I need to get my mother onto Medicaid as soon as possible so she can afford a nursing home for the duration of her stay on earth. I’m concerned that my parents money situation may bone the whole deal. Just enough money to disqualify them but not enough for a decent place.
But only mom needs care in a facility, Right?
So what the likely near future situation for your dad??? .... like he’s fine and could live on his own as a “community spouse” for a few years OR is he kinda on the heels of needing a facility himself? To me this is pretty central to deciding what to do. A CS that could live another 5,10 yrs on their own is a very different planning scenario for Medicaid than for one that likely could go into a NH at the same time or a few months after your mom.
You wrote your folks have enough $ to disqualify them, are you referring to too much in non exempt assets (if dad remains a CS, it’s abt 119k but for couples both going into NH it’s 3k for most states)?
OR
is it that for each of them their monthly income (like their SS$ or a retirement / pension or annuity that’s paying them monthly) is over the Medicaid income limit for their state (abt $2100)?
Assets and Income are different creatures in how Medicaid evaluates. You have to know what goes into which category and IF you as dpoa could shift $ from 1 to another to better benefit dad if he’s to be a CS. But this stuff is imo not a DIY. Personally, couples medicaid is not simple and really benefits from having an experienced atty (like NAELA or CELA level) give you folks options.
But to me, it really is helpful when you into meeting with the atty with your folks to already have some idea where they stand in the eligibility maze and what ?s or concerns to ask about. And that Grem, is what this forum is really good at. So tells us a bit more about the folks and you’ll get suggestions.
Each state is different, but, after I consulted with an Elder Law attorney who focused on Medicaid issues, I got my LO to her doctor, with the Healthcare POA and filed Durable POA) to get her diagnosed and treatment recommended. I then took income information, bank statements, etc to the social services/Medicaid office and met with case worker, answered questions, signed as POA, and was basically approved on the spot, but, told that I needed two things: For the doctor to complete and sign a state form that describes the applicant's condition and need for care AND a TB test for the AL facility. IT was pretty quick, though, I don't think all states are required to get it done that fast.
It's my understanding that if a place accepts Medicaid, they are bound to the terms of what Medicaid pays. So, the facility may have some private pay residents, right along side Medicaid residents. There is no way to know which is which, based on what I have seen in various facilities. Of course, some facilities do not accept Medicaid and all are private pay. That doesn't always mean the best care though.
I'm not sure what the options are if their monthly income is too high.
I didn't think it was particularly difficult to get our LO approved for Medicaid once the assets and income had been dealt with. But it didn't happen quickly.
The lawyer wanted $7000 to file the Medicaid application. However, we hired a social worker to do that for us after the financial aspects had all been arranged. The SW doesn't give financial advice or do anything with the income or the assets. But once that was all done, we paid her by the hour to get the forms processed for us.
what they do is waive some of her income to go to dad instead of almost all of it being paid to the NH as her copay. It seems some states factor this in automatically but others do not and he has to apply for it.
Most states have the CS asset limit at 119k. Depending on his age and likelyhood of out living her for years or decades that 119k plus his own monthly income may or may not be enough. If they still have a mortgage (horrors!) and he has his own serious prescription drug costs, he needs to file for a waiver. To me, he should at least attempt to get CSRA or MMNA. Somethings gonna happen to him or the house and that extra $ will come in handy.
The amounts allowed vary by state. There was a poster from CT on AC whose mom got CSRA and the NH dad actually only had a copay to the NH of $45.00 plus his needs allowance; her mom got all the rest of his monthly income as she had high housing & health care costs.
As an aside on this, TX has a high MMNA of up to about $2800 which I find interesting as TX is like 48th or 49th in medicaids daily room & board reimbursement paid to NH.... it’s yet another incentive not to have Medicaid beds.
Be patient, this can be a long process including several hours waiting for a slot to talk to someone.
We checked into getting an elder care lawyer but the cost was ridiculous since my parents had so little money to begin with your it seemed pointless to spend +$2500 to get my Dad into a program for indigent people!
In terms of money Dad was allowed to have $2000 of his own money. Mom could retain their home as her residence, we had the title transferred to her, and $24,000 in assets. There are a lot of ways you can legally spend down the money that will be to their advantage such as clothing, medical devices, medications, etc. Even a car if it is for their use.
I was put in touch with Catholic Family Services who were a great resource for advice. You don’t have to be Chatholic.
Just remember, if a person has assets they will be expected to spend them for their care. Once that money has been spent Medicare kicks in.
Good luck. My dad died a few weeks before he qualified so I don’t have any insight into what happens then.