If a family member goes into a nursing home, contact an attorney to discuss your Medicaid planning options.
What would happen if your spouse or a parent went into a nursing home? How would you or they pay for it?
The average cost for a semi-private room in a nursing home in Tennessee is about $90,000 annually.
Let’s imagine that dad had a stroke or is disabled by dementia. Your mom is still alive and will need money to live on after your dad dies. Does she have to spend all her assets to qualify dad for Medicaid “TennCare”?
There is important information that we all need to know. It is not necessary for mom (under the law called the “Community Spouse”) to be completely impoverished in order for dad (the “Institutionalized Spouse”) to qualify for TennCare. We recommend seeking counsel from an elder law attorney offering Medicaid planning assistance.
History of Medicaid in Tennessee (TennCare)
Medicaid (called TennCare here in Tennessee) was passed by Congress in 1965 and was designed to provide medical care for the elderly, blind, and disabled poor. Eligibility is sensitive to both assets and income.
Before 1988, all of a couple’s assets were required to be “spent down” so that the ill spouse could qualify for nursing home care. The couple’s only alternatives were utter impoverishment or divorce. There were articles in the newspapers about elderly women eating cat food so that their husbands could get nursing home care.
In 1988, Congress passed provisions now known as the Spousal Anti-Impoverishment Act. If correctly applied, this law allows the Community Spouse to keep half of the assets with a minimum amount of $29,724 and a maximum of $148,620 (in 2023). The Institutionalized Spouse must spend his half so that he only owns $2,000.
But there are “Medicaid-friendly” ways to spend down. There are also legal ways to assist an unmarried senior (who must spend down to $2,000) to qualify for TennCare.
Medicaid Planning in Tennessee
TennCare Medicaid is convoluted and ever-changing. To take advantage of the laws and regulations, it is best to consult a lawyer who works with TennCare on a regular basis.
The bottom line is this: when someone who is not already impoverished goes into a nursing home, it’s time to see a lawyer. Especially when that person has a living husband or wife, assets can be set aside to help the Community Spouse afford living expenses to pay for his or her own care in the future.