A person can work very hard for a lifetime, scrimp, save, and build a nest egg, only to lose it within a matter of months, depending upon which illness is encountered.
For example, if a person contracts cancer and requires surgery, radiation therapy, or chemotherapy, Medicare will pay $500,000, $1 million, or more, if necessary. The money is paid to hospitals, oncologists and others involved in delivering the high-tech, acute care we have come to admire in this country.
But, if a person is incapacitated with a series of strokes and requires palliative, low-tech care in a nursing home, federal policy requires that such a person become impoverished as a condition to receiving Medicaid assistance.
"It isn't fair!" asserted a 76-year-old senior helpline caller. She and her husband worked a small ranch for 35 years � "Most years, just barely getting by; many-a-time ending up in the red," she said. "But we loved it. We put our souls into it."
He was vigorous � herding cattle, fixing fence, hauling feed � until last year, shortly after his 81st birthday, when he suffered what turned out to be a series of small strokes. He is now in a nursing home, bedridden and unable to speak. "But he smiles when I enter the room," she said.
She sold the land and now resides in the ranch house, surrounded by 12 acres. Each day she drives 40 miles to the nursing facility. She holds him, monitors his condition, and alerts staff to his needs. She is a loving wife.
Jointly, they have about $242,000, the amount remaining from the land sale. "That's all we have," she said. "Will Medicaid make us spend that on the nursing home?" she asked. "Most of it," I advised.
As the "community spouse" she will be allowed to retain assets totaling about $95,000, with a yearly market yield of less than $5,000. The balance will have to be paid to the nursing home, which costs $55,000 a year. That means their resources will be exhausted in about 34 months.
I asked if her husband is expected to live that long. "Oh yes," she said, "his heart and lungs are strong. He will probably outlive me." In the meantime she is working as a caregiver, earning $120 a week. It may not be fair, but it is federal policy.
(Pro bono legal information, advice and limited assistance is available to persons 55 and older at USD Senior Legal Helpline, 1-800-747-1895;email@example.com)