One of the biggest mistakes many couples make is assuming that once a spouse is qualified for Medicaid, their planning is complete. This attitude results in many missed opportunities.
Because couples can protect significant assets when one spouse enters a nursing home, if proper planning takes place, generally the spouse at home still has considerable assets at his or her disposal after one spouse is qualified for Medicaid. However, it is at this point that the most important planning for spouses takes place.
For healthy spouses at home, this can be a time to make strategic gifts of cash or other assets directly to a trust or to a child. This must be done carefully, because the transfer rules for spouses of Medicaid recipients are complex—however, the benefits of planning can be considerable.
Additionally, assets should (and often must) be re-titled into the name of the spouse still living at home. This can prevent issues later if the spouse at home were to predecease the spouse in the nursing home.
Most importantly, the spouse at home's Will should be updated to ensure that only a minimal share of the spouse's assets pass to the spouse in the nursing home. Again, this protects against the possibility of the spouse at home predeceasing the spouse receiving Medicaid.
If your spouse or a parent has recently qualified for Medicaid, and a spouse remains at home, it may be a good time to meet with an elder law attorney to discuss the post-qualification options available to you.