Suggestions for parents running out of money?

TheCatWantsOut

My mother and father are divorced, and I'm managing each one's financial affairs in their cognitive decline phase. My father has a live-in aide + house expenses at about $15,000 per month and my mother is in assisted living at about $8,000 per month. Both of these cost them individually about $5,000 - $7,000 per beyond their pension and Social Security income so the difference is coming out of their savings. Coincidentally both will run out of savings in about 2 years.

My understanding is at that point they will become essentially financial wards of the state and they will have to be moved (forcibly, if necessary) into Medicaid-funded nursing homes. For anyone who has gone through this transition, do you have any advice on the processes? For example, how far in advance did you start researching facilities? Or does the family not really have any input once Medicaid is paying? How far in advance did you get a lawyer involved? Anything you wish you had done differently?

H1235

In some states they allow a Medicaid waiver that will pay for assisted living or memory care. Some facilities will accept the Medicaid waiver as full payment (in my experience these are not very nice places). In other facilities they will accept it as full payment, but only if the resident has paid out of pocket for x number of years (2 usually). Other facilities will accept the Medicaid waiver, but expect family to cover whatever Medicaid does not. I don’t really know about a ward of the state. There shouldn’t be anyone from the government forcibly making them move. On the other hand in home aids will not work for free and assisted living is going to expect payment. It’s up to the DPOA to figure this out and come up with a plan B. When moms assets dropped below the maximum allowed to qualify for Medicaid(that is not zero, they are allowed to have some money, how much varies by state), I chose a nursing home and filed all the paperwork to get her qualified for Medicaid. They can do a 5 year look back to make sure money or assets were not gifted to allow them to qualify. I had to provide bank statements, proof of income, cancelled checks, an explanation for what happened to her car, documents for the prepaid funeral, and explanation for large money transfers…. It’s a real process. I now pay the nursing home all but $50 (this is an allowance for personal needs, it also varies by state) of her income each month and Medicaid pays the rest. No government agency stepped in and made decisions about were mom went. As DPOA it was on me to make it all happen. I would definitely talk with an elder law attorney. There are income restrictions you might want to ask about, our lawyer suggested a prepaid funeral so family was not left with that expense, some assets will need to be sold, others they may need to keep(if it makes sense). I will attach a link that might give you a rough idea of qualifications and what is covered, but like I said, I would definitely see a lawyer.

https://www.medicaidplanningassistance.org/medicaid-eligibility-income-chart/

TheCatWantsOut

Thanks for the info. It sounds like the options are to move to a not so nice assisted living for the next two years so they will be eligible to stay there with Medicaid assistance, or wait until all their money is gone and then nursing home as I understood.

H1235

https://alzconnected.org/discussion/comment/284609#Comment_284609

In my area there were nice Al that expected out of pocket payments for 2 years. The Al I chose expected family to pay the balance. I simply asked if they accepted Medicaid and they said yes, so I thought all was good. I didn’t find this out until she had been there a while and she didn’t have enough to cover the necessary 2 years somewhere else. The Al facilities that would accept Medicaid on day one were the ones that were horrible. I don’t think i mentioned, but some facilities can have a waiting list to get in. Usually if they are not ready to move when they get to the top of the list, you can just turn it down and they will stay at the top for the next opening. You said til all their money is gone. In my state they are allowed to have $9,900 in assets (not much when you consider the cost of Al) and are allowed to keep their home. Although the government may be able to come after that (in some states) after they pass (some states allow a ladybird dead that will get around this). But since they will have almost no money upkeep and costs would fall on you (not worth it in my experience). I want to say they can keep a car too. It’s a lot to figure out. On top of all that you have to somehow guess how fast things will progress and the level of care they will need several years down the road (which is impossible).

LisaLH

My father is in memory care that is private pay. They do not accept medicaid. I have found when looking, just for FYI, that it is easier to find them a medicaid accepting place if you are a private pay going in. The info I'm getting is if you are running out of money within 6 months, you are considered in a spend down period. I plan to move him when he has 1 year left of funds unless he is really near the end.

Victoriaredux

Getting advise from an elder law attorney and probably an accountant as early as possible is a good idea. You may have choices in the beginning that aren't there later on .