Kristof Column Highlights Problems with System, Need for Planning
September 1st, 2009 by Margolis
Nicholas D. Kristof, in a recent column in The New York Times, “Until Medical Bills Do Us Part,” writes about a friend — “M” – who has been advised to divorce her husband so that she will not be impoverished paying for his anticipated long-term care needs. She was advised to do this by a social worker at the hospital where her husband’s degenerative condition was diagnosed.
This is a second marriage for both M and her husband and they have a prenuptial agreement, which is irrelevant to issues of Medicaid eligibility.
Kristof decries a medical system that forces people to divorce “not because of irreconciliable differences but because of irreconcilable medical bills.” We could not agree more. This is the sad reality of our dysfunctional health care and long-term care system.
Another sad reality of our system and M’s situation, however, is that M has been getting bad legal advice. First, in any second marriage in addition to a prenuptial agreement, clients should be advised to purchase long-term care insurance.
Second, in terms of divorcing for Medicaid planning purposes, it sounds like M was getting legal advice from social workers rather than elder law attorneys. Divorce is certainly an option, but it is not the only long-term care planning strategy available to clients. In more than two decades of practicing elder law, not one of my clients has sought divorce for Medicaid planning purposes.
Another sad reality of our dysfunctional system, is that citizens need qualified elder law counsel to navigate it relatively unharmed.
Tags: Long-Term Care Insurance, Medicaid planning, Nicholas D. Krisoff, The New York Times
September 1st, 2009 at 4:53 pm
How would the health reforms now being discussed help in such circumstances?
September 8th, 2009 at 10:41 pm
Mostly through Sen. Kennedy’s CLASS Act which would provide every American with basic long-term care insurance, though taxpayers could opt out. While he was alive, Sen. Kennedy made adoption of this provision a condition of his support of health insurance. Perhaps in his honor it should be named after him.
December 8th, 2009 at 4:04 pm
I can see this happening and after a visit with a lawyer it might turn out to be good advice. The admonition to buy long term care insurance is a straw man. They don’t have it and likely can’t get it now. Many people have trouble buying that product and the cost is very high. It isn’t always the answer.
So, imagine the situation where two people get married late in life. One has fairly significant assets, maybe a 401k from their prior spouse with $500,000 in it. The other has little and mostly lives off of Social Security. They have a prenup to protect their individual assets. Medicaid doesn’t care, it requires a significant spenddown by the wealthier spouse. So, why not get a divorce? So what?