A recent thread has lead me to believe it may be useful to start a discussion on how to place loved ones with dementia or a progressive illness who live with you in a SNF or Memory Care facility. Mainly for those who cannot afford the upfront out of pocket costs for these facilities. These folks typically will have a small SS check or pension, no savings or property and have not yet applied or are in the process of applying for LTC Medicaid. They need now or will need soon 24 hr care and the family is not able to provide it. Paying for in home care is not an option either. What is the best way to have them get the help they need? What are the resources available? How can we as a society best advise and help? Also, different states have different Medicaid rules, what are experiences people have had in different states? Does anyone have any experiences, positive or negative, that would be useful to share? Any other ideas along these lines would be helpful as well, hopefully we can get a better understanding and help some of these people who have had problems getting proper help for their love ones.
Due to the Medicaid look-back laws..
before you do anything apply for community-based medical assistance if your loved one has an income of less than $23,000 ..
If your loved one has transferred any assets , property, graduation gift, wedding gifts, etc , monetarily within the last 5 years, ur loved one will b penalized .
He/she will enter into a five-year look-back period..
what this means is medical assistance will take any asset your loved one has and use that to pay for their care until medical assistance kicks in after look back period is over.
If your loved one has a house in their name that has to be sold , and that money given to the nursing home.
if your loved one transferred the property in your name within the last 5 years their will be a hefty penalty.
Medicaid comes up with an equation to determine how many months of self paying for nursing home care will be the family's responsibility.
Most most nursing homes are $350 per day .
Medicaid only pays $7000 per resident in a nursing home ...
so , of course they are hoping to find a glitch within the look back period.
If you're not on top of your game like I have been this last 11 months you will lose everything
Your loved one worked/saved for.
Nursing homes love nothing better than billing you for $10,000 a month or $11,000 a month depending on how many days are in that month ..
More money is gotten from self paying families then by medical assistance ..
You can bet that they hope to find somewhere , that your loved one has given away a potential asset ,that cud have paid for their nursing home care.
This is this is just the tip of the iceberg of what I've discovered I saved our family and my mother's home by applying for community-based medical assistance .
I cannot stress that enough !!!
do not wait until your loved one is in the facility...
if you can
https://www.dementiacarecentral.com/medicaid/alzheimers/amp/
"In almost every state, Medicaid will pay for some care in assisted living / memory care residences. However, an important distinction must be made. Medicaid, by law, is prohibited from paying for the cost of room and board or “rent” for its beneficiaries who reside in assisted living residences. Rather, Medicaid can pay for their cost of care in those residences. In very ballpark terms, half of the monthly cost of memory care goes toward “rent” and the other half towards the care the residents receive."
~Half the cost isn't going to help some. While this may be helpful to some, it isn't always going to be enough!** Our mother has a very nice federal pension (thanks dad!), which even includes yearly increases. She also gets SS (which has been reduced recently because they consider the trust money fed into her account as "income", but except for some OTC items (meds as well as briefs and a sunday paper mostly) ALL income goes to the residence. I wouldn't mind if the "income" was being used by her to party, shop and travel, but it isn't - it's all to keep her OFF Medicaid!
Now, if she were like some others, with SS only, there is NO WAY she could stay at this MC place as the "half" she could afford would be less than 15% of the total! Sale of her condo would cover a bit, but once that is gone (or for those who have less net or no home to sell), up the creek!
There is a link within that article for waivers, but in bold highlighted red is this:
! Assisted living waivers do not cover room and board in memory care, they only pay for care costs.
Sounds the same as the original paragraph to me. NO room and board, just the "care" portion of the cost. Am I reading this wrong? Again, my plan is to NEVER have to even think about Medicaid, but at the rate the stock market is going...
** From a recent thread by Tiredmomma:
3) mom's income ($1400) > Medicaid limit
4) mom's income way < MC facility ($4000)
5) mom has no house, no assets of any kind - no spend down or home sale
So, this mom would be short of the "half" by $600/month, if that's what Medicaid did cover, plus OP said she was denied Medicaid as the income was over the limit for that state.
https://www.payingforseniorcare.com/medicaid-waivers/assisted-living
https://www.dementiacarecentral.com/medicaid/alzheimers/amp/
Also on the subject of AL....44 states offer some sort of financial assistance for AL.
In addition a huge problem I read about is the income limits in some states are so ridiculously low that some elders' meager income exceeds the limit, but isn't anywhere near enough to cover any LTC facility.
If the market continues this free fall, we may end up needing Medicaid at some point!! Hoping the paranoia over the coronavirus settles down soon, so we can assume more normal-ty!!! I would rather not have to deal with Medicaid at all.