Financial Help(1)

StelG

My mom has Alzheimer’s and it’s time to find a memory care facility for her to move into. She is not eligible for Medicaid but cannot afford to pay on her own and neither can I. Has anyone else had this problem and where do we go from here? Where do we begin?

dayn2nite2

What is the reason she’s not eligible for long-term Medicaid?

Have you already made an appointment with an elder care attorney for advice?

In many cases, you have to liquidate the assets and use them for self-pay until her assets are at or below the threshold for your state.  

M1

Welcome to the forum StelG.  Day2nite is correct, she should be able to qualify for long-term Medicaid eventually, but you have to be willing to spend down her assets and it has to be done in a legally and fiscally correct manner; this is what certified elder law attorneys (CELA) specialize in and it is worth getting the correct legal advice for your state.  That's a hard step for some to take, but it is what you should consider.  Many memory care facilities will require private pay until she does qualify for Medicaid but will then not kick her out once she is on it.  You definitely need professional fiscal advice, for most states there is a five-year lookback at how money is spent, and you don't want to make mistakes that might disqualify her.

Mobile AL

I've been in tears, literally, since I was told that the house would have to be sold for daddy to qualify for medicaid. He and my mother worked for years to get this house and insisted they wanted it to go to me and my siblings. 

I moved back home several years ago to help my parents and my sister. Sister and mother had cancer, father was mid stage alzheimers.  I sold what I had remaining after my ex got half the proceeds. I paid for half my brother's funeral and all of my sisters funeral. My mother had prepaid her funeral. This was going to be my home. I also have three of my sisters adult kids living on the property as well as their father in mobile homes.  All of us will have to find accommodations elsewhere. Or I would be paying monthly payments close to at least $3,000 for a nursing home. Right now he is in at home hospice which is killing me. I'm 70 years old and can't roll him to change his diapers. Aides come 5 days a week for about 45 minutes a day. Right now I hear him moaning and thrashing in his bed from the pain and can't give him morphine for another 50 minutes. 

God bless America. If you can work to pay your taxes and buy a house you are penalized when you're old, sick and need help. I'm on disability and will be getting a cola increase next year. Medicare plan B is increasing the deduction from my check every month beginning the first of the year. Go figure. 

I've been trying to figure out where to go from here. Yes, I have some family to help if I call them. One can help if he's sober but the others have jobs and young kids in school. I'm about ready to just walk away but I can't. It's my father. And he sacrificed so much for me over the years. 

Cynbar

Stel, is it possible you are confusing community and long term care Medicaid? They have different qualification criteria, many people are not eligible in the community but would be eligible for long term care coverage. Basically, in the community there is an asset limit and a (very low) income limit. Applicants are rejected if they are over either limit (or both, of course.) But when you enter long term care, the income limit is basically waived unless you get more than the cost of a facility, which is a lot. You still have to qualify on the asset limit, too. Anyway, some people get a rejection letter in the community and think "That's it, I'm not getting Medicaid, when it is not necessarily true. Here in Massachusetts, people are encouraged to apply while still at home even if they are over income --- they get a rejection notice but all their information is in the system, and they can convert quickly onto long term care Medicaid if they enter a facility. Could that be what is happening with your mom? Now, if she is over the asset limit, she would have to spend that excess on approved medical expenses before getting Medicaid (there is a 5 year lookback period where you can't have given money away.) It's a little different if she has a spouse at home, that's a separate discussion. And yes, it is true that some people are ineligible for Medicaid, usually because they have given large amounts of money away. But if they have too many assets they have to use them up first in approved ways.

Stuck in the middle

Mobile, everyone who is thinking of quitting their jobs and moving in to care for their parents should read your post.  I heard a thousand versions of your story during my career with the SSA.

I  am sorry this happened to you.

StelG

Thank you all so much for the warm welcome and this wonderful information.

She is over the income limit that’s why she’s not eligible but I also didn’t realize there were different types of Medicaid. I feel so stupid. All of this was so confusing to me, I never heard of a CELA either. I feel so much better because it seemed hopeless and as you can see I was completely lost but now I have a bit more clarity and can figure out our next steps, I am so grateful! Thank you! 

Mobile AL

I wasn't aware of the different medicaid plans either but I did further research and saw where the home cannot be touched if an adult child lives in the home who has been caring for the applicant and has helped to avoid putting them in a nursing home until medically necessary. 

I am disappointed that the hospice group I've been working with has not brought that option to my attention. I will contact a lawyer tomorrow and set up an appointment to discuss it with him. I need to avoid probate if at all possible because Daddys accounts are in both our names. Seems that may be a problem too but I'll see. 

Maybe there is a light at the end of the tunnel that isn't an oncoming train.  And I've got someone coming tomorrow to fix my hot water heater!  It's been out since Thursday. I had to heat water for the aides to give daddy his bath, for me to clean him up when I change him (those wipes are so cold) and for me to wash his sheets and blankets. 

Cross fingers...

towhee

Hi StelG, perhaps this example will help to clarify Medicaid income limits. This is for just one state, you need to know that all states are a little bit different in how they handle Medicaid.

Medicaid long term care / Nursing home     Income less than 5500.00 - 7000.00 per month, varies by location in state for one applicant

Medicaid waiver programs- these usually help to keep people in their homes, they usually have a waiting list. Can cover Adult day programs, some home care, some home modifications. Income less than 1073.00 per month for one applicant

Regular Adult Medicaid- This is basically medical insurance, covers doctor visits, hospitalizations, medications, some dental and vision. Primarily for people under 65, although can be used as a supplement to Medicare for people over 65. Income limit is 1073.00 per month for unmarried applicant but 1452.00 for one applicant who is married.

Care in an assisted living or memory care- This is not medicaid in this state, in several states it is a state program, and a few states have no funding for AL or MC. In this state the program is called Special Assistance and the income limits are less than 1250.00 per month for AL and under 1550.00 per month for MC.

You can google your state and assisted living and medicaid, look for a .gov site and get general information but you really need that CELA lawyer, especially if your mom has any assets, you don't want to do anything with them that would make her ineligible. Keep in mind that you usually do not get to decide what level of care your mom goes into, that is usually decided by a doctor, and also you will have a better chance for a "medicaid' bed if you have some funds for private pay first.

Good luck-

towhee

Mobile AL, your being on disability might also help with the home. Your situation sounds complicated however, and you really need that CELA lawyer or at least one that does a significant amount of elder law. And it does not hurt to do some research and get a second opinion.

Please do not be upset at hospice. They are supposed to know medical care, not all the ins and outs of medicaid regulations, that is for county social service departments and lawyers.

King Boo

Certified Elder Law Attorneys may be found at www.nelf.org

Many profess they do elder law; not all who do so really know it.  If a CELA is available, they have national certification.

Mikela

I am just starting this aging parent journey myself.  I found out about CELA attorneys from this website and having one is priceless.  We had an emergency hearing today.  It went great.  Our CELA attorney knocked it out of the park.  I know they offer advice for traversing medicare/medicaid too.  We only have 29 CELA qualified attorneys in the whole state.  

Mikela

StelG

@towhee Thank you very much for providing those details, it is very helpful. I’ll take your advice and research the information for my state and get started in my search for a CELA. I’m so glad I found this board!