Spousal Refusal & New York Medicaid

In the U.S., the program that oversees most medical care for the elderly and disabled is Medicare, which offers coverage for many different types of service. That said, if a Westchester County resident needs long-term care, it is Medicaid that will cover those bills, assuming the person qualifies for benefits. Applying for New York Medicaid can be complex, particularly if you and your spouse have extensive assets. A legal concept called “spousal refusal” can help to protect some of your assets from being claimed by Medicaid after your passing.

Medicaid Asset Limit Poses Problems

Medicaid is a means-based program which offers healthcare benefits to lower-income individuals. If someone has extensive assets, but needs medical care that Medicare will not cover, the rationale is that those assets should be liquidated before applying for government assistance. What this means for a couple with assets and/or income above the Medicaid resource limit is that you must either 1) divest yourself of those assets, or 2) legally protect them in a way where they will not be counted against you by Medicaid.

The important thing to keep in mind is that, if you have assets you must dispose of, you cannot do it simply by gifting items to friends or loved ones.  That doesn’t mean you cannot transfer the asset, it just means that you cannot do it at less than market price. In most states (New York included), Medicaid has what is known as a look-back period, lasting 60 months or five years. Any gift given or transfer of property at less than a fair price will trigger a penalty period during which care is not covered – unless it is a gift to your spouse.  In the case of a gift to a spouse, there is no penalty.

Just Say No

Spousal refusal is a legal concept that allows a couple to shift assets into the name of the non-institutionalized spouse in order to preserve those assets. What most often happens in this situation is that an experienced attorney helps to shift assets into the name of the spouse who is not seeking Medicaid benefits. Then, the non-institutionalized spouse signs a spousal refusal form, which states explicitly that they will not use any part of their assets to cover the bills of their spouse because they need those assets for their own upkeep.

This sounds quite hard-hearted on the surface, but in reality, it means that those assets are now untouchable by Medicaid and can be used for the well-being of the non-institutionalized spouse. After a person’s death, Medicaid has the right (in some cases) to seek repayment of the amount spent on that person’s care. While it does not apply to those who receive assistance paying their premiums, it applies in most other cases, and without taking appropriate steps to protect assets, a person’s surviving spouse may be deprived of assets or funds they may be ill-equipped to lose.

Contact A Westchester County Medicaid Planning Attorney

Medicaid planning can be a difficult and confusing endeavor, and its high stakes can make it easy for the average person to get overwhelmed and frustrated. A Westchester County Medicaid planning attorney from Meyer & Spencer, PC can help to demystify the process, and to help you choose the best option for you, your spouse, and your extended family. Contact us today at (914) 741-2288 to schedule a consultation in our Westchester County or Putnam County offices.

Source:

medicaidplanningassistance.org/Medicaid-eligibility-new-york/