Medicaid is a very complex system. It is authorized by federal law, but it is implemented by state laws and state administrative rules. It is different in every state, therefore.

A great deal more can be saved for a Well Spouse when an Ill Spouse goes onto Medicaid than many people think.

In addition, if planning is started early enough, a much greater amount can also be saved for children or other beneficiaries than may be possible if Medicaid planning is delayed to the last minute.

Many joint estate plans need to be changed if various assets are to be saved for the Well Spouse after the spend down to qualify the Ill Spouse for Medicaid has been completed. This is true of both Trust based plans and Will based plans.

The Ill Spouse often needs some specialized provisions in his or her Power of Attorney and often in other documents. The Well Spouse often needs an entirely new estate plan. If the joint plan is a Trust based plan, the Ill Spouse often needs new estate planning documents as well.

It may be too late to make these changes if the Ill Spouse no longer has capacity. Time can be of the essence. A great deal will depend on the existing documents, and on whether the Ill Spouse still has periods of competence. It can be important to discuss this with a skilled elder law attorney as soon as possible.

Qualification for Medicaid can be complex. Working with a lawyer who has experience with Medicaid may assist both in more rapid Medicaid qualification for an elder, and in helping to save assets and income for the benefit of the Well Spouse.

Delaying a Medicaid application, or not understanding the system and properly positioning oneself for Medicaid, can result in delays and may result in the Well Spouse spending down to far less than could have been saved for the benefit of the Well Spouse with proper planning and an earlier Medicaid application.

NOTE: Wills, Trusts, Estate planning, and Qualification for Medicaid are very complex matters. The above address only a very few of the issues which may be of relevance in these matters, and should not be considered legal advice, nor should the above be taken as a statement of the only time that one might benefit from consulting a legal or other professional.