Elderly, low income, assistance?

In My Humble Opinion
1

The in-laws have Social Security and nothing else; no assets whatsoever due to a combination of bad luck and bad decisions.

Total income is about 2400 a month / 28,000 a year. This is enough above various poverty levels that “on paper” they don’t qualify for any kind of assistance. In their county they just qualify for a subsidized apartment - at 900 a month or more for some dumps. Surrounding counties with lower rents have lower income cutoffs as well. We’re in the process of purchasing a condo for them that will be more like 700 a month.

Between their Medicare fees, a Medigap policy (about 450 a month), a fee for prescription coverage, and doctor and prescription drug copays, their medical expenses are nearly half their income. We’re getting conflicting figures on what their out of pocket costs are for prescriptions but I’d say it’s a minimum of 300 a month, and possibly up to 600 - so that’s anywhere from 850 to 1150 a month.

Being human, they also need food, transportation, utilities… They’re currently dealing with a shortfall of 500 a month and that’s by just paying their HOA dues (not their mortgage, which has just been foreclosed).

At present, family support has been specific amounts (e.g. we gave them the “down payment” for the car, which is leased; SIL is paying the lease fee). There’s a habitual refusal to give us ANY financial info at all, and this week they implied to me they could pay the condo mortgage (< 200 a month) while implying to another sibling that they couldn’t pay anything. So what information they DO give us is conflicting.

The only place I see for them to save money is to cut the medical expenses. Or failing that, to use the large medical expenses to leverage eligibility for food stamps, other medical assistance, etc. Anyone have any experience with this kind of thing?

The medical expenses sound insane. Yes, FIL is on some expensive stuff (and the “help the uninsured” programs explicitly exclude people getting Medicare etc. ). But half their income???

Forgot to mention: this is in Florida.

2

If they are on brand-name meds, I’d look into manufacturer assistance programs.

3

Somebody else posted on here about GoodRX.com.
Put in the name of the med and your zip code and it will give the cheapest place.
You have to do it for each med, just because one med is cheaper at one location doesn’t mean they all are.

4

I don’t know if they do this, but when they sign up for a Medicare Medigap or Advantage plan, usually there are options that are better or worse for people given specific medical needs/prescriptions.

My gut reaction is that a Medigap policy is not ideal for those with high prescription costs and that an Advantage plan might be the better choice. I think Medigap does not cover drugs and you have to buy separate coverage, while at least some MA plans cover drugs.

BUT, my caveat is that when I was really knowledgeable about this stuff, my husband was on Medicare because of disability, not age, so he was not eligible for Medigap. So I’m not a Medigap expert.

So, if there is an MA plan that covers what they need covered, they may save hundreds of dollars a month.

5

Do some research on Medicare Supplement Plans:
https://apps.fldfs.com/mcws/

http://www.medicare.gov/find-a-plan/questions/medigap-home.aspx?AspxAutoDetectCookieSupport=1

You may be able to find cheaper options than what they have.

6

Definitely look into SNAP (food stamps). The elderly are not subject to the gross income test, only the net income test. The net income test is after deductions for housing and medical expenses. Given their financial situation, it sounds like they’d likely be eligible. More information about eligibility here.

7

If the parents aren’t being open about the financial problems they are in, what can you do? Sounds like they may be playing the kids against each other. If things are as bad as you say they are, one of the kids may need to take in both parents, with the other siblings chipping in what they can.

8

Your in-laws may qualify for extra help with their prescriptions from Social Security. They could save up to $4000 a year. You can find information here.

As an example, I pay $6.60 copay for each brand name prescription and $2.60 for each generic, and I have NO coverage gap. After a certain total amount of out-of-pocket and insurance costs, my prescriptions become free. This is only my personal experience. Their coverage may be different. Forgot to add, this assistance is specifically for people on Medicare, so this would definitely benefit them.

If they qualify for SNAP, they should also look into having their state pay for their Medicare premiums. That’s a savings of $104.50 monthly.

9

I don’t have any information on US American healthcare costs, but I have some support for you - if your in-laws are taking financial help from their adult children and their spouses, they have given up any rights to financial secrecy. I have a feeling all the siblings and spouses need to provide a united front on this issue.

Best of luck to getting their medical expenses down - that sounds insanely expensive to me, too.

10

I highly recommend them talking to their doctors about their financial situation and asking about prescriptions. Are they on something that could be replaced with a cheaper med? Could their doctor prescribe twice the dose so they can cut pills in half and double the length of time their meds last? Their doctor might really be able to help them get their prescription costs under control.

11

They should also ask their doctor for samples. My doctor has been very helpful in the past by giving me samples when my meds became too expensive.

12

Bad past decisions got them where they are. Bad current decisions are keeping them there. If they won’t be realistic about their finances, you can either use leverage to force honesty** or **disengage. Either they open up their checkbooks to an honest overview by all the kids, or they stop getting help. You’re letting them pretend to be helpless. You’re letting them lie to you. This is enabling them to continue being irresponsible. It’s not helping them, and it’s not helping you.

Practical advice: transportation costs are mutable. They do not need or deserve to lease a car. If they live on a fixed income and don’t work, then they can get by with a cheaper car, or no car (and rely on family/occasional cab for transportation).

13

Agreed. I’m getting the impression that they don’t want to make the decisions and changes that living within your means entails. $2400 per month is not really peanuts - there are plenty of low income people who live on far less per month.

14

Going to try to address individual comments in one long post:

Car lease: This was actually the most cost effective choice for them, 2 years ago. Their old car (12+ years) had died, and they truly need some transportation. The family thinking is that in 4 years (well, 2 years now) who knows if they’ll still be able to drive, so why make huge payments in the short term to purchase something. As little as I like car leasing, it was quite possibly the right choice. (of course, MIL lists that 209/month payment in her monthly budget - despite the fact that SIL pays that - but omits the 500+ for insurance… :smack:).

With their health issues and assorted doctor visits, not to mention routine stuff like shopping, they need transportation, taxis would be prohibitively expensive, and the county’s senior-transportation bus might not be a good substitute. It’s something we’ll look into in 2 years of course. No family nearby - we’re the closest, physically, and we’re a thousand miles away.

Giving up the right to make their own decisions: oh hells yes. They fight for privacy but when they lie, forget to tell us stuff, or give us conflicting info, we can’t allow it to go on. Typo Knig and I agreed to a condo purchase as the cheapest monthly cost for housing (and it is - subsidized places are 200+ more per month) but that was with the understanding that they had a little room in their budget for some of the cost. This turns out to be untrue.

Prescriptions: Samples would definitely help. The drug companies’ assistance programs generally specifically rule out any help for people with any government-sponsored coverage (what???) but at least one says they can waive that in some cases. FIL is looking into that for one of them that costs him nearly 300 a month. In some cases the brand-name may be truly be better or may “just” be a combination medication that improves compliance (the combo meds are usually, in my opinion, a money-grab versus truly beneficial).

I don’t believe they’re deliberately playing kid-versus-kid but they ARE, intentionally or not, saying different things. Like last week I said NUMEROUS times “you can pay the mortgage directly to the bank, not to us” (long story involving a family connection: bought place for the parents, collected rent, and didn’t bother to pay the mortgage, resulting in parents getting foreclosed / evicted). They never said anything to deny that. We kids, however, are talking so we all get our stories straight.
**
BetsQ**: Thanks for the info on the SNAP program: I didn’t realize that it was a “net income” test. The in-laws were CONVINCED they didn’t qualify. Their net income is a hella lot lower than 2400 a month.

cochrane: thanks for the info on the prescription assistance! I had not heard of this. And the Medicare payment would be a help - each is having 104 dollars (I think) taken out to pay for that. I’ll also remind them to ask the doctors for samples. Even if it’s only a couple weeks worth after visiting the doctor every 6 months (or whatever), every little bit helps.

My sister-in-law made a good point: we need to get the housing dealt with first, as the parents are so acutely stressed by the situation they can’t even LOOK at other things to do (hell, they’ve known this was coming for over a year but did not apply for services until 3 weeks ago when my husband flew down there and walked them through the steps).

15

Is FIL a veteran?

And ditto on researching other Medicare supplements. If they’re paying $450 a month and still having to pay another $300-$600 a month for meds, damn.

What kind of scrips do they have? My husband takes 14 pills a day for diabetes, cholesterol, blood pressure, and prostate. Two are through the VA but the others he gets at Wal-Mart at $10 or less for a 90-day supply.

16

Do they have much equity in their home? Sell it and move into subsidized senior housing, maybe?

17

Its being foreclosed on - my guess is the ship has sailed on equity in their home.

18

Look into Medicaid in your state, it’s for those with no assets.

Also, it might be time for an assisted living place rather than a condo, if they’re being forgetful (or saying different things at different times)

19

We’re told they may qualify for a Medicaid Waiver program (which helps with medical costs).

Re assisted living: I don’t think either would qualify, nor do they really need it yet. If FIL were gone, MIL might - her mobility is severely impaired (hip problems). But if they did need it, the only option would be some kind of institutional care (or some program that provides in-home support), as there simply aren’t the assets for it. We can’t afford that anyway.

I think the conflicting info is more that they’re wearing blinders, than anything else - plus they’re so terrified they can’t force themselves to look really sit down.

The facilities are pretty grim, as well, from what I’ve heard. A friend’s mother is about to have to move to one: she has severe dementia and every penny of her assets went to keeping her in a decent place, and now that’s run out.

Oh, and of course with any assistance, it requires the state agency to follow up, dadgummit. They applied a month ago, got a request for proof of citizenship a week or so later, sent that in, and… nothing.

I took a look at the info regarding food stamp eligibility and they should indeed qualify - since net income is gross minus their considerable medical costs, and some of their housing costs. Of course this gets them a whopping 150 or so a month in benefits. Still, it’s 150 they can spend on other needs. I’m so annoyed they refused to even apply last year - they looked at the “gross income”, said “we don’t qualify”, and didn’t even try.

In the meantime, we’re getting jerked around by the seller of the condo we’re trying to purchase. They panicked about HOA rules and mortgages (no problems whatsoever, they just freaked), and have promised to have a contract to us today (the expiration date on the offer we wrote). No contract. If our realtor doesn’t have signed paperwork by tomorrow morning I’m very tempted to tell her “the old offer expired. Write a new one and knock 1,000 off the price”.