Case Studies

Married Couple- Age 80- Fred & Alice
Fred diagnosed with dementia. Alice can no longer physically provide needed care at home. Fred is moving into a Nursing Home.

Neither spouse has Long-Term care insurance.  Alice worries the nursing home bill will deplete their life savings, so she meets with a local agent to find out how Fred can qualify for Medicaid benefits.

GOAL: Obtain Medicaid eligibility for Fred as quickly as possible while preserving the couple's assets so Alice has enough income and assets to live comfortably at home for the rest of her life.

Details:
Fred's Income: $2,800/mo
Alice's Income: $2,500/mo
Assets            : $400,000
Cost of Care   : $9,000/mo

At the time of this case, KY Medicaid laws indicated that Alice can keep $157,920 without impacting Medicaid benefits for Fred. To avoid going over that number, she keeps $155,000. Fred is allowed to keep $2,000. Based on their Assets, they would need to spend down $243,000 to qualify for Medicaid LTC Benefits for Fred.

How we helped:
  • $15,000 Funeral Expense trust for Fred, and one for Alice to quickly and easily pay for their final expenses upon death
  • Remaining $213,000 in assets are turned into a Medicaid Compliant Annuity (MCA) providing Alice with additional monthly income. 
Result:
  • After purchasing the MCA, spend-down assets are eliminated and Fred is immediately eligible for Medicaid LTC Benefits. 
  • Fred's Medicaid Co-Pay is $2,750/mo after receiving $50/mo for his Personal Needs Allowance.
  • This is a savings of $6,250/mo for every month Fred resides at the facility over the original cost of care.
  • Alice's Income increases from $2,500/mo to $6,938/mo with her current income and the income from the Medicaid Compliant Annuity.
  • Alice has less anxiety knowing that she has the income she needs to live independently in the community while Fred is getting the care he needs in the facility. 
If they would not have proceeded with this plan, they would have exhausted their spend-down amount in about 27 months.

Note: Names have been changed to protect the identity of those involved in the cases. Also, while the numbers included are real, they have been rounded for ease of summarizing these cases.
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Other Case Studies
Read about actual cases where individuals were able to preserve assets and get the care they needed. Note; these are just a few examples and there are many other potential scenarios to consider.
Note: Names have been changed to protect the identity of those involved in the cases. Also, while the numbers included are real, they have been rounded for ease of summarizing these cases.