Issue: LO was placed in assisted living/memory care in May '24, then placed on hospice July '24. They are paying for memory care from an inheritance, and the money will be gone July '25. A Medicaid application was submitted January '25. We are POA.
There were lots of doctor bills before hospice. We've been paying Dr bills monthly to make the inheritance money last longer and to pay for memory care. Should I completely pay the old dr bills off? Also, LO now has major teeth issues which will require oral surgery. LO has no dental insurance and hospice will not pay.
We took care of LO for 3 years at home, which was very, very difficult. We cannot do that again. We let our own health go and are still trying to catch up. We also need major surgery in spring.
We should hear something from Medicaid by the middle of March, but were told it could take longer. What do I do when money runs out and LO has to leave memory care?
Also, LO says teeth hurt one day, but the next day they don’t. The dentist says there is decay and it could be pressing on a nerve. We do not want LO in pain. Hospice seems to be hands-off when it comes to teeth.
We are in a very difficult situation. I know I wrote a lot. I would appreciate any advice.
Take the dental issues first.
If your LO is in no pain leave well enough alone. Doing major dental work involving anesthesia will probably cause a decline.
It is also difficult to manage oral wounds and I hate to say it but facilities are not great on following up with oral hygiene let alone any open wounds.
You should not be paying bills from your own savings. These are your LO's bills. Pay bills using their funds. If there is money to be spent down before Medicaid kicks in the bills qualify as part of the spend down. (If there is an "inheritance" to be had that has to be spent down before Medicaid qualification.
Memory Care/Hospice - Check with loved one's usual doctor to see if qualifies for skilled nursing facility. Medicaid will pay for snf and there are facilities that will take Medicaid pay clients.
These situations are different in many ways.
I recommend you STOP using your own money to pay for her care although an attorney / accountant could give you needed advice.
Gena / Touch Matters
And I would pay older medical bills now rather than trying to save the money to pay for memory care until the money runs out. Make sure all payments are documented, or have a receipt, or some way of showing where the money went, which Medicaid will want to see.
When the money runs out, then Medicaid can help to pay for the care she needs.
But, if you are neglecting medical bills to pay for current memory care, then who is going to pay those outstanding bills later?
Talk to the care home. Most will accept a patient who has already applied for Medicaid, and consider payment due as "medicaid pending", assuming that they will get the money once the application has been approved. But the money is going to have to be spent down first. So, spend it now. On any medical bills and by all means, pay for a dentist to keep her comfortable!
If oral surgery is not recommended, then, talk to hospice about pain management. That is what hospice does.
That means all bill paying for former services is stopped.
Your loved one's money cannot be touched if it is down to SS only, and as the inheritance is now gone, that's where you are.
Bill collectors cannot touch SS funds.
Stopping payment on bills will result in ruined credit, but your loved one is now receiving end of life care through hospice and doesn't need a good credit score.
Be certain that you do not yourself EVER pay a bill in your own name, with your own checks as you may then be left with the debt and accusing of having "assumed" the debt.
Your loved one, being on hospice now, is on end of life care.
That means no treatment for anything unless there is a good deal of pain involved (say a bedsore, a UTI and etc.) . Pain is treated. It is all about comfort care now. There will be no payment for dental care other than what is covered through hospice for pain/discomfort.
If there is pain involved, discuss with hospice. They may choose to medicate for pain. Dental surgery would be out of the question, and if your loved one is ill enough now to need hospice it's unlikely that LO will want to sit overmuch in a dental chair for dental surgery in any case. As your LO is on end of life care, there is no longer a reason to invest in dental surgery.
All questions now are best referred to Hospice personnel. We, being a Forum of strangers, don't know you or your loved one, nor any history.
By law Hospice has Social Workers and Doctor and weekly RN visit to discuss these issues with. Just ask them. And I am wishing you the best of luck.
To me it makes absolutely NO sense to have a loved one have any kind of surgery when they are under hospice care and are dying.
Just ask the hospice nurse to have the hospice doctor prescribe something for your loved ones pain, and allow your loved one die in peace.
And honestly we were told that the anesthesia could be life threatening anyway. No point in putting them through extra pain for no real gain. "Fixing things" now is not recommended.
Who is the "they" paying for the MC from an inheritance? Does this mean your LO is not the one paying? Do you mean your LO's assets?
Medicaid varies by state but it can pay for medical bills incurred during the application period (3 months). That's how it went for my MIL in MN, that was in 2017. I think this is a question you may be able to answer in a browser search, or actually call Medicaid (as long as you are prepared for a long hold).
The app review usually takes no more than 3 months once they have all the proofs requested.
If your LOs are on hospice, which is paid for by Medicare, why would they need to leave? Are they in the same facility that they were in MC? Or are they in a dedicated hospice facility?
If your LO is on hospice, then request pain management/comfort care and not a dental procedure.
Do one or both of your LOs have dementia? Your post is a little confusing, please provide more information.
Because I think you are confused about what's going on, I suggest you spend a little to consult with a certified elder law attorney or a Medicaid Planner for your LO's state of residence, or hire a Geriatric Care Manager.