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<I>They say that some fixed annuities (that they will sell you naturally) will not be included when reporting
income to determine qualifying for Medicaid nursing home care.

Let me take a shot at the fact pattern on this question. If the marital assets are used to purchase an immediate annuity on the life of the community spouse, prior to applying for Medicaid, the monies so invested will not be counted in the asset picture to be considered for spend-down before the institutional spouse becomes eligible for Medicaid. I believe the annuity must be immediate, and not deferred. If it is deferred, it could be withdrawn, and would thus become part of the assets picture for determining Medicaid eligibility. I believe the amount of the annuity distributions are considered, but since they are income to the community spouse and not the institutinoal spouse their role in medicaid qualification is peripheral.

Some larger questions are: how much money is at stake and what is the intended use of the money? Is the purchase of long term care insurance a viable consideration?

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