Ask Mike - Will Medicaid pay for the entire assisted living bill for my disabled husband

Dear Mike,

my husband of 33 years had 6 heart attacks in 5 hours in 2005. These left him with a brain injury and motor skill damage. He only has 25% of good heart muscle left. He is now 55 years old and I am 51. We have a son at home who just turned 18. I have been trying to take care of my husband at home and working 45 hours a week just to keep a roof over our heads. I recently put him in a assisted living faculty for which they took his SSD check and medicaid paid the rest. The strain was to much on me financially we almost lost the house. I had to bring him back home and I know I will not be able to give him the care he needs. How do I get medicaid to pay all hisss assisted living bill and let me keep his check for mortgage.

Nowhere to turn in Virginia

Dear Nowhere to turn in Virginia,

Thanks for contacting me. You wrote that you live in Virginia and have been married for 33 years. Your husband is disabled and was in an Assisted Living Facility (ALF), but because the ALF took his entire Social Security Disability Insurance check as well as the Medicaid payment, you had to bring him home due to financial strain. You also note you are afraid you will not be able to provide all the care he needs. Because of these problems, you would like to know how to get Medicaid to pay for the entire assisted living bill and you keep your husband's disability check.

This is an all too common problem. ALFs, like nursing facilities, are within their rights to take all but a token amount of an individual's Social Security check, pension or other income if the cost of their services exceeds what Medicaid pays. This is pretty much a standard practice. I doubt you will find an ALF that will not do this.

I am no expert by any means, but the only other thing I can think to share, is a legal option called "division of assets". Division of assets is a legal mechanism to divide spousal assets typically when one spouse resides in a nursing facility and one remains living in the community. I don't know how division of assets applies to ALFs, or even if it does since ALFs are often funded by home and community dollars, not nursing facility dollars.

Again, I am not an expert. You should contact a knowledgeable lawyer to get help. Sometimes Area Agencies on Aging can help with information and/or referrals to entities that can help. If you are unfamiliar with Area Agencies on Aging (AAA) or do not where to find one closest to you, our website can help. Go to Agencies Related to PAS and click Virginia on the map of the USA. Next, click on "State Unit on Aging". Use the contact information to ask for the location of the nearest AAA and ask the state agency about division of assets directly after sharing your issue.

Here's hoping you find some help! Good luck!

Mike Oxford

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