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I am a full-time caregiver to my mom who is a homeowner with a mortgage living in Maryland---I work in DE and driving over 2 hours round trip a day to take her to daycare and then off to work. There are not many job opportunities in MD where we live and the local medical daycare is open from 8a to 2p---so we need to keep doing as we are currently. We are paying out of pocket for daycare and can no longer afford. There is a waiting list in MD for Medicaid waiver but no waiting list in DE. I want to sell her house and move to DE as she has a mortgage but the family wants to keep the house. Is it possible for us to have a secondary residence in DE so that she can receive Medicaid waiver and allow us daycare assistance and possible home health and respite. I am employed as a home health aide and would like to be able to work more hours in the evening and be in DE near where I work, but take her to her home on the weekends. Not sure what to do and how we would afford 2 households. Any advice greatly appreciated! She has Medicare but I only want the Medicaid waiver for community services.

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NOPE. And when you sell the house, she will have a big chunk of money that has to be spent down. If she uses a Delaware address, Delaware Medicaid will insist the out of state property be sold and the funds used for her care first. Somehow they think if you have two residences you don't need Medicaid.
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First you need to get durable power of attorney if you don't already have it. Plan to sell the house in Maryland and talk to an elder law attorney about options. Perhaps there's an option to put the proceeds into a special trust for your mother's care in Delaware. Medicaid is for people who have no money or assets to sell to pay for their own care.
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We were not planning to sell her house and I am her POA.
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VSusanC, chances are your Mother wouldn't be able to qualify for Medicaid since she owns two houses.
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She only owns her house in MD and it has a mortgage. I want to move us to DE because that is where I work and I am traveling with us over 2 hours a day to keep working. I had taken a year off from work to care for my mother but have to take my life back and work because I love working and need to take care of myself also. I live with her in MD but I want to rent a place in DE for us to stay during the week to cut down on our travel and fatigue. We would still be keeping her house. I am just looking for a cheap apartment in DE for during the week. She goes to daycare in DE and all her docs are in DE. I wish we could move but there is sentimental value attached to her house and I do not want to cause her unhappiness by selling it, but at the same time I am her full time caregiver and my needs must be met also. Her income is $2500 a month and mine is down to $1000 a month because I can only work part time now. Sorry to sound frustrated but I am...
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My question is if I can manage to get myself an apartment in DE would I be able to apply for DE Medicaid waiver for assistance with her daycare and home health aides while I work (even though her primary residence and home is in MD)? I do not need the help on the weekends and can take her home to her house in MD, so we would actually be living part time in both states.
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You would need to check with the Delaware State Medicaid office to see what is allowed, since all States have their own rules and regulations. Waivers vary.

Please note, Medicaid does a 5 year look back on finances. If Medicaid finds that your Mother owns a house, they could possibly place a lien on the house.... thus, once your Mom passes, the house would need to be sold to help reimburse for your mother's care under Medicare. Remember, Medicaid is funded by the taxpayers and Federal funds.
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Yes---thanks freqflyer---I have been concerned about the possible lien on her house and this has been what has kept me from applying thus far. I am considering applying now because we are overwhelmed since a large portion of her income takes care of the house and utilities, which leaves almost nothing for daycare and hiring outside help so that I can work. My other family is very supportive but they work also, and I live with her so it is left up to me. I was hoping the Caregiver Child Exception would protect her house and allow transfer to me---she wants to leave me the house and I guess we need to seek legal counsel. Problem is even if she leaves me the house I still would rather reside in DE and I do not really have a problem with the state taking the house to recover cost, but my brother wants us to keep the house so I need to know how to protect it. I guess my only option is to tough it out and continue to pay out of pocket and still try to move part time to DE so that I am not endangering our lives and anyone else with driver's fatigue.
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I just sent an email with these questions to the State of DE Social Services---thanks for all replies:)
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Regarding the Caregiver Child Exception, you would need to check the guidelines of the State.

This Exception is usually for a grown child who is taking care of an elder who would qualify for nursing home care, but would be taken care of at their home for two years. You would need doctor proof that your Mom should be in a nursing home or having nursing home care at home. The home would need to be set up like a nursing home.

Usually if a person is in a "nursing home" environment, they are unable to go outside to go to daycare. Also, the fact that you work outside of the home could disqualify you. Thus, there is a lot to check out.
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Yes---very complicated because her strokes have affected her speech and ability to walk but she can walk short distances with maximum assist---she is wheelchair bound as she cannot make transfers without falling. She has weakness from the strokes and balance issues which impact her activities of daily living and I must perform all of this for her. She cannot be left at home alone because she has cognitive impairment which causes confusion, but she still has ability to understand and make decisions otherwise for now. I want to be prepared and do have durable POA in the event she has another stroke. She is only accepted at medical daycare since she needs total assistance. I am worried the day will come when she can no longer leave the home and trying to prepare by getting assistance. I am only applying for Medicaid Waiver 1915c and would like her Medicare to remain as primary so that she can keep all her doctors if possible---and they can all attest that I am keeping her out of a nursing home because she cannot live independently.
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And her home is set up like a nursing home---I thank God everyday that I am a home health aide because would be very difficult without training. She has the bedside commode, Hoyer lift, stand up recliner, head and foot lift bed, wheelchair, motorized chair, walkers, etc.
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She is able to feed herself but her meals must be prepared. She has the motorized chair but is not able to drive it, so I just use it to transport her around the room. I obtained the chair and Hoyer on my own from previous owners and have been trying to be resourceful in doing this without state assistance, but am growing more and more stressed by the day and with my own future. I had dreams of going to nursing school but looks like it is not in the cards for me now. I love my mom and will always put her first but just trying to take care of myself so that I can care for her.
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"Problem is even if she leaves me the house I still would rather reside in DE and I do not really have a problem with the state taking the house to recover cost, but my brother wants us to keep the house so I need to know how to protect it. I guess my only option is to tough it out and continue to pay out of pocket and still try to move part time to DE so that I am not endangering our lives and anyone else with driver's fatigue."

So what is your brother doing to facilitate keeping the house? Does he help to take care of your mother? If not, why not? Is it all on you?
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This is the question everyone asks: Yes---he offers support of keeping her for a few hours if I want to work on weekends and he cuts our grass and helps me with maintaining the house---and understands how I feel about wanting to move but feels I would be at a loss on selling it and to pay rent somewhere else would not be much less than we are paying for mortgage, which is $900 a month. He has an emotional attachment to the house, as does my mom. My feeling is a house is for the need of living and then when needs change it should be an asset to facilitate that change. He is as supportive as he can be under the circumstances, but he also lives in DE, which is where I want me and mom to be---then he could assist us even more.
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I am really appreciating all of the feedback---has been very helpful and thought provoking:)
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My mom's house would be more of an asset if there were no mortgage, but she refinanced after my day died out of necessity. If not for the mortgage I would probably be able to swing all of this as we are doing now. I would think it would not be considered an asset since there is still a mortgage.
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typo---after my dad died---meant to say...
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I am currently in arrears over $700 on daycare and my brother has offered to help me pay. Luckily I have found a great daycare for $20 a day in DE, but even this is stretching our budget now.
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The caregiver exception allows you to stay in the house, assuming you have been living with her and can document that your care kept her out of the Nursing Home. It does not give you title to the house. MERP will continue to lien on the house. The bank will foreclose when she dies or stops paying them. Delaware will deny her completely based on the fact that she owns an asset, the house, in another state. Forget Delaware. If you intend to keep the house, forget Medicaid altogether.
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Yes Pam---you are right and it means that staying in the house does not mean I own it, but I guess as long as the mortgage is paid they will not foreclose. The part about not getting assistance in DE is disappointing, but will not stop me for looking for an apartment for us to stay in during the week and just being near my brother who can stay with her while I work some extra hours to be able to afford this. I don't think she qualifies for Medicaid anyway because of her income alone. Very difficult situation. So far I am the only one who qualifies because of my income now and I qualify for Medicaid and food stamps in MD while living here with her---not where I thought my life would be. I am not sick and I want to work like I used to and afford to live my life. I will get back there somehow.
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Walking a fine line, trying to comply with governmental requirements is hard.
You say all her doctors are in DE, her daycare is in DE, etc. You will be having a difficult time proving to the government she is actually residing in MD, since Medicaid pays her doctors.
However, if a person enters a nursing home and also plans to return to their home (within a specified period of time), they can keep their home. I could be wrong.

In my opinion only, you (and family) are not rich enough to support two homes for Mom for sentimental reasons. Mom's needs and care is more important, sentiments don't get covered by any government programs. Mom is too poor on Medicaid (don't know how she qualified with $2500/mo. income) to have two homes.
If you sell the house and use equity for a down payment on a senior home, (again within a specified time period), that may work.
Maybe you should act fast on your Mom's behalf.
Sounds like you are not only driving too far, this is driving you crazy.
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My advice: Work and live where it best suits you, then Mom. Never design a life based upon what the government is going to give you as a benefit, or do to you as a punishment. Imo, the gov. gives with one hand, takes away with the other, often.

Sharing a home in DE with mom, her income could help tremendously.
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Sharing a home in DE will only help if she sells the house in MD. I am surprised that MD is paying you benefits, usually they consider the entire household income.
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I agree and right now don't even know if she qualifies for Medicaid because I have not applied for the reasons you have outlined. She has always had Aetna Medicare from her employer she retired from and she can choose a doctor in any state---she worked in DE which is why her docs are there. Most of the people who live in the town we live in work in DE since relatively close and not many job opportunities here. I did not want Medicaid to replace her Aetna Medicare---only wanted to apply for Medicaid waiver 1915c---which covers community services to assist with staying out of the nursing home such as daycare and home health aides. And yes---driving me crazy and causing me sleepless nights. My plan was to allow her income to continue to pay for her home in MD and for me to afford my own apartment in DE where we can stay during the week for work---problem is finding an apartment for no more than $500 a month.
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And Pam I was surprised to be able to get benefits as well since I did have to put my mom down for household income. I went to the Healthcare.Gov website and applied after I lost my health insurance because I could no longer work the required hours to keep the benefits. When my income goes back up I lose the benefit, but covered as long as I earn under 16000 per year. I want to work full time again and get my benefits back as I have always been self sufficient and would like to keep it that way.
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I was only applying for health benefits, but when I put in all the household info it said I qualified for medical assistance. After I entered my mom's info it said she did not qualify for assistance (even though I was not asking for her at the time, but had to put in her income). This pretty much tells me that she will not qualify for state assistance unless she become ill enough for longterm care.
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Update: Great News---just found out that if (I) move back to DE we can still keep mom's house in MD and apply for Medicaid Waiver in DE since I am her caregiver who would be living and working in DE---while she is under my care in DE. Now the hard part is finding an affordable apartment. No more driving us over 2 hours round trip a day. Just take her home to MD on the weekends so she can enjoy her home and everybody is happy:)
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V - although it sounds just fabulous that mom even though she has a home in MD can get DE Medicaid, to me it seems that financially the math doesn't work.

All the costs on the MD home including the mortgage still MUST be paid. If she moves to DE there will be a change of address. The MD homestead exemption for her more than likely is toast. Property tax reductions & payment plans for elderly & disabled are pretty generous. All that goes away & the city/state will find out. The old $600 tax bill could morph to $ 4,000. Homeowner insurance could need to change to vacant dwelling policy -these are somewhat expensive and very narrow on coverage. If she moves and does not notify the insurer and there is a big claim, they will not pay as policy was not in effect. The mortgage requires full insurance or shes in default for loan terms. Also Utilities, yard, repairs all still have to be paid for. Again more $. Her income is fixed at $ 2500. Can she afford 2 households? Yes you will find a job, but realistically how much can you take home after taxes? If you are on ACA low income the premium is being subsidized. Once you start working that and other income "at need" benefits will stop. What is a realistic rent & what up front costs to move in? You mentioned $ 500 a month is your budget. I just cannot imagine what kind of hovel $ 500 could rent for you and a disabled parent....

Really look at the probable increased costs to run 2 households. Please!. If you are going in every weekend to MD, you can't just shut off the power, cover furniture with sheets, pull closed the shutters and seal the house up. You are going to be running & paying for two fully in use households. Most folks in the US just cannot afford a second home.

Also clearly find out IF DE allows the waiver only because there is the agreement or understanding that the out of state property will be sold with the proceeds used to pay towards current or future care provided by DE. Usually this has a set time limit of 6 mos but can be renewed to a year with property listed by Realtor so there's a MLS agreement & # on the property.
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To say nothing of all that equipment and paraphanalia that Mom requires. Double up on the clothing and disposibles. Remembering her meds at both homes. Will the apartment management allow you to install a ramp to get her wheelchair-bound self to the car that is parked--where? Not in the garage. Maybe they'll let you reserve one by the door, maybe not. I don't envy you at all. Working all those hours to pay rent, utilities, and somehow $20.00/day daycare has morphed into a $700.00 debt to be paid. Maybe I misread that. But still. You don't just throw a Hoyer lift in the backseat and carry it back and forth. Good luck!
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