My mother has recently moved into Assisted Living. She is 90 years old. She recently fell and fractured her back and has been in Skilled Nursing for a month. Doing well overall and going back to Assisted in a few days. Talked to the Social Worker at Skilled today and asked questions about long term care in a nursing home if needed. She told me to apply for Medicaid but when I told her my Mom brings in about $3200 a month she told me that Mom would probably not qualify. This is very discouraging because there is no way she can afford a nursing home and there is no way my wife and I can afford thousands a month. She has no assets whatsoever. Just her monthly income which does cover Assisted Living but leaves her absolutely no extra money. What can we do? She is the widow of a Veteran but someone told me she makes too much to qualify for that as well. Right now she is okay, but if something happens we are in a world of hurt. We do not have room for her in our home, with another dilemma being my wife's Mom is 90 years old as well and starting to become frail. There is no way we would be able to care for both. Any advice? Thank you!
- if your states Medicaid does NOT pay for AL, you do not, again do not want her to even look at moving back into an Al. She needs to become a permanent resident in a NH - aka a skilled nursing facility. Skilled nursing is a required, dedicated program within Medicaid for all states. AL is not and most states do not ever pay for AL on Medicaid or if they do it’s a very narrow program done via a waiver..... read that as long waiting list for a waiver spot.
About the $3200 a mo, there are ways around dealing with this.
- first, If part of her $3200 a mo is coming from VAs Aide& Attendance program, once she becomes ok for LTC Medicaid, the VA A&A $ will stop and then VA only pays her a monthly stipend of $90 (& this $90 is VAs version of a personal needs allowance so not counted in her monthly income total). So look at her “awards letters” to see what her other monthly benefits are paying and if once A&A goes away IF she’s within whatever her state has as the maximum monthly income for Medicaid.
- her awards letters are mucho importante, these she gets like in Nov or Dec that state to the penny what her income will be for the coming year. SSA, federal & state retirement send these out as a trifold type of letter. The kind of letter that has a tear off on 3 sides. Find hers, they are central to her application and eligibility
- find out the exact amount ok for LTC Medicaid in her state for 2018. For most it’s abot $ 2,125.00. But the exact $ is important. Substract the VA A&A, is she under the state limit? If so, she good to go on applying for Medicaid.
BUT if not then you need to see if your state allows for Miller Trust.
most states allow for Miller. But the income source has to be guaranteed. SS, federal & civil service annuity/ retirements are, RRRB is, but some pensions cannot meet the “guaranteed” aspect required for a Miller. What a Miller does is essentially - to me - is Miller acts as a pass through for income payment. Say your state has $2200 a income max for Medicaid; mom gets $1000 SS, then $1200 from late hubs retirement and she also gets a teeny teachers retirement of $300 mo. Mom gets $2500 a mo and it’s that frickin $300 teachers retirement that’s taking her over. So a Miller is created in which all her retirement are titled into the Miller trust. Miller makes the $ and pays her $2200 a mo and Miller retains the extra $300. Now some states just have the extra $ in the Miller get paid to the facility (so it zeros out each mo) and other states have it actually build into a trust account that has the state as the beneficiary so that upon her death whatever $ is there in her Miller then escheats to the state as beneficiary.
Miller not a diy as the $ has to be determined to be guaranteed, then trust paperwork done up for however your state does these but it’s fairly routine stuff. And mom will be eligible for Medicaid.
so review her paperwork and let us know what’s what, ok