Question: I’m a social worker trying to help a man who needs a skilled nursing facility, but who has no money and has been estranged from his wife for 35 years. He needs to apply for Medicaid to pay for the nursing facility, but because he is not “officially” divorced from his spouse, I’m not sure how that would work. The estranged spouse will not give out any financial information. Do you know what the law is in this situation? There doesn’t seem to be any policy written for estranged spouses.

Answer: In fact, there is a policy and a strategy for this type of situation often referred to as “just say no” or “spousal refusal.” If a spouse refuses to cooperate with a Medicaid application, the state Medicaid agency is supposed to evaluate the nursing home resident’s application without regard to the estranged spouse’s assets or income. As a prerequisite, the nursing home spouse must sign over to the state his rights of spousal support, meaning, at least in theory, that the state could then sue the estranged spouse for support. But that’s quite unlikely to happen. For more information, click here.

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