How difficult was it to get your parent or loved one on Medicaid?

I also found out the nursing home has Medicaid specialists and could have done all the things my lawyers did for 8,000 but didn't know until after got her in long-term care in this home with the lawyers help, and began working with them on other things my lawyer dropped off on (because they had their $8,000) that still needed taken care of .

I paid a lawyer $8000 to file the Medicaid application and do everything else under the sun required, it was a lifesaver for the big items like getting her on Medicaid, in the NH I wanted, and allowing me to keep the house. They told me exactly what assets I had to get rid of like the car, how to protect her remaining assets by putting in a trust, etc. And paperwork needed from the doctor to let me keep the house. Medicaid bought it all but it was certainly Justified. I had moved back home and lived and and taken care of her and my disabled mrdd sister for over 14 years . My mom fell twice and second time had dementia which required NH even though I told her I'd never let that happen but the fall risk was too great. And then my sister developed issues which required her to be in a nursing home and I had a similar battle but much more difficult with MRDD . Anyhow back to my mother , when I asked the NH administrator if he had long-term beds prior to the lawyer involvement he said no. Once the lawyer was involved (I suspect he knew the lawyer could get her on Medicaid pending but assumed that I didn't know how) and when asked again by her said yes. So that was a miracle, along with saving the house.

What state are you in? Ohio has a service called Passport that helps connect you with senior services including a social worker who can give advice. I worked through the process for my dad last year. I was advised to go to the county Medicaid office ( Family Jobs and Services here) to get set up with an agent.
Be patient, this can be a long process including several hours waiting for a slot to talk to someone.
We checked into getting an elder care lawyer but the cost was ridiculous since my parents had so little money to begin with your it seemed pointless to spend +$2500 to get my Dad into a program for indigent people!
In terms of money Dad was allowed to have $2000 of his own money. Mom could retain their home as her residence, we had the title transferred to her, and $24,000 in assets. There are a lot of ways you can legally spend down the money that will be to their advantage such as clothing, medical devices, medications, etc. Even a car if it is for their use.
I was put in touch with Catholic Family Services who were a great resource for advice. You don’t have to be Chatholic.
Just remember, if a person has assets they will be expected to spend them for their care. Once that money has been spent Medicare kicks in.
Good luck. My dad died a few weeks before he qualified so I don’t have any insight into what happens then.

Please get Help ASAP... the process is not easy to work thru,,,the social worker can only do so much and will not advise on financial matters... We wasted precious time and lost quite a bit of savings due to letting the nursing home "help" w/ application... Good intentions on their part or maybe not because they benefited from the first two Medicaid denials and we had to pay,,, almost bankrupting my mother in law. We paid for a Medicaid financial consultant which was great and less than a lawyer. Best Wishes

I’m in the same position and just retained an elder care lawyer . It’s expensive but after the initial meeting I’m convinced it’s a good decision for my situation . We are by no means rich but have too much for Medicaid and my step dad will not be able to be taken card of at home. I’m hoping to be able to have something available left over to care for my mom later and this is gonna do it . I’m also burnt out over the whole situation . I have been dealing with the parents for awhile and am done . This is far from over but I actually have some time rt now that IM not the only one digging and trying to decipher Medicaid lingo . Good luck and God bless ya

Contact an elder attorney, very helpful with ideas for "spend down" options... It is very difficult to maneuver yourself, you need to keep track of EVERYTHING..... It is a LOT of work, but you will get through it. We started out as private pay, and we are paying down assets now. Get as many things as you can to make things comfortable for your mom. Bedding, clothes , games / puzzles, decorations for the room... Best of luck.

Grem, should dad need some of your NH mom’s monthly income in order for him to live as a CS in his home, dad should try to get CSRA or MMNA. Community spouse resource allowance / Monthly maintenance needs allowance (assessment). Think of these as kinda like old school alimony for dad.

what they do is waive some of her income to go to dad instead of almost all of it being paid to the NH as her copay. It seems some states factor this in automatically but others do not and he has to apply for it.

Most states have the CS asset limit at 119k. Depending on his age and likelyhood of out living her for years or decades that 119k plus his own monthly income may or may not be enough. If they still have a mortgage (horrors!) and he has his own serious prescription drug costs, he needs to file for a waiver. To me, he should at least attempt to get CSRA or MMNA. Somethings gonna happen to him or the house and that extra $ will come in handy.

The amounts allowed vary by state. There was a poster from CT on AC whose mom got CSRA and the NH dad actually only had a copay to the NH of $45.00 plus his needs allowance; her mom got all the rest of his monthly income as she had high housing & health care costs.

As an aside on this, TX has a high MMNA of up to about $2800 which I find interesting as TX is like 48th or 49th in medicaids daily room & board reimbursement paid to NH.... it’s yet another incentive not to have Medicaid beds.

There are ways to deal with too much income and too many assets. You really need to consult an Estate planning attorney in your state who can advise you. Excess income and assets can be spent down. It's important to do this properly so some expert guidance is recommended.
I didn't think it was particularly difficult to get our LO approved for Medicaid once the assets and income had been dealt with. But it didn't happen quickly.
The lawyer wanted $7000 to file the Medicaid application. However, we hired a social worker to do that for us after the financial aspects had all been arranged. The SW doesn't give financial advice or do anything with the income or the assets. But once that was all done, we paid her by the hour to get the forms processed for us.

If they have savings and assets it should be used to pay for care. When assets have run out then they can apply for Medicaid. Money cannot gifted or saved for inheritances.

This was not for my parent, but, a family member that I care for. I might consult with an attorney first. Because, the rules are so complicated, I'd get info and advice from a professional.

Each state is different, but, after I consulted with an Elder Law attorney who focused on Medicaid issues, I got my LO to her doctor, with the Healthcare POA and filed Durable POA) to get her diagnosed and treatment recommended. I then took income information, bank statements, etc to the social services/Medicaid office and met with case worker, answered questions, signed as POA, and was basically approved on the spot, but, told that I needed two things: For the doctor to complete and sign a state form that describes the applicant's condition and need for care AND a TB test for the AL facility. IT was pretty quick, though, I don't think all states are required to get it done that fast.

It's my understanding that if a place accepts Medicaid, they are bound to the terms of what Medicaid pays. So, the facility may have some private pay residents, right along side Medicaid residents. There is no way to know which is which, based on what I have seen in various facilities. Of course, some facilities do not accept Medicaid and all are private pay. That doesn't always mean the best care though.

I'm not sure what the options are if their monthly income is too high.

Your mother should be okay. It shouldn't be difficult if she meets the right requirements for the situation. I hope you find a solution quickly.

Gremlin - so you still have both parents, right?
But only mom needs care in a facility, Right?

So what the likely near future situation for your dad??? .... like he’s fine and could live on his own as a “community spouse” for a few years OR is he kinda on the heels of needing a facility himself? To me this is pretty central to deciding what to do. A CS that could live another 5,10 yrs on their own is a very different planning scenario for Medicaid than for one that likely could go into a NH at the same time or a few months after your mom.

You wrote your folks have enough $ to disqualify them, are you referring to too much in non exempt assets (if dad remains a CS, it’s abt 119k but for couples both going into NH it’s 3k for most states)?
OR
is it that for each of them their monthly income (like their SS$ or a retirement / pension or annuity that’s paying them monthly) is over the Medicaid income limit for their state (abt $2100)?
Assets and Income are different creatures in how Medicaid evaluates. You have to know what goes into which category and IF you as dpoa could shift $ from 1 to another to better benefit dad if he’s to be a CS. But this stuff is imo not a DIY. Personally, couples medicaid is not simple and really benefits from having an experienced atty (like NAELA or CELA level) give you folks options.

But to me, it really is helpful when you into meeting with the atty with your folks to already have some idea where they stand in the eligibility maze and what ?s or concerns to ask about. And that Grem, is what this forum is really good at. So tells us a bit more about the folks and you’ll get suggestions.

My mother required nursing home care for four years. She was initially a combination of private pay and using her long term care insurance. The we had to use Medicaid. There was a bit of spending down her assets to make her eligible but it wasn’t much and didn’t take long. The social worker and business manager at the nursing home helped us through the process, they were very familiar with it. Mom was in a nice nursing home, her care was no different when private pay or Medicaid, it’s a misconception that all places that take Medicaid are dumps. The nice places take it also, it may be a specified number of beds, but Medicaid is there, and the workers don’t often know who’s paying which way, for them the work and the patients are the same. Your mother can go to a nursing home now if that’s what’s needed, using her money, when it runs out Medicaid will step in and pay. Talk to the business office of the place you’re interested in and see about getting their help

Apply and if she is denied, see the reason. Then consult an elder law attorney too see if there is a solution. Many states are reducing Medicaid budgets due to lack of tax money the program. Medicaid was established for the very poor not for those who have who have real estate and cash assets. But an attorney may be able to assist.