My 91 yr old uncle is in a nursing home with dementia for rest of life, which is paid for by Medicare and Medicaid. How do we avoid reaching the limits on cash asset in his patient account so that Medicaid doesn't drop him from care. He doesn't need anything but some clothing from time to time. Should I spend it on more clothes and treats, maybe gifts for his caring staff if allowed?
Consult an attorney knowledgeable about the Massachusetts specific rules. If he is already receiving Medicaid and receives a large amount of money there are limited ways to spend funds without penalty. Gifting is generally going to result in a penalty, meaning he could be ineligible for Medicaid for a set period of time. Tread carefully. Some states allow what is known as gift and return, but an experienced Massachusetts practitioner can tell you how best to proceed. Do not spend anything until you have consulted with an attorney. This answer is not taking into account power of attorney issues, etc. which could come into play in this fact pattern.
You can spend your Uncle's money on anything that benefits him. Food, clothing, entertainment. It's not a good idea to give it away, but a small token of appreciation for caregivers would probably not be a problem. Usually people in nursing homes need new clothing every once in a while (as old clothing gets worn out, lost or destroyed). Most folks have a favorite treat like a candy bar or soft drink and a supply of those could be purchased. If your uncle likes music you could buy him some headphones and a music player of some sort. If your uncle likes movies you could get him a tablet or viewer so he could watch movies on it, along with a subscription to a streaming service perhaps.
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I have two additional suggestions: take care of any outstanding funeral and burial expenses and set up a burial account. The account can be jointly owned and can be funded with up to $1,500.
I am a Massachusetts lawyer with a practice limited to elder law, estate planning, probate, special needs planning, estate administration, guardianship and conservatorship, and wills and trusts. All answers are based on Massachusetts law and are for educational purposes only. No attorney-client relationship is formed by as a result of my answering your question. Please call my office at 781-433-8665 or e-mail me at [email protected] if you would like more information about our services.
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