What to Know About Spousal Refusal and Medicaid Planning in Florida

When someone you love needs nursing home care in Clearwater, the emotional and financial impact can be overwhelming. Many families face a difficult challenge: one spouse requires long-term care while the other wants to remain at home and protect shared assets. Fortunately, Florida Medicaid law offers a strategy called spousal refusal that is appropriate in some cases.

Our Clearwater elder law attorney has helped countless families understand and use this option as part of a comprehensive Medicaid plan. Here’s what you need to know about how spousal refusal works and when it might be right for you.

What Is Spousal Refusal And When Is It Used?

Medicaid helps cover the high costs of nursing homes or other long-term care, but you must meet income and asset requirements to be eligible. If a nursing home patient has income that exceeds the Florida Medicaid income limit, a Medicaid Income trust is a valuable tool in this situation. But what happens when one spouse needs nursing home care and the other will remain in their home?  In that situation, certain assets retained by the spouse staying in the home are not “countable” BUT other assets are “countable.”   If the spouse at home has more “countable” assets than what is allowed, then the other spouse cannot qualify for Medicaid assistance.

There are various strategies that can be used by the spouse at home to reduce the “countable” assets to a level that will enable the other spouse to qualify for Medicaid.  Spousal refusal is a strategy that may be available for Florida residents in appropriate cases. It allows the spouse at home to refuse to use their excess assets above the Medicaid limit to pay for the nursing home costs of the spouse in the nursing home. This allows their spouse to qualify for Medicaid, even if the couple’s combined resources exceed the “countable” asset limit. Here’s how it works if you are the refusing spouse:

• Florida is one of the few states that allows spousal refusal under federal Medicaid law.
• You must formally declare you will not contribute to the cost of your spouse’s care.
• In appropriate situations, this strategy can help preserve “countable” assets in excess of the Medicaid limit.

Before Relying On Spousal Refusal In Clearwater, Get Legal Help

Medicaid Spousal Impoverishment Rules help ensure that non-applicant spouses have sufficient income and assets to live on. You get a Monthly Maintenance Needs Allowance (MMNA), and, depending on the amount of their own income,  your partner may be able to transfer all or part of the income from the spouse in the nursing home to themself.  Most assets can also be transferred from the spouse in the nursing home to the spouse remaining in the home.

While spousal refusal may seem like the simplest way to provide for long-term needs, it is not without risks and complications. Here’s why working with an experienced Clearwater elder law attorney is essential:

• Spousal refusal may be appropriate in some cases, but not in others. The use of this method will be carefully scrutinized by Medicaid.
• The process involves complex legal forms and strict Medicaid documentation requirements;
• If done incorrectly, your spouse could be denied benefits;
• Errors and mistakes could cause the state to seek repayment from the non-applicant spouse;
• Other options, such as Medicaid-compliant annuities, asset transfers, or spenddowns, may be more suitable.

Our Experienced Clearwater Elder Law Attorney Is Here To Help With Medicaid Planning

Spousal refusal can help one partner qualify for Medicaid benefits, which offsets the high costs of nursing home care, while allowing the other to retain more assets than the Medicaid rules allow.  To find out if this is an option in your case, contact our experienced Clearwater elder law attorney.

Board-certified by the Florida Bar and the National Elder Law Foundation, William Rambaum has over 40 years of experience helping clients with long-term care needs and other aspects of estate planning. For trusted legal guidance, request a consultation today.

Source:

medicaid.gov/federal-policy-guidance/downloads/cib05222024.pdf