When we lose someone we love – whether to an unexpected event or a prolonged illness – we don’t always get the chance to say the words we wish we had. And for some, the loss is harder to process because of the things left unsaid. But there is hope. Taking time to write these thoughts down is an excellent and proven method
for helping people heal from emotionally stressful events. By writing a letter to your lost loved one, you can give expression to the thoughts and feelings rolling around inside
your mind and heart, so that you can move forward in the healing journey.
By writing a letter, you give yourself time to think through all the questions in your mind. You can be honest and reflect on your true feelings. Do you wish you’d shared something with them, whether good or bad? Are you struggling with “why” questions? Do you simply miss them and want to feel connected again? All of these are good reasons to take time to write a letter addressed to your loved one, allowing yourself the opportunity to release your emotions and unburden yourself.
A Few Tips
- This is an exercise for you, so there’s no time frame. Take all the time you need.
- You may need to write more than one letter. That’s perfectly fine. Write to your loved one as often as you need. In the beginning, you may write more often.
- Write down EVERYTHING you want to say. Don’t hold anything back, even if it’s something negative.
- If you’d like, after you’ve written the letter, you can read it aloud. Perhaps you can go to your loved one’s gravesite or another significant place to read it so that you feel close to them.
To Get Started
First, choose a medium. Do you want to write a series of letters? Perhaps a notebook or journal would be appropriate. Would you prefer to write a traditional letter on stationery? Or would you prefer to type on a computer or smart device? Take a look at a few examples
, and choose whatever medium best fits your needs.
Second, find a comfortable place to write, knowing that this may be an emotional process. For some, coffee shops are appealing, and for others, a quiet room at home is preferred. Alternatively, you can find a beautiful spot outdoors or visit a special place to begin your letter.
Third, write. There’s no instruction manual, so there’s no way you can do this the wrong way. Just write openly and from the heart. Tell your loved one all the things you didn’t say. Allow yourself to really enter
into the exercise and put it all out there. Maybe you need to ask their forgiveness. Or, you just wish you’d said, “I love you” one more time. Maybe they hurt you deeply and you need to put that pain into words. No matter what you feel, tell them.
Different Approaches & Prompts
Again, there’s no wrong way to do this, but if you’d like a place to start, here are some tips and prompts to help.
- Share what has happened in your life since their death.
- How do you feel?
- What do you miss about them?
- Is there something you regret not doing or saying?
- Were there unresolved issues that you need to get off your chest?
- Talk about ways that you’ve grown and changed.
- Tell them how you plan to honor their memory.
Write to them as if they are still alive, and make sure to say everything you need to.
What Do I Do Once It’s Written?
There are a number of things you can do with your letter. It will all depend on what is most satisfactory to you. This is not a comprehensive list, so feel free to come up with another option that may work better for you.
- Destroy the letter – burn it, rip it up, shred it, or some other method.
- Seal it in an envelope and keep it in a special place.
- Keep it in a place where you can see it often, like on a bedside table.
- Save it on your hard drive for reference later (if you used an electronic device).
- Send it to someone you trust, who will take care of it until you want it back.
- Share your letter with others through email, social media or a blog.
No matter what you decide, writing a letter to your loved one and saying everything that’s on your heart and in your mind is a step toward greater acceptance and reconciliation
to the loss you’ve suffered. This exercise will not miraculously remove your grief. In fact, grief isn’t really something we can “get over
.” But we can give our grief a voice, and you will find that the more you express your feelings of grief, the easier it becomes to deal with those emotions. Sharing your heart and giving expression
to all the emotions – good, bad, tender, destructive – is an important step on the journey toward healing.
When a person you love passes away
Look to the night sky on a clear day.
The star that to you, appears to be bright
Will be your loved one,
Looking upon you during the night
The lights of heaven are what shows through
As your loved one watches all that you do.
When you feel lonely for the one that you love,
Look to the Heavens in the night sky above.
Are you looking for ways to spend down your assets so you can qualify for Medicaid coverage? Planning ahead for your funeral wishes can help! Prearranged funeral plans can be set up as exempt assets so they won’t be counted when applying for Medicaid coverage. Not only will a prearranged funeral plan protect your assets from long-term care costs, but it will also put more money in your family’s pocket and give them a clear understanding of your funeral wishes!
While each state has its own rules and regulations regarding Medicaid eligibility, the basics are the same across the country. Here are the basics of the Medicaid spend down program and how it may help you qualify for Medicaid.
What is Medicaid?
First of all, let’s discuss what Medicaid does. Medicaid
is a state- and federally-funded program that provides health insurance for low-income families, individuals, and those in critical need of medical care. Medicaid covers over 86 million Americans, including seniors, disabled individuals, children, parents, and pregnant women.
Many states also offer “medically needy” programs as a part of their Medicaid coverage. These offer healthcare assistance to those who need medical help but whose income is too high to qualify. If you want to qualify for Medicaid’s medically needy program, you can “spend down” your assets to a level that makes you eligible.
To learn about your state’s Medicaid programs and eligibility requirements, click here.
What does “spend down” mean?
In order to qualify for Medicaid’s medically needy program, you must decrease your assets to the allowable limit (usually less than $2,000). This process of decreasing your assets to get long-term care coverage is called spending
down. In most cases,
spending down is done by paying for nursing home care expenses out of pocket until your assets have dwindled to the allowable limit.
However, nursing home care is expensive
, so you may lose a large portion of your assets before qualifying for Medicaid. That’s why it’s essential to consider other options and make a plan before you need to spend down.
How can I protect my assets from being spent on nursing home costs?
Most state Medicaid programs allow certain assets to be exempt from consideration. These assets won’t count toward your total, which could help you qualify for Medicaid sooner. Before spending down, take time to learn
which of your assets are considered exempt, which are non-exempt, and how much you can preserve for your family. You can see some examples in the next section, but check your state’s specific rules about exempt assets.
Depending on your situation, you may need to transfer your assets up to 5 years before applying for Medicaid coverage. For example, if you apply for long-term services and supports (LTSS)
, you will be denied if your assets have been transferred for less than fair market value within five years of your application for Medicaid assistance
. That’s why planning ahead before spending down is so important!
Most states follow the Social Security Administration’s (SSA) Supplemental Security Income (SSI) guidelines
to establish Medicaid eligibility for disabled individuals and seniors over 65
. However, some states have their own guidelines, so be sure to check your state’s specific eligibility requirements.
In general, what kinds of assets are exempt from being counted for Medicaid qualification?
Before you apply for Medicaid, you can set up certain assets as exempt from being counted for Medicaid qualification. The list of exempt and non-exempt assets below isn’t exhaustive, but it can be a good starting place. If you have questions about whether a specific type of asset is exempt, check with your state’s Medicaid program. Every state can set its own qualification rules, but these assets are typically exempt:
- Your principal residence (subject to equity limits in some states) if you, your spouse, or your dependent child still live in the house or if you intend to return to the house.
- Personal property and effects, such as furnishings, belongings, appliances, and household goods. Some states place a cap on the allowable amount.
- Life insurance with a cash value of up to $1,500. Term life insurance is generally excluded as an asset.
- A designated revocable (can be canceled) account for burial funds with a value of up to $1,500 per spouse. Other burial funds, irrevocable burial contracts, and cash surrender value from life insurance will reduce this allowable amount.
- An irrevocable (cannot be canceled) contract for burial space items (with no limitation on the amount) for you and your immediate family members, including your spouse, your children (including adoptive and stepchildren), their spouses, your siblings and their spouses, and your parents. Burial space items include caskets, urns, vaults, burial plots, cremation niches, headstones, grave opening and closing, and perpetual care. Burial space items are separate from burial funds.
- A larger irrevocable contract for burial funds for you and your spouse only that includes funeral service costs such as transportation of the body, embalming, cremation, flowers, clothing, services of the funeral director and staff, etc.
- One automobile (in some cases, there is a limit on the market value).
- One wedding ring and one engagement ring.
- A married couple can keep considerably more if one spouse is still well and does not need Medicaid. Learn more about Medicaid’s protections against spousal impoverishment.
Non-exempt assets are those that Medicaid considers as part of your accessible, countable assets when you apply for assistance. You will be expected to liquidate these assets to help you pay for long-term care costs. Non-exempt assets include (but are not limited to):
- Checking and savings accounts
- CDs, stocks, bonds, or mutual funds
- Retirement accounts including IRAs, 401(k)s, 403(b)s
- Prepaid funeral contracts that are not irrevocable
- Trusts (depending on how they are set up and your access to them)
- Property other than the primary residence
- Jewelry and valuable art or collections
- More than one vehicle, boats, RVs, etc.
- Cash surrender of life insurance with a face value of $1,500 or more
What is the difference between burial funds and burial space items?
Irrevocable contracts for burial funds and burial space items, which can’t be canceled or liquidated, are exempt from being counted as an asset for your state’s Medicaid program. But what are burial funds and burial space items?
Burial funds are funds set aside to cover
the services provided by a funeral home. These cover funeral services and most goods a funeral home sells, like embalming, burial clothing, preparation of the body for burial, cremation fees, limousines, flowers, and much more. To be considered exempt, burial funds can only be purchased for the Medicaid applicant and their spouse. Burial funds must be placed in an irrevocable prepaid funeral contract (maximum value determined by state) or a revocable account of less than $1,500. Because an irrevocable contract has a larger maximum value than a revocable account, you can save more money from nursing home costs with an irrevocable contract.
Burial space items
are merchandise and items associated with the burial of a body, like cemetery plots, vaults, caskets, urns, opening & closing of graves, cremation niches, headstones, grave markers, family estates or crypts, and perpetual care. Burial space items must be in irrevocable contracts to be considered exempt with no limit on the amount. Plus, you can purchase burial space items for almost all of your family members, including yourself, your spouse, and your immediate family members and their spouses. This is one of the few ways to legally set aside some of your assets for your children!
Consult an experienced prearrangement specialist or licensed funeral director
to ensure your contract meets your state's Medicaid spend down requirements.
Important Notice about Medicaid Eligibility Rules
Please be aware that Medicaid rules vary greatly from state to state and are constantly changing. The listed examples of exempt and non-exempt assets may vary from state to state and will often depend on various individual factors. Most states follow the Social Security Administration’s (SSA) Supplemental Security Income (SSI) guidelines to establish Medicaid eligibility. An attorney can assist you in designing a Medicaid plan that preserves as many assets as possible under your state's laws and eligibility requirements.
Always speak to a qualified attorney who is knowledgeable in elder law before spending down or transferring assets to qualify for Medicaid. Purchasing a prepaid funeral contract is an important part of your complete Medicaid plan, so be sure to consult a licensed funeral prearrangement specialist or licensed funeral director who can assist you in creating a properly structured prepaid funeral plan.