“How do I deal with spending down assets, what is the best strategy? We have $100,000 in IRAs and 401ks put together, $1,000 cash in the bank, $5,000 a month in Social Security, a free and clear house that’s worth $200,000, my wife has urgent need for medical care. I can’t take care of her very well right now and she’s going to need nursing home placement.”

This is a classic “crisis planning” scenario, and having a structured questionnaire will make your consultation with an elder law attorney far more productive.

Here is a comprehensive questionnaire tailored to your specific situation. You can print this and bring it with you to the meeting.

Questionnaire for Elder Law Attorney: Crisis Medicaid Planning

Client Note: My wife has an urgent need for nursing home care. We need to protect our assets and get her qualified for Medicaid as quickly as possible. Our primary assets are our home and retirement accounts.

Our Core Question: Given our urgent situation, what is the absolute best and fastest strategy to protect our assets while getting my wife the care she needs?

Part 1: Our Financial Snapshot (Please fill in any blanks)

Assets:

• Cash & Bank Accounts: $1,000
• Home: Owned free and clear. Estimated Value: $200,000
  • Who is on the deed? _________________________
• Retirement Funds (IRAs/401ks): $100,000 total
  • Whose name(s) are these accounts in? _________________________
  • Are you (the husband) taking Required Minimum Distributions (RMDs)? ❏ Yes ❏ No
• Vehicles: Number and approximate value? _______
• Other Assets (Life Insurance, etc.): _________________________

Income (Monthly):

• Social Security (Combined): $5,000
  • Husband’s Share: $_________
  • Wife’s Share: $_________
• Other Income (Pensions, etc.): _________________________

Care Needs & Costs:

• Current Monthly Cost of Wife’s (Nursing Home / Care): $_________
• Is she already in a nursing home? ❏ Yes ❏ No
  • If yes, since what date? _________________________

Part 2: Specific Questions for the Attorney

Category 1: Immediate Eligibility & The “Spousal Impoverishment” Rules

1. Given our assets, is my wife currently eligible for Medicaid, or will she be denied?
2. As the community spouse (the husband at home), what assets am I allowed to keep? What are the specific resource allowances for a community spouse in this state?
3. What income of my wife’s must go to the nursing home? How much of my own income am I allowed to keep?
4. Can my wife’s income be used to support me, the community spouse, if my income is too low? (Ask about the Minimum Monthly Maintenance Needs Allowance – MMMNA).

Category 2: Protecting Our House ($200,000)

1. Is our home a countable asset for my wife’s Medicaid eligibility?
2. What are our options for protecting the house?
   • Does the Community Spouse Resource Allowance (CSRA) protect it?
   • Should we consider transferring the house into my name only? What are the risks?
   • Is a Life Estate a good option for us now?
   • Given the urgency, is a Medicaid Asset Protection Trust (MAPT) an option, or is it too late?
3. What happens to our house if I, the community spouse, pass away first? What if my wife passes away first?

Category 3: Dealing with the Retirement Accounts ($100,000)

1. How are our IRAs and 401ks treated by Medicaid? Are they countable assets?
2. If they are countable, what can we do with them?
   • Is converting them to an income stream (via a Medicaid Qualifying Annuity) a viable and recommended strategy for us?
   • What are the specific rules and timelines for this to work?
   • What are the tax implications of doing this?

Category 4: The “Look-Back Period” and Penalties

1. We have not made any large gifts or transfers in the last 5 years. If we need to move assets now to qualify, will that cause a penalty?
2. If a penalty is triggered, how long would it be, and how can we manage it? Can we use the transferred assets to pay for care during the penalty period?

Category 5: The Overall Strategy and Process

1. Based on our numbers, what is our specific, step-by-step plan to achieve Medicaid eligibility for my wife while protecting the most assets for me, the community spouse?
2. What is the realistic timeline from starting the process to getting Medicaid approval?
3. What documents should we start gathering immediately?
4. What are your legal fees for developing this plan and handling the Medicaid application?

What to Bring to the Consultation:

• Deed to your house and most recent property tax statement.
• Recent statements for all bank, investment, and retirement accounts (IRA, 401k).
• Social Security Award Letters for both you and your wife.
• Marriage certificate.
• List of monthly expenses (mortgage/rent, utilities, insurance, etc.).
• Any information you have from the nursing home (costs, admission date, etc.).

This questionnaire will ensure you cover all the critical points and demonstrate that you are organized and serious about finding a solution. It will guide the conversation directly to the heart of your crisis, allowing the attorney to provide the most relevant and urgent advice.

Summary

keep it simple summary of above what to do what not to do

Of course. Here is a simple summary of what to do and what not to do in your urgent situation.

The Bottom Line

Your wife needs nursing home care now. This is a crisis, so you need to act quickly and correctly. The goal is to get her on Medicaid without losing everything you’ve saved, especially your house and retirement funds.

What You MUST DO

1. CONTACT AN ELDER LAW ATTORNEY IMMEDIATELY.
   • This is the most important step. Do not make a move before you do this. They specialize in this exact crisis. The consultation fee is worth it.
2. Understand the “Spousal Protection” Rules.
   • Medicaid has rules to prevent the healthy spouse (you) from becoming impoverished. You are allowed to keep:
     • A significant portion of the assets (likely your house and at least some of the retirement funds).
     • Most or all of your income.
3. Explore a “Medicaid Compliant Annuity.”
   • This is likely your best tool. You can take excess countable assets (like some of the $100,000 IRA) and convert them into a safe, non-countable income stream for you, the husband. This makes the asset disappear for Medicaid purposes quickly and legally.
4. Protect Your Home.
   • As the healthy spouse living in it, your home is likely protected from being counted for your wife’s Medicaid eligibility. Do not transfer it or sell it without absolute legal advice.

What You MUST NOT DO

1. DO NOT Give Away Assets.
   • Do NOT give money to your children. Do NOT put your house in your kids’ names. Any large gift or transfer within the last 5 years will trigger a severe penalty period where Medicaid will refuse to pay for care.
2. DO NOT Panic-Sell Your House or Cash Out Retirement Funds.
   • Selling the house turns a protected asset into a pile of countable cash. Cashing out the IRA creates a huge tax bill and a countable asset. These actions will likely make the problem worse.
3. DO NOT Pay the Nursing Home Bill Yourself.
   • Do not start draining your $100,000 IRA to pay the full nursing home cost ($7,000-$10,000+/month). You will run out of money in less than a year. The goal is to get Medicaid to pay this bill.
4. DO NOT Assume You Have to Spend Everything.
   • You do not have to spend down to $2,000. The spousal impoverishment rules are designed to protect you. You just need a legal strategy to reclassify your assets.

Your Simple Action Plan

1. Call an Elder Law Attorney today. Use the NAELA directory (www.naela.org) to find one.
2. Tell them: “My wife needs a nursing home. We have a $200,000 house and $100,000 in IRAs. We need a crisis Medicaid plan.”
3. Follow their instructions exactly. They will likely recommend a “Medicaid Compliant Annuity” as the core of your strategy to protect your savings.

You are in a difficult but common situation. The right legal strategy can protect most of what you have.