A Guide to Spousal Refusal

Spousal refusal is a great strategy to gain Medicaid eligibility and assist in paying for the extremely high cost of care for your institutionalized spouse. This is the only strategy that will allow you, as the community spouse, to retain control and access to ALL of your assets while simultaneously getting your spouse approved for Medicaid.

In order to implement the strategy you will need to transfer ALL of your institutionalized spouse’s assets into your name alone, except for one joint bank account, which must maintain a balance of less than $2,000.00 by the end of each calendar month. This joint account should be the account that your spouse receives their social security and/or pension in each month.

Spousal Refusal is a unique Medicaid planning strategy, in that, it is the only strategy available that does not:

1. Have any additional third party fees to create eligibility
2. Have any tax consequences
3. Allows you, as the community spouse, to retain control and access to ALL of your assets.

Risks Associated With Spousal Refusal

One potential risk that you take when using this strategy is that, should you pre-decease your institutionalized spouse, any assets that are titled individually in your name (which will be the majority of your assets) will have to pass through probate in order to be properly distributed to your heirs and your spouse. The current court costs associated with opening an Estate range from $300-$600. In addition to court costs, attorney fees for the administration of an Estate start at $2,000 for a basic Estate and range upwards depending on the size of the Estate. While our office would be able to provide such Estate administration services to your family, they would not be part of our current representation agreement.

However, keep in mind that the only time that an Estate would have to be opened would be if you pre-deceased your spouse, which, given your health, is unlikely. As well, with the amount of money you will be saving each month on your spouse’s care, once your spouse is on Medicaid, will outweigh any court costs or fees for the administration of the Estate.

To learn more about spousal refusal in West Palm Beach, please contact Shalloway and Shalloway, P.A.