Attorney & Mediator
Attorney & Mediator

Second Marriages – Who will pay for Long Term Care?

It comes as a surprise to many couples who are looking at re-marriage later in life.  They discuss their finances, make decisions as to estate planning, make decisions concerning the payment of current expenses.  They decide to execute a Pre-nuptial Agreement to set forth all of their agreements.

They want to agree that if one becomes ill and requires nursing home or long term skilled nursing care, the other will not be required to pay for it.  They want this provision in their Pre-nuptial Agreement.

What affect will such a provision have?  Will it be binding?  NO

While the individuals can agree in writing that they will not have any responsibility for the other’s long term care costs, Medicaid rules do not see it that way.

When applying for Medicaid for long term care, a snap-shot of the couple’s assets are looked at – his and hers.  All assets are counted toward paying for the nursing home resident’s care.  Medicaid does not honor Pre-Nuptial Agreements and it is not bound by the provisions in such an agreement.

This is a significant issue for couples. While they can specify who pays for what while they are married and can agree upon an inheritance for one another and for their children, they are unable to control the cost of long term care for themselves or one another.

For couples concerned with this issue, I recommend seeing a long term care insurance specialist to determine if the parties are eligible for insurance (given their age and medical condition) and whether the insurance coverage is affordable. 

In some cases, when unable to obtain insurance, some couples have decided against getting married in order to shelter their own assets from the possibility of paying for the other’s health care needs.