Spouse Fights To Keep Money From Being Used For Nursing Home Care

83-year-old Amelia Lopes went to court to fight to keep money from an annuity she purchased after her 85-year-old husband, John, was admitted to a nursing home. She’d already spent $100,000 of own money and used a $68,000 long term care policy to pay for her husband’s care. Her attorney Paul Czepiga says Lopes still had about $170,000 that she didn't want to give up.

 

"They've been married for sixty some odd years.  She clearly bought this annuity because she said, 'I don't want to have to spend all of my life's savings on medical care for my husband'."

 

But the state had a different opinion. 

 

DSS contacted a financial company to see if it would purchase the income stream from Mrs Lopes' annuity at a reduced price to pay for her husband's care. However, that plan hit a snag because the annuity's original terms did not allow it to be re-assigned or sold. Meanwhile, DSS denied the Medicaid application to pay for Mr Lopes's nursing care because it ruled that Mrs Lopes was not cooperating. 

 

A federal judge ruled in the Lopes' favor. Attorney Czepiga says that’s because federal law states the income of a spouse living in the community can not be counted as an asset to pay for an ill spouse's care in a nursing facility. The judge also agreed that the annuity could not be sold.

 

The state is appealing the court's decision. In a statement DSS spokesman, David Dearborn says the Lopes' approach amounted to ‘gaming’ Medicaid by essentially disguising or diverting certain excess assets that should have gone toward paying for the individual’s care. He adds, Medicaid is the biggest part of the state budget in terms of services, and, it’s supposed to be a program for the genuinely poor

 

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