012 numbers; but in 2014 she would keep all the monthly income). Medicaid will pay the balance for his monthly nursing home bill. They should seek personalized legal advice from a certified elder law attorney before taking any other steps.

Paul Premack is a Certified Elder Law Attorney practicing estate planning and probate law in San Antonio.

Original Publication: San Antonio Express News, February 20, 2012