that’s what I have to do, to get my elderly mom into assisted living. I am asking, is this an onerous process? I’ve heard it can be a nightmare. I’m the only one to do this, there is no one else. A lawyer said it would cost almost $5000 f’ing dollars for him to do it! It’s not that complicated! Me and brother owns the house. Mom gets pension, SS, has small savings. No car. Has a will, I have a PofA, theres a living will, health care proxy.
I’m sorry. I’m not asking for expert legal advice, but I have to make a call and wonder how it will go. I know nothing about these things.
I am all on my own here, looking at a phone number to call. Any tips? Anything I should know?
My nephew is trying to do the same thing for my (step)mother. The difficulty is not, as I understand it, Medicare. the difficulty, at least for him, is getting power of attorney for someone already in demetia. If she’d signed the POA before she was observed to have problems, all good. Since she cannot sign now, it’s a complex process to go before a court, get the court to approve that the person is indeed incapable of legal consent, and assigning the right and determining this is the appropriate person to assign this.
Talk to the assisted living place you are thinking of putting her in. They probably have a great deal of experience doing this.
As to you and your brother owning the house when did this happen? Medicaid has a look back period of 5 years so if the transfer happened during the last 5 years then that will disquality her from receiving coverage:
Thank you. Brother and I have owned the house for at least 9-10 years. We do have a durable PoA, though for some reason my brother 2000 miles away is listed as the primary, and I am the backup. (I am hoping they will accept me for this and we won’t have to be overnight mailing forms back and forth.) I am on mom’s checking account in order to sign her checks. (I have kept as many receipts for groceries, etc. as I could, but not all of them). I do plan to call the facility to take a ‘tour’ but I just wanted to get started as much as I can…It seems pretty simple, she has so much coming in, Medicare, supplemental insurance, and I’m told she’s eligible right now for Medicaid (a few thousand in her savings)…I am wondering right now, how much of a hassle will it be if they are going to question what happened to the things I wrote a check for, but no receipt? I do her shopping, write a check, and round it up maybe $20 for gas, fast food, Depends, spare cash to have in her house for whatever…I don’t have receipts for Burger King or a bag of bird seed, those other little expenses…
Medicaid is administered by the states, so a lot will depend on which state you are in, including whether Medicaid will pay for long-term assisted living in the first place (they don’t everywhere).
That also means the onerousness of the process depends on your state bureaucracy and on which social worker is assigned to the case. I’ve been involved in the process twice, and it was very difficult both times (although to be fair, there were extenuating circumstances both times: an adult dependent child and a spouse not going into nursing care).
Whether or not they take the durable PoA may depend on exactly how it is written. If, e.g., you are the backup only if your brother refuses or is unable to serve, you may need to get him to resign as primary, or both of you get very well acquainted with FedEx.
Your local agency on aging can be an excellent resource, or it may be worth paying an elder-law attorney for an hour or two of consultation to find out how your state works.
What’s the complication with house ownership? My nephew mentioned they would delay the house sale (both my step-mother and my father just went into a home at Christmas) because they were trying to get Medicare to help pay for her, at least. Is home ownership treated differently than cash?
Yes. The primary residence of the Medicaid recipient, to which they plan to return (and they may or may not be picky on how realistic that plan is, depending on state), is an exempt asset, at least up to certain dollar limits. Exempt assets such as the home, certain prepaid burial plans, a vehicle, and so forth are not considered to be available to pay medical bills. Cash and cash equivalents are most certainly available, and the expectation is that they will be spent on the nursing home before Medicaid kicks in anything.
I’m not sure how delaying the sale benefits in the case you mention, though, because once it is sold the assets are usually considered to be available. Moreover, the estate recovery team will try to recoup monies if a Medicaid recipient dies while owning exempt property. Is the house only in your father’s name?
I don’t know for sure, but I seem to recall reading somewhere that if you go into a Medicaid-sponsored nursing facility that is expected to be permanent, you are expected to liquidate pretty much everything to help pay.
Exceptions for a surviving spouse, of course - hubby has to live somewhere.
As far as eligibility for Medicaid assistance in general, I believe that in most states the house is indeed exempt in determining one’s assets.
If the parent is living in a house provided by a family member, the value of the housing (fair market value of rent) is treated as “in kind” support and may well reduce their eligibiltiy - say the income level is 1,000 a month, the rent on the house would be 500 a month, mom has 800 a month in Social Security - she’s treated as though her income is 1,300 a month. I don’t have cites at the moment, but I saw this explicitly stated in some reading I did last year.
Go ahead and call. If you are in Texas, you will never get a human being to answer. So you have nothing to lose by calling. That’s probably the case in some other states, as well.
A recording will take your name and address, and mail you forms. If you quality, you will likely be accepted, but they might request that you appear in person for an interview or a hearing. Their objective is to inconvenience and humiliate people who are elderly, infirm or disabled. But they will still come through with the benefits if you genuinely meet the criteria.
Another thought, six minutes later. Phone a local hospital and ask if they can refer you to a local advocacy group, who specializes in helping people like yourself. Hospitals helpfully cooperate with people trying to get financial assistance, because sometimes that’s the only way a hospital can hope to get paid.
My father went into hospital and now a home at the same time. Technically, if he could be sure his mobility issues were solved, he could go home… so I assume half the house would count as his asset.
The problem is that good care is expensive, and selling the house might provide the necessary supplement to support them as long as they need. Not sure how much of a subsidy Medicare gives, or what happens when they do sell. What happens if they sell after being approved? Technically, my mother could not (should not?) drive so it’s my father’s car if they sold that.
Well, I called and spoke to a nice man who said he was sending me a couple of forms to fill out and return, and then I would be assigned a caseworker. So it’s a start.
I’m now wondering, we have a place in mind who said they could take Mom, with Medicaid. Someone said, “oh no, not that place! it’s awful! Call around to different nursing homes to see if she’s eligible.” I can’t find a single comment anywhere online about the original place, good or bad (it’s fairly new). None of the nursing homes here are great places, and the good ones have a long waiting list. It’s imperative that we get moving here, having extra help coming into her home will not be sustainable for long.
In my state (Kansas), the Medicaid office relies on the patient’s own statement about whether they intend to return home, and the regulations specifically state “The statement shall be accepted without challenge and regardless of whether or not the intent is realistic” KEESM 5331.3. If you tell them you are moving permanently to a nursing home, yes, you must sell your own home after three months and use the proceeds to pay expenses. If you tell them it’s a temporary stay in the nursing home and you intend to return, you can keep the home even if you are going to the nursing home because of Alzheimer’s or some other irreversible condition. (You won’t have any income left to pay for upkeep or property taxes, and they’ll have a lien against the property, but if you really want you can retain ownership.)
Other states, though, can have different rules. In Ohio, the house is exempt for 13 months; if you haven’t moved back home by then, you have to sell and use the money for the nursing home.
In my state, “in kind” benefits are always exempt. Again, your state may be different.