Nursing home care is expensive, costing upwards of $8,000 a month. Paying for that care can cripple the savings of the elderly. The problems double in complexity when one spouse needs assistance while the other lives on his or her own. A spouse’s lifestyle can suffer because their partner needs to be in an expensive nursing home. Medicaid has adopted guidelines to prevent so-called spousal impoverishment.

Protecting your health

The good news: Medicaid pays more than 40 percent of the country’s nursing home bills. The bad news: It does not pay until you have used up almost all your assets. To qualify for nursing home care under Medicaid, the following must apply:

· You must meet income eligibility guidelines.

· You must receive care in a nursing home.

· The nursing home must be state-certified.

This can be a major crisis when one spouse requires nursing home care, but the second spouse can live at home. The quality of life for the second spouse is at risk. He or she may face a life of poverty.

Protecting your finances

The Medicare Catastrophic Coverage Act of 1988 protects against spousal impoverishment. It classifies the person in the nursing home as the “institutionalized spouse.” The second person is the “community spouse.”

The law allows the community spouse to keep some of the couple’s income and assets. while the institutionalized spouse receives Medicaid. In some cases, a shelter allowance covers rent, mortgage, taxes, insurance and utilities.

But the standards are complex, relying on a “resource assessment tool.” Categories include “minimum community spouse resource standard,” “maximum home equity limit” and others. And the numbers change from year to year.

Protecting your future

The Medicare Catastrophic Coverage Act of 1988 provides a safety net for elderly couples. But complex federal and state regulations add stress and frustration to the situation. Taking care of an elderly spouse is an act of love. The more you know, the better you can help your loved one.