There is a great deal of confusion regarding the spend-down of assets for Medicaid qualification.

For a single person, who can only keep $1,500 in Ohio and $2,000 in Kentucky, that individual may find him or herself won­dering what the money can be spent on without causing any Medicaid disqualification.

Similarly, for a married couple, the rules are even more complex. The community spouse, (i.e. the at-home spouse) may generally keep roughly one-half of the couple’s assets up to a maximum of about $113,640. Depending upon their resources, again the couple may have a substantial amount of money which needs to be spent before the nursing home spouse qualifies for Medicaid.

That is often where the confusion begins. That’s because there is so much misinformation about what kinds of things the money can be spent on.

For someone who is pursuing Medicaid eligibility, the following are the types of spend-down items, in no particular order, which should be considered:

1. Purchase pre-paid funeral plans. The rules regard­ing funerals are complicated so you should only deal with a funeral home knowledgeable in this type of planning.

2. Make home improvements. Home improvements are often an excellent use of funds in a Medicaid spend-down. For instance, the community spouse might fix the roof, get a new air conditioning system, new carpeting, new furniture, etc. The intention here is to fix the house up so that, hopefully, no other home repairs will need to be done during the lifetime of either spouse. That is especially important since the community spouse will have to spend down one-half of his or her assets and may no longer have the resources necessary for large expenditures later.

3. Buy household goods or personal effects. Once again the intention is to have the community spouse get the types of things which are needed to keep the household running without major expenditures down the road.

4. Attorney, Accountant and other Professional Fees. Paying professional fees can be an effective way to access expert advice, while also helping achieve your spend-down.

These are, of course, not the only items that qualify. The main rule to keep in mind is that whatever goods or services are purchased must be done at fair market value.

Also, don’t let anyone tell you that anything spent must be done solely for the benefit of the nursing home-spouse. However, please bear in mind, that in the case of a married couple, the spend-down may only begin 30 days after the nursing home stay has started.