Newbie here

SYA

I care for my husband who has been dx'd with mixed dementia since 2015.  I need advice on how to navigate Medicare to Medicaid. All the Memory care places told me l have to pay out of pocket for 2 years then they will accept Medicaid. We have a small savings which might not even last 2 years, and live on SS.

M1

Welcome to the forum.  Needing to qualify for Medicaid for long-term care is common,  but not necessarily straightforward--worth consulting a certified elder law attorney so that you do it right.  If you google that (or CELA) in your state you should get a list; it may be worth calling several, as rates may vary.  You can also search old threads on this site, as this is a topic that comes up not infrequently.  Good luck!!

Crushed

"The first decision point comes when the client seeks admission to the facility. Some
facilities—particularly ALFs—require an agreement, by the client or his/her agent,
not to apply for Medicaid for a period of time (“duration of stay agreement”). This
agreement may be sought in writing; more commonly, it is communicated orally. Some
facilities ask family members to agree that they will be personally responsible for
paying for the client’s care (“responsible party agreement”). Federal and state laws clearly make such requirements by nursing homes illegal.2 State rules that govern other long term care facilities are less clear. Adult foster homes are permitted by state rules to refuse admis-sion based on Medicaid as source of payment in some circumstances.3 The state rules  governing RCFs and ALFs are silent about Medicaid discrimination in admissions"
 

 old problem and old source but still the law 

New source

Discrimination against medicaid recipients is absolutely prohibited but is still happening, which is why My Elder is ready to respond when it comes to elder care crisis.

While it is illegal for a nursing home to discriminate against a Medicaid recipient, it still happens. To prevent such discrimination, nursing home residents and their families need to know their rights.

The potential for discrimination arises because Medicaid pays nursing homes less than the facilities receive from residents who pay privately with their own funds and less than Medicare pays. Nursing homes are not required to accept any Medicaid patients, but Medicaid payments are a steady guaranteed payment, so many nursing homes agree to accept Medicaid recipients.

When a nursing home agrees to take Medicaid payments, it also agrees not to discriminate against residents based on how they are paying. Medicaid recipients are entitled to the same quality of care as other residents. A nursing home that accepts Medicaid cannot evict residents solely because they qualified for Medicaid (although it can refuse to accept more Medicaid patients once the number of Medicaid patients reaches whatever the facility has set as its maximum).

Unfortunately, discrimination against Medicaid patients does occur, and the discrimination can take different forms. The nursing home may refuse to accept a Medicaid recipient or may require that a resident pay privately for a certain period of time before applying for Medicaid. When a resident switches from Medicare or private-pay to Medicaid payments, the nursing home may transfer the resident to a less desirable room or claim that it doesn’t have any Medicaid beds.

There is at least one way that nursing homes can treat Medicaid recipients differently, however. Nursing homes are allowed to switch residents who were privately paying for a single room to a shared room once they qualify for Medicaid, although the resident must be given notice and a chance to appeal. In addition, the nursing home is not required to cover personal and comfort care items, such as a telephone or television. In some states families are allowed to pay the difference to get a private room or the care item. Other states do not allow any supplementation.

Keep in mind that these are general rules and that the rules in your state may be somewhat different regarding what is discriminatory. Your elder law attorney can tell you the precise rules for your state.

I

https://myelder.com/nursing-homes-medicaid-recipients-need-not-apply/

 

Ed1937

SYA, welcome to the forum. Sorry you need to be here. I can't add anything to what has already been said, but just wanted to welcome you.

Cynbar

Crushed is right, it in illegal to discriminate, but that doesn't mean you won't run into this. Facilities have some latitude over whom they admit, there isn't a lot of oversight there. They can just choose to offer a bed to a private pay patient first, saying that person is a better fit for the facility or the spot they have open.  In the same way, they can refuse a patient for admission by saying it isn't a good fit, they don't say officially that the reason is payment source. Many posters here have had LOs refused admission to a particular facility, for a variety of reasons --- they don't have to take anyone who applies. This is a tough battle to fight. You probably need to find a facility that understands your financial position from the beginning, even if it isn't your first choice. If the memory care places will not accept him under your terms, it will have to be a nursing home.