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Local attorney lays out Medicaid spend‑down rules and planning steps
Summary
Attorney Jennifer Garner explained durable powers of attorney and the Medicaid spend‑down process in a detailed scenario: she listed income and asset thresholds for special assistance and nursing‑home Medicaid, explained countable vs. non‑countable assets, and described exceptions such as the two‑year caregiver child rule and the five‑year look‑back on gifts.
Jennifer Garner of Garner Law Firm gave an extended, detailed explanation of legal and financial planning relevant to seniors facing long‑term care.
Garner began with estate‑planning basics: durable financial powers of attorney and health‑care powers of attorney (living wills/medical directives), recommending long forms and notaries so documents survive incapacity. “Durable power of attorney simply means that it is a power of attorney that survives your incapacity,” she said.
She emphasized that different Medicaid‑related programs are distinct: the special assistance waiver for assisted living (application at county DSS) has a strict gross‑income cap that she cited at $1,397 for standard eligibility and $1,792 for an enhanced (memory‑care) rate; eligibility also requires countable assets at or below $2,000. Nursing‑home Medicaid (long‑term care) applies different rules, and qualifying can require a documented “spend down.”
Using a fictional couple, Donald and Daisy, Garner illustrated how a spend‑down can be documented: samples of permitted expenditures included home repairs, buying a replacement residence for the community spouse, prepaying insurance premiums and purchasing allowable funeral/burial contracts; prohibited actions include prepaying multi‑year taxes or making transfers that constitute gifts within the five‑year Medicaid look‑back period unless covered by an exception. In her example she calculated an illustrative required spend‑down of $275,340 and described how transfers and expenses must be documented to Social Services.
Garner also explained the caregiver child exception (a child who provides at‑home care for two years may receive property transfers without penalty) and noted the two‑year caregiver exception and five‑year look‑back rules should be considered carefully. She cited 2026 home‑equity shelter guidance, noting a home value threshold of $752,000 for being non‑countable in that year.
Garner repeatedly cautioned that rules are complex and individualized and encouraged attendees to consult attorneys and DSS for case‑specific advice.
