Hurley Elder Care Law Newsletter - April 2017
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April 2017   

Nursing Home Medicaid for Married Couples Still Misunderstood and How to Protect the Well Spouse—

An Explanation of Income 

After our blog post on 4/5/17 on Nursing Home Medicaid for Couples, we received a flood of calls and emails from folks looking for more information. We have decided to do a series of blogs and newsletters addressing this issue. We will aim to alleviate and prevent the fear and stress felt by families receiving bad information about these important benefits.  Today, let’s take a closer look at how income impacts Medicaid eligibility for married couples.  Medicaid is a means-tested, government-provided health insurance benefit.  It is the largest payer of nursing home care in Georgia. Most nursing home residents in Georgia rely on Medicaid to help some of their costs.  Nursing home residents receiving Medicaid benefits do have a cost-share; the nursing home resident pays all of their income to the nursing home (with a few exceptions we will explain in future blog posts), and Medicaid pays the difference. 

For a nursing home resident to be eligible for Medicaid, the resident’s income has to be below the private pay rate of the nursing home. In other words, the resident has to make less than the cost of the nursing home bed on a monthly basis.  In Georgia, the average cost of a nursing home bed for long term care is $6,175 (it is closer to $8,000/month in the Metro Atlanta area). So in most cases, a person must make less than $6,175/month in order to qualify for Medicaid.  The state of Georgia also has an income cap limit on Medicaid eligibility of $2,205/month. This means that if you make over $2,205/month but less than the private pay rate at the nursing home, a Qualified Income Trust (or Miller Trust) must be used to be eligible for Nursing Home Medicaid. A Qualified Income Trust only handles the resident’s income (it’s not like most Trusts that deal with assets); and it’s just a hoop that must be jumped through in order to get Nursing Home Medicaid if your income exceeds the Income Cap.

So what does this have to do with couples? Notice that the above paragraphs mention only the nursing home resident’s income. For Medicaid eligibility, only the nursing home resident’s income is considered. So a resident could make $2,000/month in income but be married to someone that makes $7,000/month in income, and only the resident’s income is used in determining Medicaid eligibility.  That’s the first thing to know about Nursing Home Medicaid for Married Couples: Only the resident’s income is considered for eligibility.  This simple piece of Medicaid eligibility is often forgotten, and families are sometimes told that a resident cannot qualify for Medicaid because the couple makes too much money (and often in this situation, the couple has income which is less than the private pay rate of the nursing home but it exceeds the income cap of $2,205—so the wrong number is often used).

After the resident proves that he/she qualifies for Medicaid based on the income test, we can then consider if the resident’s spouse (or the well spouse) is entitled to receive any of the resident’s income. Georgia has spousal impoverishment protections that allow the well spouse to keep up to $3,022.50 of the resident’s income. This means that if a couple makes $3,500 a month ($2,500 belongs to the resident and $1,000 to the spouse at home), the well spouse could receive $2,022.50 of the resident’s income so that he/she will have a total income of $3,022.50/month. The resident would get to keep $50/month and pay the nursing home $427.50/month for his/her care. This is known as spousal diversion, and it is grossly misunderstood by many.  Many families call or meet with us feeling terrified that the spouse at home will be left with nothing to live on while his/her spouse is in the nursing home. Getting clarification of the rules for Medicaid as well as the entitlements for the spouse at home brings a great deal of relief to these families.

We will continue to share more in-depth information about Nursing Home Medicaid for Couples in our upcoming blogs and newsletters. We still have to cover how assets work for couples! So be sure to follow our blog or follow us on Facebook or Twitter! And if you or someone you know has questions about how Medicaid could work for them, please call our office for a complimentary consultation at (404) 843-0121.

Family Business The last boys in the Pace Academy crew went to Prom this past Saturday night! Ross Cefalu, Graham Hurley and Harrison Lewis (pictured left to right) all had a night that they will never forget along with their dates. Prom means that we are close to ending the school year and we finally know where our Senior, Ross Cefalu, will be attending college. Go Georgia Tech Yellow Jackets!
Upcoming Speaking Events & CEUs

 Mr. Hurley will explain the difference between capacity and competency and provide guidelines for evaluation. Our speaker will also will review an ethical decision-making model for practitioners to use when confronted with such dilemmas in clinical practice. CEUs available:  1 ethic or core hour for social workers (GA NASW); 1 contact hour for case managers (CCMC); 1 contact hour for RNs (TNA).
4:00PM-6:30PM; Park Springs Health Services, 500 Springhouse Circle, Stone Mountain, GA 30087, RSVP:

Tuesday, May 9- Please join Miles Hurley, JD, CELA, for a Complimentary Presentation on "You Don't Know What You Don't Know-The Importance of Being Educated Prior to a Crisis"
 at Gracemont Senior Living
The options for paying for long term care are limited.  Did you know that Medicare will not pay for home care or assisted living care?  Do you know what Medicaid provides?  Most families do not realize their limited options until they are in a crisis—usually when their loved one is about to be discharged from a hospital. This seminar is intended to provide information prior to a crisis. 6:00PM-7:30PM; Gracemont Senior Living and Memory Care, 4940 Jot-em Down Road, Cumming, GA 30041, RSVP: Mryna Shaw, 

This continuing education presentation will help healthcare professionals learn to identify with confidence where individuals may be on the care continuum and understand the resources available at each stage.  CEUs available:  1 core hour for social workers (GA NASW); 1 contact hour for case managers (CCMC); 1 contact hour for RNs (TNA). 11:30AM-1:00PM; Garden Plaza at Lawrenceville, 230 Collins Industrial Way, Lawrenceville, GA 30043, RSVP:

Tuesday, May 16- Join Danielle Humphrey, JD, CELA, for a Complimentary Presentation on “VA Aid and Attendance: Making the Most of Your Past Service” at Heritage of Sandy Plains
The “Aid and Attendance” benefit is one of the VA’s best-kept secrets from our retired service men and women. War time veterans over age 65 who require the “aid and attendance” of another person to meet their needs may receive as much as $2,127 per month to help defer the cost of long-term care expenses such as home care, assisted living community fees and nursing home costs. Surviving spouses can qualify for up to $1153 per month. Learn more about this “hidden benefit” and other non-service related benefits. 5:30PM-7:00PM; Heritage of Sandy Plains, 3039 Sandy Plains Road, Marietta, GA 30066, RSVP: Dyan Bernstein, 

The process of applying for guardianship (or conservatorship) is complex and can be overwhelming to healthcare professionals and families alike – Ms. Humphrey will review the basics of guardianship and conservatorship. In addition, learn what can be done to avoid Guardianship/Conservatorship.  Current information on Georgia’s Advance Directive will also be provided.  CEUs available:  1 ethic or core hour for social workers (GA NASW); 1 contact hour for case managers (CCMC); 1 contact hour for RNs (TNA). 11:30AM- 1:00PM; Ridgeview Institute, Pro North Auditorium (first building on left), 3995 S Cobb Dr SE, Smyrna, Georgia 30080, RSVP:

Thursday, May 18- Join Miles Hurley, JD, CELA, for a Complimentary Presentation on “Hidden Secrets of Veterans Benefits that the VA Won’t Tell You About” at Northlake Gardens
The “Aid and Attendance” benefit is one of the VA’s best-kept secrets from our retired service men and women.  Veterans over age 65 who are disabled can be eligible for as much as $2,127 per month in addition to any other VA pension or service related benefit they may receive.  Surviving spouses can qualify for up to $1,153 per month.  Learn more about this “hidden benefit” and other non-service related benefits. 3:00PM- 4:00PM; Northlake Gardens Assisted Living and Memory Care, 1300 Montreal Road, Tucker, Georgia 30084, RSVP: Paula Drake, Pdrake@5SSL.COM

For more details and a complete list of upcoming events, please visit Hurley Elder Care Law Community Education.
Recent BlogsKey to a Longer and Happier Life- Learn about the link between positivity and longevity.

The Cost of Care- Long-term care costs how much?

Mindfulness Walking- Learn the about the health benefits.

Repealing and Replacing Obamacare- Read the Republican’s latest proposal.

Elder Care Resources
SCAM ALERT- Read this important alert from the GA Attorney General.

Dispute After Death- Planning ahead can prevent disputes among family members over your belongings.

Alzheimer’s Statistics- These staggering figures will surprise most.  

Miles P. Hurley, JD, CELA  Miles P. Hurley founded Hurley Elder Care Law in 2006 to provide legal assistance to the elderly population on issues relating to aging including retaining independence, quality of life and financial security. Mr. Hurley is one of ten attorneys in the state of Georgia to receive the Elder Law Attorney Certification, and one of approximately 400 nationwide. 
Hurley Elder Care Law is dedicated to the process of long-term care and estate planning. 
Call us today for a free phone consultation with a client coordinator at (404) 843-0121.

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Hurley Elder Care Law
100 Galleria Pkwy, Suite 650
Atlanta, GA 30339

Satellite Offices
2011 Commerce Dr. Suite 100, Peachtree City, GA 30269   
225 Creekstone Ridge, Woodstock, GA 30188       
2180 Satellite Blvd, Suite 400, Duluth, GA 30097

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