Long Term Care Planning for the Married Couple

LTC for couplesThere’s another layer of complex rules for married couples when hoping to get the government's help paying for long-term care if one spouse is still living independently. States are treating such “well” spouses in dramatically different ways and Virginia's rules are especially onerous.

Marriage is a wonderful institution when it works. In fact, a good marriage means a lifetime of living happily with another. What happens though in cases where as couples live longer and longer, one spouse’s health fails?  It is important to understand the unique challenges ill health might pose for couples especially if one spouse is trying to maintain a home while the other spouse is living in a long term care facility.  In Virginia, because of its very strict interpretation of the federal Medicaid rules, spousal impoverishment could be a real possibility.  Our practice is especially skilled at helping our clients avoid this pitfall.

Against the backdrop of the in sickness portion of the vows, one question that I am frequently asked as I assist married couples with their estate plan is “what if one of us becomes chronically sick and needs long-term care, will the other be driven into poverty”?  Without planning, the answer to this question could very well be yes. With the cost of care in area nursing homes exceeding $80,000 annually, how long would it take before these costs begin to seriously deplete your savings?

Marital assets, whether owned by the husband or the wife, are part of the equation when it comes to determining Medicaid eligibility. Medicaid is the joint federal/state government program to provide means-tested health care assistance to those who qualify. With both federal and state coffers bleeding red ink, Medicaid money is tight, especially in terms of long-term care coverage — whether married or single. Some states are treating the “well spouses” more generously than others regarding how much wealth they may retain while the “sick spouses” are receiving taxpayer support through Medicaid. I would definitely place Virginia in the category of ‘less generous’. In Virginia, the Medicaid rules adopted by the state often results in a situation where the wealthier applicants are able to retain more assets than the less wealthy – certainly not the intention of the program as originally designed.  In the 1960s, as this program was designed, who would have imagined that the cost of healthcare would increase so dramatically that Medicaid would become one of the largest provider of payments to our nation’s nursing homes?

You can learn more about this topic as well as other strategies on our website under the tab entitled: elder law planning in Virginia. Be sure you also sign up for our complimentary e-newsletter so that you may be informed of all the latest issues that could affect you, your loved ones and your estate planning.  However, proper estate planning is not a do-it-yourself project.  Why not call us for a complimentary consultation at 757-259-0707.

ReferenceThe Wall Street Journal (April 2, 2012) “Long-Term Care and Couples: Who Pays?

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We've been putting together as many resources as possible so that we can continue to help:

  • If you’re a current client with a signing appointment or a prospective client with a consultation and would prefer that meeting take place in your own home, we can accomplish that with a little bit of pre-planning on our part and with the addition of a laptop, smartphone, tablet or other computer in your home to facilitate this virtual meeting. For those of you that need to sign legal documents, that too can be accomplished with the use of a webcam (FaceTime etc.), so that we can witness and electronically notarize all of your important legal documents.
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Update to our Process

The unprecedented coronavirus pandemic has taken our entire country by surprise. We understand how difficult this time is for America’s businesses and families.  However, we believe it is vitally important that we make every effort possible to continue to offer solutions that avoid disrupting our important partnership with you, your family and friends.  As you know, estate planning is not something that should wait for a more convenient time, therefore the opportunity to address your important goals both during and after this crisis should not wait.  To that end, we have added the option of a ‘virtual consultation’ to our office process.  You will now have a choice of either meeting with us in our office or in the comfort of your own home.