DENIED by Medicaid

riajean

 As expected, Saturday, the letter arrived denying benefits for my poor husband in long-term care, in Hospice care and re-certified after 3 months to remain in Hospice care.

Due to my father's death, 3 years ago today, and his wealth divided among my siblings of which we had no knowledge, Medicaid took it upon itself to deny my right to their financial help for my DH.    For more than a year, I paid out of pocket, using my SS, my husband's SS and part of my inheritance monthly to pay for memory care until Covid hit, and took away my DH's ability to walk and eventually and quickly, his ability to feed himself. 

He is bedbound, has been since October.  My intention was to pay what I could as I was paying out of pocket up to $5K/month for memory care.  The county office of Medicaid after raping through 5 years of my personal, private life, decided that there was a transfer of funds for which I have been penalized for 6.45 months.  I do not see/find that amount in any statement or checkbook register, therefore, it's unjustified.

Beside myself, a woman alone, struggling to live on my own, pay for my needs and the  needs of my husband, I have NO idea how to pay $76K +/- to Medicaid for my husband's current care in long-term; Hospice dictated care.  The long-term care facility charges $14K/month and there is literally little difference from memory care other than he now is bedbound and needs to be fed, changed, etc.  In memory care, at least there were activities.  Now, there's none of that and my husband is simply "existing'. On several visits, I've found him unclothed, wet, on wet sheets, not clean, having to ask for someone to care for him.  For this I'M PUNISHED. 

We treat illegal aliens better in this country than we do our sick/terminally ill.  I'm beside myself. 

Yes I have an attorney who said it will cost me - out of pocket - more of my inheritance that is going directly for the care of my husband (not me or my future as my father directed) between $5-$8K for his "help".  This is just sick and stupid.  Makes me want to leave the good 'ole US of A for some other country. 

Now onto the continual FIGHT for what is RIGHT and just.  It just wasn't enough that I'm losing my husband to a devastatingly cruel disease for which I've been directly involved going into 9 years?  Saddened to my very core.

toolbeltexpert

Riajean I hate that this seems to be a constant thing with Medicaid. I was originally told I needed to spend 17k then after doing that I was told I needed to spend 53 k. I had placed my dw in a Medicaid facility that cost me 8500 for 30 days. I looked at how things were going to end and made my decision to try to fund this on my own.

Just after 1 month at the Medicaid facility, an opening came up at my personal pay number 1 choice,I jumped on it, 3659 a month. She has been there just over 4 months, our house is for sale and that will be the funding for dw's care hopefully thru the end. I will buy a smaller place and move closer to where she is. Till then I will pay. Our combined ss wouldn't cover her care so right now now I am doing a slow bleed. 

I had to make that decision as early as I could so I could fund her care for a year or more. This works for me but not everybody. I am sorry that Medicaid can't get their act together.

Stewart

Crushed

I kept careful track of the hours I spent on my wife's OPM/MSPB  appeal   It was in excess of a hundred hours of legal time. worth $20-30 000 in 2014  The victory has been worth in excess of $ 80,000 already

You Just have to do the number to see if litigating is worth it 
  

harshedbuzz

Riajean-

I am sorry you find yourself in this situation.

I am confused though. It sounds as if the distribution of your father's estate was flagged in Medicaid's 5-Year-Lookback. Did you not notice the transfer of those funds or did the transfer never happen?

We had a similar situation before my dad died. My mother was due to come into an inheritance in the low six figures as the result of her sister's death and the CELA explained that those funds would be considered available for dad's care which rankled her. This was around the time that we discovered that dad had lost over $350K day-trading in the early middle stages of the disease. She saw the money as some sort of compensation for what the illness had cost her financially, but Medicaid doesn't see it that way. 

TBH, this all blew my mind. My aunt's husband worked a long career as a teacher pioneering cooperative education and a long-time navy reservist who invested wisely. Dad died before the distribution was made, but if hadn't the money would have been considered available for dad's care. My uncle didn't particularly care for dad; had that happened there would have been significant seismic activity noted in Mid-Coast Maine.

I'm not sure what the undocumented have to do with any of this.

HB

Newbernian

My lawyer told me about a year ago that medicaid rules are controlled individually by the state.  I live in NC.

My husband's condition has been slowly deteriorating.  My lawyer said I should give him about 45 days notice before my husband is put in a care facility so that he cold transfer the deed to the house into my name only. It didn't sound like it was part of the 5 yr. look back. I hope not.  I have $10K left in a 401K which I understand I would lose half of.  The only thing we have our investment in is our house.  But I don't think I could afford the taxes or insurance without his SS.

dayn2nite2

I had made a post earlier today but posted to the wrong thread, so I deleted it.  In a nutshell, Medicaid is for when you're out of resources.

With my mom, we ran through her savings and I even used my own retirement savings (bad idea, don't do this!) and she  had nothing but her Social Security check.  So she was approved.  Every month I wrote a check to the NH for everything but $60 of her total check to cover her contribution, Medicaid paid the rest.  Then I wrote a $60 check to the escrow account the NH had for her personal expenses, which consisted of her hair appointment.  I purchased all clothing/toiletries that I wanted her to have and things like wipes, which Medicaid did not cover (they did cover incontinence briefs - but I was paying for them for a year before I found out on my own that they were covered).

Yes, it is a state-administered system so each state will have different requirements on what they consider eligible.  But rightfully it is for those people who have almost nothing left.

I also am unsure how one can get an inheritance and not be aware of it or aware that it could affect when Medicaid kicks in.

Regarding hospice, that is a MediCARE benefit.  MediCAID would cover room and board.

jfkoc

Maybe this will be helpful;

https://www.medicaidplanningassistance.org/medicaid-eligibility-north-carolina/#:~:text=North Carolina has a 60-month Medicaid Look-Back Period,This includes asset transfers made by one’s spouse.

[Deleted User]

The user and all related content has been deleted.