When Harry Met Sally

The Today show recently interviewed a national elder law expert, Hy Darling, about the topic of Divorce and Medicaid. How do those topics align, you wonder? As unsavory as it may sound to any of us, divorce is sometimes the chosen course for a couple when one of the two faces long term care.

Before passing judgment on this choice one must fully grasp the scenario. What does this situation look like? Well, when Harry met Sally they were both young and healthy and very much in love. Time has passed. Sally is now 68. Sally was diagnosed with Alzheimers five years ago. Her decline progressed rapidly. She now requires 24 hour supervision. Harry is a devoted husband; he has had 40 wonderful years with Sally. He is suffering on many levels. He misses his wife; he is terribly lonely and he is riddled with guilt. The Sally he knew is no longer there; there are many days when Sally does not even recognize Harry, but still he goes to visit her with the hope that she will be having a "good" day. He tried to keep Sally at home, but this became unsafe for Sally and extremely stressful for Harry: Sally would go for walks and get lost. Sally would take three days worth of her medications on one day because she forgot she had already taken the first and then the second dose.

Harry and Sally are "upper middle-class" Americans. They worked hard during their working years and were frugal with their spending. They own a modest home and had other assets, including IRAs, retirement funds, CDs and savings accounts totalling $600,000. Will it be enough? Sally's monthly cost for care in the long-term care facilitytops $6000 a month. Long term care is not paid for by Medicare. Long term care is not paid for by Medical insurance or Supplements. Harry and Sally, like most Americans, do not have Long Term Care Insurance. After five years of paying for Sally's care in the Alzheimer's unit of the Long-term care facility, Harry and Sally's funds are nearly depleted--they have spent $400,000 on care and prescriptions. Sally is only 68 years old. She has a life expectancy of 78. What is Harry to do? He needs the support and guidance of an elder law attorney who will guide him through his options for paying for Sally's care.

Married couples are legally obligated to support one another. Medicaid will not help Harry and Sally until they are broke. Is this true? Yes, sadly, this is accurate. Harry can go through a Division of Assets process to prevent complete impoverishment; the question of whether this is the chosen course is Harry's decision. The most that Medicaid rules permit Harry to retain is approximately $100,000---and this assumes that Harry is sufficiently savvy to fully utilize the Division of Assets process to its fullest. And in addition, Harry can live in his house, but when Harry dies Medicaid will have to be repaid from the sale of Harry's house. As attorney Hy Darling mentioned in the Today Show interview, on rare occasion divorce is the answer. I think Harry would rather poke out his eye and go broke, but I believe in love over money.