With Medicaid pending, what happens if my father moves back into assisted living that he can afford?

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T

theplanner Asked February 2016

With Medicaid pending, what happens if my father moves back into assisted living that he can afford?

With medicaid pending for long term care costs (4 months). Last October my father was moved into long term care which is outside his budget. He is medicaid pending but is now able to move into a new assisted living facility that he can afford. If approved, will medicaid cover the period of time in long term care and support his move back to assisted living? or will they require him to pay for all of the time in long term care and completely deplete his assets? He is married (wife lives in assisted living as well).

Medicaid

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score 0 · Answer 1

If he was financially and otherwise eligible while in a long-term care facility Medicaid should cover the cost of care even if he leaves the facility and is subsequently not eligible. Some states provide a Medicaid benefit for assisted living for which he may still qualify for.

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score 2 · Answer 2

Medicaid expects him to pay out of pocket until he is down to $2K or less. So if he has assets right now, he has to use them to pay bills at the NH and at AL.

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score 2 · Answer 3

You should have a case worker assigned to your father's Medicaid application who would be able to answer your question better since the regulations regarding eligibility varies from state to state. The answer from Pamstegma may be correct but the limits on assets varies from state to state and there is consideration given to the "medical expenses" associated with assisted living that may play into the formula. Do not be afraid to ask a social worker at the nursing home this question as well. I'm sure the facility has dealt with this same issue countless times in the past. They will want to work with you to ensure they get paid, but as long as you have been up front with them regarding the finances and have done what you can to complete the arduous Medicaid process, they will be your ally.

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score 0 · Answer 4

How is it that he is "medicaid pending' but "able to afford" an AL? It does come down to real numbers and real assets to make sense of it. Generalities are hard to work with.

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