• Kathy L. McNair, Esq.

Three Tips to Protect Your Assets when Your Spouse Needs Nursing Home Care:

Updated: Dec 28, 2021


When your spouse needs nursing home care, it can feel overwhelming. You also may be worried about how you will be able to pay for nursing home care. In the Boston area, nursing homes can cost over $180,000 per year. At this difficult time, the least of your worries should be losing your life savings to pay for your spouse’s care. As Elder Law attorneys, for the past twenty years, we have helped many spouses protect their assets and navigate the confusing process of moving a spouse into the best nursing home possible.


Medicaid (also called “MassHealth”) can help pay for nursing home care for those that meet certain financial and clinical requirements. Meeting the clinical requirements is usually easy. However, meeting the financial requirements can be much trickier, especially if your combined assets are over $130,000 (not counting your home).

Here are three tips for protecting your assets:


1. Act now to get the right advice. Meet with an elder law attorney right away. Each day that you wait can cost you hundreds of dollars. If you have more than $130,000, your spouse won't be able to qualify for Medicaid benefits unless you make significant changes. You can't just give away the excess. You also need to carefully weigh income tax considerations.


In our office, we start with a thorough review of your assets and income (for both you and your spouse). You will need to make a list of all of the assets that you and your spouse own (bank accounts, retirement accounts, investment accounts, stocks, bonds, life insurance policies, real estate, etc.) and how each asset is owned (in joint names, individually, or in a trust). In most cases, as long as the assets that you own, (excluding your home), are less than $1 million dollars, we are usually able to help protect all of the assets for the spouse still at home. In some circumstances, the cost of the nursing home can be $0. In others, the cost may be higher, but should be limited to the monthly income of the spouse that needs nursing home care.


Perhaps, you are worried about the cost of hiring an attorney. In our office, we start by analyzing your unique situation and providing a plan tailored specifically for you with detailed instructions to protect your assets. The initial plan usually costs about $2,500. Each month that you wait will likely cost you $15,000 in nursing home costs. Since the MassHealth application usually takes six to nine months before you receive a decision, you could spend almost $100,000 if you make a mistake along the way. Deciding not to hire an elder law attorney because you don't want to pay the legal fees, is a costly mistake.


2. Don’t rely on advice from the nursing home, your neighbor, a friend, or an attorney that doesn't practice elder law.

The nursing home receives more money from patients that pay privately than those that receive Medicaid benefits. They have an interest in having you pay privately for as long as possible. Do not rely on their advice. Even if the nursing home offers to prepare the Medicaid application for free, do not agree to this (unless you have less than $2,000 in assets total and do not own any real estate).


Your neighbor or friend may have gone through a similar situation with their parents. Perhaps, they have ideas about how you can protect your assets. Every situation is unique and what may have made sense for their parents may harm you. There is absolutely no one size fits all approach. Since time is precious getting the wrong advice can cost you dearly.


Attorneys who practice in another area or do general estate planning are not equipped to provide Medicaid Planning advice. The rules change frequently, and you need to find an elder law attorney who is up to date on the recent changes.


3. Do talk to neighbors or friends about any experience they may have had with nursing homes in the area and start looking for a quality nursing home.

If you think that your spouse may need nursing home care in the near future, you should begin looking for a quality nursing home in your area, that accepts Medicaid benefits. You can always call the admissions office to request a tour. However, the best way to find out about a nursing home may be talking with someone who has been there or has a loved one there.


Often the easiest and most cost efficient way to get into a high quality nursing is to first spend three nights at a hospital and get discharged to the best nursing home possible on your Medicare benefit. (Note: Medicare is not the same as Medicaid. Most Americans who are over 65 receive Medicare benefits automatically. It provides short term coverage for nursing homes up to 100 days.) If this is not possible, then your spouse can get admitted to a nursing home directly from your home, as a private pay patient. Just ask the admissions staff to meet with your spouse and determine if they can offer a room. Ideally, you would be working with an elder law attorney at this point who could provide you guidance on the best way to proceed.


As elder law attorneys our goal is provide you with the best advice, while still following the laws, to protect your hard earned life savings. If you are worried about protecting assets if your spouse needs nursing home care, please call our office at 617-489-5900 or schedule a brief free consultation or by clicking: https://seniorsolutions.as.me/FreeConsult


Senior Solutions, Attorneys at Law, is an Elder Law and Estate Planning law firm, serving the Greater Boston, Massachusetts area, since 2001. We are ready to help you with Medicaid Planning, Estate Planning, Probate, Guardianship & Conservatorships, Special Needs Trusts, and Fiduciary Services. Our office is located at 30 Church Street, Suite 210, Belmont, MA 02478.


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