Spousal Refusal A Method of Survival With Medicaid Covering the Costs of Nursing Home Care for The Sick Spouse

This is for care that goes for areas outside of Medicare coverage such as Alzheimer's or stroke victims. The healthy spouse can keep a car and a house and must have a monthly income of less than $2700 a month. If that level is exceed, the the healthy spouse needs to help pay along with Medicaid.

Nursing home care is around $100,000 a year and in some areas such as New York, it is higher. It is the ability to get long term care for spouses without having to lose everything the healthy spouse has. The healthy spouse refuses to share the marital assets and the sick spouse assigns their right of support over to the state.

The cost makes sense as Medicaid pays less for care than the healthy spouse would without this arrangement. Spousal refusal is helping some from having to file bankruptcy. New York and Florida are the 2 states mentioned in this article; however there could be other states offering the same or a similar type of program. BD

Until five years ago, when his wife, Wen Mei Hu, racked by bone-marrow cancer, had to be put in a nursing home, where the bills ran past $100,000 a year, threatening to quickly drain the couple’s life savings of $500,000. The nursing home told him not to worry: If he signed a document essentially refusing to support his wife of several decades, Medicaid, the federal insurance program for the indigent, would pick up the bill.

“What about me, because I am responsible?” Mr. Tung inquired. He was told that only millionaires had to pay such high costs, and reluctantly, seeing no other choice, he agreed.

Last year, more than 1,200 people in New York City officially turned their backs on their husbands and wives to qualify for Medicaid, triple the number of people five years ago. The practice, known as “spousal refusal,” is becoming more common as the population ages and the cost of nursing care rises — and it is coming under increasing attack by government officials looking to curb ballooning Medicaid expenses.

Health Option for Poor Used by Well-Off New Yorkers - NYTimes.com